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PubMed1992

Changing patterns in reported sexual practices in the population: multiple partners and condom use.

OBJECTIVE: To determine whether the pattern of change with regard to condom use and multiple sexual partners is influenced by gender or educational level. DESIGN: Findings from data collected from 1987 to 1990 about changes in condom use and multiple-partner activities are presented, based on telephone interviews with 9416 participants aged 18 to 44 years resident in central Scotland, UK. METHODS: Change in patterns over time were modelled in a multivariate logistic regression using a linear interactive modelling program. RESULTS: Several models showing changes in the proportion of multiple-partner respondents and condom users yielded a complicated pattern of behavioural change in educational status and gender. CONCLUSIONS: There is a large difference in reported condom use and multiple sexual partners by gender, but the difference is decreasing over time. Better educated respondents increased their use of condoms while less educated respondents showed a decrease in the proportion of multiple partners.

Adolescent↗
PubMed2006

Symptom reporting in childhood asthma: a comparison of assessment methods.

BACKGROUND: One barrier to receiving adequate asthma care is inaccurate estimations of symptom severity. AIMS: To interview parents of children with asthma in order to: (1) describe the range of reported illness severity using three unstructured methods of assessment; (2) determine which assessment method is least likely to result in a "critical error" that could adversely influence the child's care; and (3) determine whether the likelihood of making a "critical error" varies by sociodemographic characteristics. METHODS: A total of 228 parents of children with asthma participated. Clinical status was evaluated using structured questions reflecting National Asthma Education and Prevention Panel (NAEPP) criteria. Unstructured assessments of severity were determined using a visual analogue scale (VAS), a categorical assessment of severity, and a Likert scale assessment of asthma control. A "critical error" was defined as a parent report of symptoms in the lower 50th centile for each method of assessment for children with moderate-severe persistent symptoms by NAEPP criteria. RESULTS: Children with higher severity according to NAEPP criteria were rated on each unstructured assessment as more symptomatic compared to those with less severe symptoms. However, among the children with moderate-severe persistent symptoms, many parents made a critical error and rated children in the lower 50th centile using the VAS (41%), the categorical assessment (45%), and the control assessment (67%). The likelihood of parents making a critical error did not vary by sociodemographic characteristics. CONCLUSIONS: All of the unstructured assessment methods tested yielded underestimations of severity that could adversely influence treatment decisions. Specific symptom questions are needed for accurate severity assessments.

Asthma↗
PubMed1999

AIDS-related perceptions and condom use of prostitutes in Korea.

The purpose of this study was to assess the impact of AIDS-related knowledge and attitudes of prostitutes on condom use from diverse 'sex markers' in Korea. The data were collected by interviewers at five different 'sex markets'. During March 1993, research assistants at the Institute of Health Services Research interviewed 371 prostitutes visiting sexually transmitted disease (STD) clinics. Multiple regression method was used in identifying the determinants of condom use. The level of condom use was regressed on personal characteristics of prostitutes, AIDS-related perceptions, and market type. Prostitutes' level of condom use turned out to be different across the markets featuring diverse types of services and fees. Neither perceived vulnerability nor perceived seriousness of AIDS had significant effects on condom use. Our findings suggested that the many AIDS-preventive educational efforts by STD clinics are ineffective. Hence, individual STD clinics need to develop AIDS-preventive education programs which are suitable for the unique circumstances of their respective 'sex markets'.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Contraception and lactation.

Lactation worldwide is estimated to prevent more births than all organized family planning programs, and thus has a definite contraceptive action. In addition, it contributes to better infant nutrition and well-being. In some societies women do not cohabit while lactating and therefore need no contraception. This situation is being eroded, and in any case does not apply generally. The risk of pregnancy increases with the length of lactation, and thus some form of added contraception needs to be adopted during lactation. Because of the nutritional value of lactation, the CMC deprecates the exploitative commercial advertising and promotion of bottlefeeding that exists in many parts of the world. It recommends that the IPPF and its member associations should actively promote breastfeeding. Since pregnancy can occur during lactation, additional contraception is desired. It should be remembered that IUDs, spermicides, mechanical methods, depot medroxyprogesterone acetate, progestagen-only oral contraceptives (OCs), and sterilization have no adverse effects on lactation. Evidence is accumulating that combined OCs have an adverse effect on the quantity and possibly the quality of breastmilk. Therefore, much greater caution should be exercised in distributing combined OCs than previously. Combined OCs should not be started until lactation is well established, and ideally not before 6 months or until the infant is weaned, whichever occurs 1st. If, however, no alternative contraception is available then OCs may be used earlier.

