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PubMedDate not supplied

A survey of knowledge and attitudes with regard to AIDS among grade 7 and 8 students in Ottawa-Carleton.

With parental consent, we surveyed 942 students in grade 7 and 8 at the Ottawa Board of Education before the introduction of compulsory AIDS education. Television was seen as the most common and credible source of information about AIDS. Parents (by girls) and school nurse (by boys) were also seen as credible sources of information about AIDS. Boys seemed to know more about the transmission of AIDS than girls did. There was high awareness of condoms as an effective method of preventing the spread of AIDS. Avoidance of sexual intercourse as an effective preventive measure was less well known. AIDS education in school should emphasize abstinence as well as barrier methods as effective methods in preventing AIDS, and utilize the media, parents and family in educating students about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[The history of family planning among women who opt for surgical sterilization in the Social Security Fund of Panama].

In this study, the previous history of family planning and prior usage of contraceptive methods are analyzed, in a sample of 175 women who voluntarily opted for surgical sterilization as a permanent method of fertility regulation, in the Panamanian Social Security System. A questionnaire was applied during the second trimester of pregnancy, by which information would be gathered in regard to knowledge, usage and adverse effects of the contraceptive methods used prior to the intervention. Results showed that 99% of the sample had heard, on some occasion about oral contraceptives (OC) and, in lesser proportion to intrauterine devices (IUD), barrier methods and hormonal inyectables. The first contraceptive method used, and the one of longest usage, was the combined OC, of which 43% begun between 17 and 25 years of age. In contrast, 7.4% initiated contraception with IUD, from the age of 26 years. The health personnel constituted the major source of recommendation for contraceptive usage and, despite the fact that 37% of the sample did not use contraception prior to the last pregnancy, over half of the subjects responded that combined OC were considered as the most secure method.

Adult↗
PubMed1984

Microbiological and histological findings in the fallopian tubes of women using various contraceptive methods.

The oviducts of seventy-three women undergoing sterilization by partial salpingectomy were submitted for microbiological and histologic studies. Twenty women were intrauterine device users, twenty-five women were oral contraceptive pill users and twenty-eight women used natural or barrier methods of contraception. Among intrauterine device users, there was an excess of mild and severe acute inflammatory histologic changes involving both the lumen and the tubal mucosa. Five of the eight intrauterine device users with acute inflammatory change had sterile tubal cultures.

Bacteriological Techniques↗
PubMed1995

Contraception. A clinical review for the internist.

Effective use of contraception allows couples to control their fertility and, in certain instances, is associated with important noncontraceptive benefits. Surgical sterilization offers safe, effective, and permanent contraception for women and men. Low-dose OCPs offer safe, effective contraception for most women able and willing to take pills consistently. In addition, their use confers a variety of important noncontraceptive benefits. The availability of long-acting progestin injectable and implantable methods has made highly effective and convenient birth control available for women who are not good pill takers as well as for those for whom contraceptive doses of estrogen are contraindicated. Barrier methods are readily available and provide protection against STDs; unfortunately, erratic use is all too often associated with inadequate contraceptive efficacy. IUDs offer convenient, highly effective contraception for appropriate candidates.

Contraception↗
PubMed2004

Guided tissue regeneration with bioabsorbable barriers. II. Long-term results in infrabony defects.

BACKGROUND: The aim of this 5-year randomized controlled clinical trial was to evaluate the long-term results after guided tissue regeneration (GTR) therapy of infrabony defects using two bioabsorbable barriers. METHODS: Fifteen pairs of contralateral infrabony defects in 15 patients with moderate to severe periodontitis were treated. Each patient received one polydioxanon (test: T) and one polylactide acetyltributyl citrate (control: C) barrier by random assignment. At baseline, 12, and 60 +/- 3 months after surgery clinical parameters and standardized radiographs were obtained. Vertical bone levels (PBL-V) were measured during surgery and 60 +/- 3 months later by transgingival bone sounding. RESULTS: Thirteen patients were available for the 60-month examinations. Twelve and 60 +/- 3 months after GTR, statistically significant (P< or =0.001) vertical attachment (CAL-V) gain was found in both groups (T12: 3.5 +/- 1.5 mm; T60: 2.2 +/- 1.8 mm; C12: 4.0 +/- 0.9 mm; C60: 2.4 +/- 1.0 mm). However, from 12 to 60 months after therapy both groups experienced significant CAL-V loss (P<0.05): two defects in the test group and three in the control group had CAL-V loss >2 mm compared to the 12-month reexamination. Twelve and 60 +/- 3 months after surgery, statistically significant (P<0.05) radiographic bony fill was found in both groups (T12: 1.2 +/- 1.3 mm; T60: 1.5 +/- 2.2 mm; C12: 0.9 +/- 1.4 mm; C60: 1.0 +/- 1.6 mm). Further, 60 months after surgery significant (P<0.05) PBL-V gain was found in both groups (test: 1.8 +/- 2.3 mm; control: 2.2 +/- 1.8 mm). The study failed to show statistically significant differences between test and control regarding CAL-V and PBL-V gain 60 months after surgery. CONCLUSION: CAL-V gain achieved after GTR therapy in infrabony defects using both bioabsorbable barriers was stable after 5 years in 21 of 26 defects (81%).

Adult↗
PubMed1998

The protective effect of condoms and nonoxynol-9 against HIV infection.

OBJECTIVES: Whether or not spermicides can reduce the risk of human immunodeficiency virus (HIV) transmission remains an important question for the control of heterosexual HIV transmission. The authors provide estimates from a reanalysis of one of the few observational studies on the efficacy of condoms and spermicides, used separately and together, per vaginal contact. METHODS: In this reanalysis, three different models were used to assess the efficacy of spermicides and condoms: linear (Pearl index), exponential (maximum likelihood), and monotonic (marginal likelihood). RESULTS: Reported use of barrier methods among 27,432 contacts was as follows: condoms plus nonoxynol-9, 39%; condoms alone, 25%; nonoxynol-9 alone, 24%; and unprotected, 11%. Under all three models, the results indicate a strong protective effect for spermicidal suppositories. The Pearl index indicated that spermicide alone is apparently efficacious, but the efficacy per contact cannot be quantified with this approach. Maximum likelihood estimates for the efficacy of nonoxynol-9 alone and condoms (with or without nonoxynol-9) were 100% (95% confidence interval [CI95] = 43%, 100%) and 92% (95% CI95 = 79%, 100%), respectively. CONCLUSIONS: The data from this observational study suggest that spermicides may be efficacious in reducing the risk of HIV transmission.

Administration, Intravaginal↗
PubMed1999

Oral contraception: current use and attitudes.

Oral contraception (OC) has been available for almost four decades. During this time, changes in contraceptive use in general and OC in particular have occurred. Knowledge and attitudes about OC may not always reflect trends in use. Contraceptive use data from 1965-1995 show that OC continue to be the method chosen consistently by more than one-quarter of women contraceptors. Probably even more women would use the pill if they had more accurate information regarding the higher failure rates with barrier methods (especially the condom), if misperceptions about OC safety were put to rest, and if greater awareness of the noncontraceptive health benefits of OC could be achieved. Increased education and awareness of women as well as their healthcare providers has the potential to positively affect future contraceptive use.

Breast Neoplasms↗
PubMed2001

Perceptions of threat, benefits, and barriers in breast self-examination amongst young asymptomatic women.

AIM: Young age at diagnosis of breast cancer is a negative prognostic factor, but early detection of breast pathology may improve prognosis. The present study examined the role of health perceptions (Health Belief Model; HBM) in young women's breast self-examination (BSE). It was hypothesized that cues to action, health motivation, and perceptions of threat (vulnerability, severity), benefits, and barriers, will predict BSE, but that threat perceptions will be more powerful predictors than benefits and barriers. METHOD: Questionnaire data from 178 asymptomatic women (aged 18-35 years) living in the northwestern region of England were analysed. RESULTS: Using hierarchical logistic regression controlling for demographic factors, only severity and barriers emerged as important predictors; lower perceived seriousness of breast cancer and fewer perceived obstacles to practising BSE predicted performance of BSE. For every unit increment on the severity and barrier scales, the odds of a respondent performing BSE decreased by approximately 8 and 20%, respectively. CONCLUSIONS: The results provide qualified support for the HBM. Perceived barriers was the most powerful predictor, although respondents assessed breast-cancer severity based on early detection through BSE. Implications for clinical interventions are considered.

Journal Article↗
PubMed2001

Long-term results of guided tissue regeneration therapy with non-resorbable and bioabsorbable barriers. I. Class II furcations.