Breast Feeding↗
PubMedDate not supplied

Dual-method use among an ethnically diverse group of women at risk of HIV infection.

CONTEXT: Few U.S. women protect themselves against both pregnancy and sexually transmitted diseases (STDs) by using an efficient contraceptive method and a condom. Understanding the factors that influence dual-method use could help improve interventions aimed at encouraging protective behaviors. METHODS: Interviews were conducted with 552 low-income women at risk of HIV who attended public health or economic assistance facilities in Miami in 1994 and 1995. Multinomial logit analyses were used to determine the influence of women's background characteristics, perceived vulnerability to pregnancy and AIDS, and relationship characteristics on the odds of dual-method use. RESULTS: Overall, 20% of the women used dual methods. Women who were not married, who worried about both pregnancy and AIDS, who had ever had an STD, who were confident they could refuse a sexual encounter in the absence of a condom and who made family planning decisions jointly with their partner were the most likely to use dual methods rather than a single method (odds ratios, 2.0-3.5); those who considered the condom only somewhat effective in preventing AIDS or who shared economic decision-making with their partner were the least likely to use dual methods rather than a single method (0.5-0.6). The results were generally similar in analyses examining the odds of dual-method use involving an efficient contraceptive, except that black and Hispanic women were significantly more likely than whites to use condoms in conjunction with efficient contraceptives (3.3-7.1). CONCLUSIONS: Both women's individual characteristics and the context of their sexual relationships influence whether they simultaneously protect themselves from pregnancy and HIV. The involvement of male partners in family planning decision-making and women's control over economic decision-making ensure greater protection against HIV infection.

Adolescent↗
PubMedDate not supplied

Condom use among women choosing long-term hormonal contraception.

CONTEXT: Women who rely on long-term hormonal contraception may neglect to use condoms, and thus increase their risk of contracting sexually transmitted diseases, including AIDS. METHODS: Data from a prospective, multisite study were collected to examine the probability of condom use among 1,073 new users of either the contraceptive implant or injectable; users were interviewed when they accepted their method and again six months to one year later. Multivariate logistic regression analyses identified factors that significantly predicted the likelihood of dual method use. RESULTS: Condom use dropped markedly among women who adopted long-term hormonal contraception. The proportion who always used condoms in the previous three months fell from 21% at the time of adoption to 11% at follow-up. Among women with one sexual partner, this decrease was from 20% to 10%; however, among those with more than one partner, use increased from 25% to 31%. The factors significantly predicting dual method use included previous condom use (odds ratio of 2.5), receipt of AIDS-specific counseling (odds ratio of 1.6), the perception of being at some risk of AIDS at baseline (odds ratio of 1.4) and having had more than one sexual partner over the study period (odds ratio of 5.4). In addition, injectable users, teenagers and black women were more likely than other women to use condoms with their hormonal method. CONCLUSIONS: Although condom use among all women declined markedly once they initiated long-term hormonal contraception, frequency of condom use varied by subgroup and was associated with several factors. Most importantly, women with more than one sexual partner and those who received a message during counseling on the need to continue using condoms were more likely than others to use condoms in conjunction with the implant or injectable.

Adolescent↗
PubMed2006

[The influence of apoptosis of lymphocytes of Peyer's patches on the pathogenesis of gut barrier damage in severely scalded mice].

OBJECTIVE: To investigate the changes in cellular apoptosis of Peyer's patches in severely scalded mice, and to explore its role in the pathogenesis of gut barrier damage. METHODS: Forty BALB/c mice were randomly divided into normal control, 12 post-scald hour (12PSH), 24PSH and 72PSH groups, with 10 in each group. The mice in all PSH groups were inflicted with 20% TBSA full-thickness scald on the back. The mice in all the groups were sacrificed at different time points, and Peyer's patches were harvested from all the mice for HE staining, DNA gel electrophoresis, and flow cytometry ( FCM) examination with FITC conjugated Annexin-v and propidium iodide( PI) staining of cells. RESULTS: HE staining revealed that there were relatively abundant apoptotic cells scattering in Peyer's patches of scalded mice . DNA electrophoresis of Peyer's patches revealed typical " ladder" pattern at all indicated time points in scalded mice. Apoptotic percentage of detached Peyer's patches cells in control and scalded group were (4. 9+/-2. 1)% , (26.7+/-3. 1)% , (21.6 +/-4.0)% ,(12. 8 +/-2.0)% , respectively, and the percentage reached the peak at 12 PSH. CONCLUSION: Apoptosis is a principle modality of cell death of small intestinal Peyer's patches lymphocytes in severely scalded mice, and it might contribute to immunity barrier failure of intestinal wall after severe thermal injury.