BACKGROUND: The aim of this 5-year follow-up study was to clinically and radiographically evaluate the long-term results after guided tissue regeneration (GTR) therapy of Class II furcation defects using non-resorbable and bioabsorbable barriers. METHODS: Nine pairs of contralateral Class II furcation defects were treated in 9 patients with advanced periodontitis. Within each patient, one defect received a non-resorbable (expanded polytetrafluoroethylene [ePTFE]; control, C) barrier and the other a bioabsorbable (polyglactin 910; test, T) barrier by random assignment. At baseline, 6, and 60 +/- 3 months after surgery, clinical parameters and standardized radiographs were obtained. Gain of bone density within furcation areas was assessed using subtraction radiography. RESULTS: Six and 60 months after GTR therapy, statistically significant (P <0.05) horizontal attachment (CAL-H) gain was observed in both groups (C6: 1.7 +/- 0.8 mm; C60: 1.6 +/- 1.2 mm; T6: 2.0 +/- 0.7 mm; T60: 2.2 +/- 0.9 mm). However, 1 furcation assessed as Class I six months after GTR therapy with a bioabsorbable barrier had progressed to Class III after 5 years, and in another patient, 5 years after placement of an ePTFE barrier, 1 furcation had lost all the CAL-H gain that had been observed at 6 months. Subtraction analysis revealed similar area gain in both groups 6 and 60 months postsurgically (C6: 0.3 +/- 0.5; C60 1.0 +/- 1.7; T6: 0.4 +/- 0.4; T60: 1.1 +/- 1.7). CONCLUSIONS: CAL-H gain achieved after GTR therapy in Class II furcations was stable after 5 years in 16 of 18 defects. The study failed to show a statistically significant difference in stability of CAL-H gain between control and test groups 5 years after GTR therapy.

Absorbable Implants↗
PubMedDate not supplied

The next contraceptive revolution.

The availability of modern birth control methods has wrought a veritable contraceptive revolution in both developed and developing countries over the past two decades. But concerns about safety, costly lawsuits involving current methods, as well as diverse and changing life-styles, have left the current array of contraceptives grossly inadequate to meet growing world-wide needs. Steroid implants and improved injectables, IUDs, barrier methods and sterilization devices should be widely available in the next few years. But the long-sought-after radically new methods that will constitute the next contraceptive revolution--like vaccines, a male contraceptive and a once-a-month pill--will not be developed in the foreseeable future without a massive infusion of new funds. The eight contraceptive research and development (R&D) programs that are responsible for more than half of all current product development efforts now spend about $30 million a year on contraceptive research. With an additional $23 million annually, they could considerably accelerate current research efforts and begin new ones on products that have become possible only as the result of recent scientific discoveries. Even this level of investment--representing a 75 percent increase over current expenditures by the eight groups--would probably not be sufficient to make optimum progress in the development of radically new methods. Since the pharmaceutical industry can no longer be depended upon to take the leading role that it did 20 years ago, current public-sector R&D organizations may need to expand their efforts to include most aspects of the process of contraceptive development and introduction, and new dedicated R&D centers will probably have to be established.(ABSTRACT TRUNCATED AT 250 WORDS)

Contraception↗
PubMed2002

Medical grade calcium sulfate hemihydrate versus expanded polytetrafluoroethylene in the treatment of mandibular class II furcations.

BACKGROUND: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non-absorbable barrier. METHODS: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freeze-dried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re-entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. RESULTS: The MGCSH-treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 +/- 0.82 mm, P<0.05) and baseline and 12 months (1.31 +/- 0.85 mm, P<0.05). There was no statistically significant change in probing depth in the ePTFE group at any time interval. The horizontal defect fill was significantly greater for ePTFE (36.7%) versus MGCSH (23.8%) (P<0.02). CONCLUSIONS: In selected defects, improved clinical measurements were achieved with DFDBA/MGCSH as well as DFDBA/ePTFE. Both treatments obtained significant horizontal defect fill at 6 months. DFDBA/ePTFE showed a significantly greater horizontal defect fill compared to DFDBA/MGCSH. Attachment level gains achieved with MGCSH held for 12 months, whereas ePTFE attachment level gains did not.

Absorbable Implants↗
PubMed1994

Effect of blood-brain barrier disruption on intact and fragmented monoclonal antibody localization in intracerebral lung carcinoma xenografts.

UNLABELLED: These studies highlight several factors that affect monoclonal antibody (Mab) localization to a tumor in the brain, including tumor permeability, nonspecific and specific binding, plasma half-life, radiolabeled antibody stability and the blood-brain barrier. METHODS: A pancarcinoma Mab [L6 IgG, F(ab')2 and Fab] and an irrelevant isotype-matched antibody [P1.17 IgG and F(ab')2] were given with and without osmotic blood-brain barrier disruption in a LX-1 human small-cell lung carcinoma intracerebral xenograft model. RESULTS: Intracerebral tumor size and permeability to antibody increased with the selection of 10, 14 or 17 days postinoculation when antibody was administered. Barrier disruption increased the delivery, particularly at earlier time points, which was dependent on antibody-specific and nonspecific binding and tumor permeability. Dehalogenation and/or antibody binding stability also appeared to affect the percent delivery. CONCLUSION: These studies demonstrate important variables that should be considered when clinical trials are designed or Mab delivery and localization in intracerebral tumor models are evaluated.

Animals↗
PubMed2005

Perceived barriers for treatment of chronic heart failure in general practice; are they affecting performance?

BACKGROUND: The aim of this study is to determine to what extent barriers perceived by general practitioners (GPs) for prescribing angiotensin-converting enzyme inhibitors (ACE-I) in chronic heart failure (CHF) patients are related to underuse and underdosing of these drugs in actual practice. METHODS: Barriers were assessed with a semi-structured questionnaire. Prescribing data were extracted from GPs' computerised medical records for a random sample of their CHF patients. Relations between barriers and prescribing behaviour were assessed by means of Spearman rank correlation and multivariate regression modelling. RESULTS: GPs prescribed ACE-I to 45% of their patients and had previously initiated such treatment in an additional 3.5%, in an average standardised dose of 13.5 mg. They perceived a median of four barriers in prescribing ACE-I or optimising ACE-I dose. Many GPs found it difficult to change treatment initiated by a cardiologist. Furthermore, initiating ACE-I in patients already using a diuretic or stable on their current medication was perceived as barrier. Titrating the ACE-I dose was seen as difficult by more than half of the GPs. No significant relationships could be found between the barriers perceived and actual ACE-I prescribing. Regarding ACE-I dosing, the few GPs who did not agree that the ACE-I should be as high as possible prescribed higher ACE-I doses. CONCLUSION: Variation between GPs in prescribing ACE-I for CHF cannot be explained by differences in the barriers they perceive. Tailor-made interventions targeting only those doctors that perceive a specific barrier will therefore not be an efficient approach to improve quality of care.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1999

Contraceptive use by female physicians in the United States.

OBJECTIVE: Little is known about female physicians' personal contraceptive use, and such usage could influence their prescribing patterns. METHODS: We used data from the Women Physicians' Health Study, a large (n = 4501) national study, administered in 1993-1994, on characteristics of female physicians in the United States. RESULTS: These female physicians (ages 30-44 years) were more likely to use contraception than women in the general population (ages 15-44 years); this was true even when the physicians were compared with only other women of high socioeconomic status and when stratified by ethnicity, age, and number of children. Physicians were also more likely to use intrauterine devices, diaphragms, or condoms, and less likely to use female or male sterilization than were other women. Younger female physicians were especially unlikely to use permanent methods, particularly when compared with their age-matched counterparts in the general population. One fifth of contracepting physicians used more than one type of contraceptive; the most frequently used combination was spermicide with a barrier method. CONCLUSION: Female physicians contracept differently than do women in the general population, in ways consistent with delaying and reducing total fertility. Physicians' personal characteristics have been shown to influence their patient counseling practices, including their contraception-related attitudes and practices. Although female physicians' clinical advice might differ from their personal practices, as women physicians become more prevalent, their contraceptive choices could influence those of their patients.

Adult↗
PubMed2007

Stability of clinical and radiographic results after guided tissue regeneration in infrabony defects.

BACKGROUND: The aim of this 5-year follow-up study was to evaluate clinically and radiographically the long-term results after guided tissue regeneration (GTR) therapy of infrabony defects using non-resorbable and bioabsorbable barriers. METHODS: Thirty-one patients with periodontitis and 50 infrabony defects that had been treated using GTR were recruited. Eleven defects were treated with non-resorbable expanded polytetrafluoroethylene membranes and 39 defects with bioabsorbable barriers. At baseline and 6 and 60 +/- 3 months after surgery, clinical parameters and standardized radiographs were obtained. During surgery and 60 +/- 3 months thereafter, the distance from the cemento-enamel junction to the base of the bony defect (vertical probing bone level [PBL-V]) was measured. Bone gain was evaluated using digital subtraction radiography. RESULTS: At 6 and 60 +/- 3 months after GTR, there was a statistically significant (P <0.001) reduction of probing depth (6 months: 4.31 +/- 1.76 mm; 60 months: 3.95 +/- 1.62 mm) and vertical clinical attachment level gains (CAL-V) (6 months: 3.34 +/- 1.66 mm; 60 months: 2.97 +/- 1.53 mm). From 6 to 60 months after GTR, three infrabony defects exhibited CAL-V loss >2 mm, and a small, statistically not significant mean CAL-V loss of 0.39 +/- 1.60 mm was observed. From baseline to 60 +/- 3 months, a significant PBL-V gain of 1.78 +/- 2.67 mm (P <0.001) and increase in bone density were observed (P = 0.003). CONCLUSION: The CAL-V gain achieved after GTR in infrabony defects using both non-resorbable and bioabsorbable barriers was stable after 5 years in 47 of 50 defects.

Absorbable Implants↗
PubMed2003

The influence of Enteral Nutrition in postoperative patients with poor liver function.

AIM: To investigate the safety, rationality and the practicality of enteral nutritional (EN) support in the postoperative patients with damaged liver function and the protective effect of EN on the gut barrier. METHODS: 135 patients with liver function of Child B or C grade were randomly allocated to enteral nutrition group (EN, 65 cases), total parenteral nutrition group (TPN, 40 cases) and control group (CON, 30 cases). Nutritional parameters, hepatic and kidney function indexes were measured at the day before operation, 5th and 10th day after the operation respectively. Comparison was made to evaluate the efficacy of different nutritional support. Urinary concentrations of lactulose(L) and mannitol(M) were measured by pulsed electrochemical detection(HPLC-PED) and the L/M ratio calculated to evaluate their effectiveness on protection of gut barrier. RESULTS: No significant damages in hepatic and kidney function were observed in both EN and TPN groups between pre- and postoperatively. EN group was the earliest one reaching the positive nitrogen balance after operation and with the lowest loss of body weight and there was no change in L/M ratio after the operation (0.026+/-0.004) at the day 1 before operation, 0.030+/-0.004 at the day 5 postoperative and 0.027+/-0.005 at the day 10 postoperative), but the change in TPN group was significant at the day 5 postoperative (0.027+/-0.003 vs 0.038+/-0.009,P<0.01). CONCLUSION: EN is a rational and effective method in patients with hepatic dysfunction after operation and has significant protection effect on the gut barrier.

Adult↗
PubMed1999

Barriers to pediatric injury prevention counseling.

OBJECTIVES: Physicians cite numerous barriers to incorporating injury prevention counseling into routine care. Health behavior models suggest that beliefs about barriers are associated with physician characteristics. This study explores associations between physician characteristics and physician perceptions of barriers. METHODS: Self administered structured questionnaires were sent to all five North Carolina (United States) pediatric residency programs. A total of 160 (72%) physicians training in pediatrics or medicine-pediatrics in these programs replied. Associations between perceived barriers and knowledge, gender, training, experience, and correlation between perceived barriers and other physician beliefs about injury prevention counseling, were measured. RESULTS: Although most residents believed that talking to parents about injury prevention during routine visits was important, they felt they lacked time, did not think to ask parents about injury prevention, or had more important things to do. The more importance residents placed on asking parents about hazards, the less the extent to which barriers were perceived (r = 0.32). Barriers were perceived to a greater extent by residents who thought their preceptors did not expect them to counsel about injury prevention (r = 0.28), lacked confidence that their counseling helped parents (r = 0.32), or felt uncomfortable counseling parents about injury prevention (r = 0.18). Knowledge, residency year, training, and previous experience with injury were not related to perceived barriers. CONCLUSIONS: Residency programs should teach the importance of injury prevention; provide opportunities for residents to become comfortable talking with parents about this; and train residents in the appropriate use of counseling as one strategy for addressing injury prevention.

Adult↗
PubMed1996

[Utilization of contraceptive methods during the lactation period].

OBJECTIVES: To find the use of family planning methods during breast-feeding and establish whether there is a relationship with social-demographic questions or the breast-feeding. Secondly, to evaluate nursing mothers' understanding of these methods. DESIGN: An observational, crossover study using a self-administered questionnaire. SETTING: Primary care. PARTICIPANTS: 398 women in their 7th month of breast-feeding were chosen by simple random sampling from the register of births. Reply rate: 85.2%. MEASUREMENTS: The use of contraceptive methods (CM), type of breast-feeding, social-demographic characteristics, information received and women understanding of family planning (additive Likert-type scale). RESULTS: 78% of the women interviewed said they used some CM after delivery: barrier methods were the most common (63.7%). Use was significantly greater in women with a lower level of information or who had previously used CM. CONCLUSIONS: Women with a lower level of information or who had used family planning methods previously said they used them more during breast-feeding. There is insufficient information about contraceptive methods during this period, especially among less educated women. Understanding of CM increases when breast-feeding lasts longer. Activities performed by health staff are not connected to women better understanding of contraception.

Adolescent↗