Animals↗
PubMed1993

Contraceptive methods for women with neurologic disorders.

Sex steroids in oral contraceptives exert several effects on the central nervous system and are therefore of concern when used by neurologically compromised women. In general, oral contraceptives do not aggravate epileptic seizures and are not contraindicated in cases of tension headache. Oral contraceptives can be used in cases of migraine without focal neurologic symptoms as long as headache symptoms do not worsen. Levels of sex steroids can be diminished through enzyme induction by antiepileptic drugs, giving rise to the possibility of contraceptive failure and exposure of the fetus to the teratogenic properties of antiseizure medications. Women with common migraine (without focal neurologic symptoms) who are taking oral contraceptives should be monitored for possible exacerbation of their symptoms. Women who do experience worsening of headache symptomatology when taking the pill should consider alternate means of contraception.

Contraception↗
PubMed2003

Involvement of multidrug resistance associated protein 1 (Mrp1) in the efflux transport of 17beta estradiol-D-17beta-glucuronide (E217betaG) across the blood-brain barrier.

PURPOSE: The purpose of present study is to investigate the involve ment of multidrug resistance-associated protein 1 (Mrp1), Mrp2, an P-glycoprotein (Mdr1a) in the efflux transport of 17beta-estradiol-D-17beta-glucuronide (E217betaG) across the blood-brain barrier (BBB). METHOD: The expression of Mrp1 and Mrp2 at the BBB was investigated by RT-PCR and Western blot analyses. The time profiles of the remaining radioactivity of [3H]E217pG in the brain were compared in wild-type, Mdr1a/Mdr1b and Mrp1 knockout mice and normal and Mrp2-deficient mutant rats [Sprague-Dawley and Eisai hyperbilirubinemic rats (EHBR), respectively] after intracerebral microinjection. RESULTS: RT-PCR and Western blot analyses revealed the expression of Mrp1 in isolated rat brain capillary; however, RT-PCR was unable to detect any expression of Mrp2. Significant elimination of E217betaG was observed in wild-type mice at a rate constant of 0.007 min(-1) which was significantly decreased (0.004 min(-1)) in Mrp1 knockout mice. In contrast, there was no difference in the efflux of E217betaG from the brain in wild-type and Mdr1a/Mdr1b knockout mice and in normal and EHBR. No significant difference was observed in the accumulation of E217betaG by brain slices prepared from wild-type and Mrp1 knockout mice. CONCLUSION: Mrp1, but not Mrp2, is involved in the excretion of E217betaG at the BBB and provides a barrier function by extruding conjugated metabolites into the blood.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Increased intestinal permeability correlates with gastrointestinal toxicity among formulations of the fluorouracil analogue tegafur in rats.

BACKGROUND: S-1 is a new antitumor agent which was developed based on biochemical modulation of fluorouracil. S-1 consists of tegafur (FT), 5-chloro-2,4-dihydroxypyridine (CDHP), and potassium oxonate (Oxo) in a molar ratio of 1:0.4:1. S-1 has been reported to enhance therapeutic effects and to reduce the gastrointestinal toxicity as compared with 5-fluorouracil. In this study performed in rats, S-1 was used to assess the relationship between gastrointestinal mucosal toxicity and changes in intestinal barrier function. METHODS: Fifteen rats were equally divided into three groups: group A (untreated controls), group B (FT and CDHP mixture), and group C (FT and CDHP in combination with Oxo). The animals in groups B and C received equitoxic doses of the drugs in their food for 14 consecutive days. The intestinal permeability was determined on the basis of the urinary recovery of orally administered lactulose and mannitol (L/M). Injury to the small intestines was evaluated by light microscopy. The cell surface expression of CD44 was evaluated immunohistochemically. RESULTS: Recovery of L/M in urine (expressed as a fraction of the dose administered) was 0.15 +/- (SE) 0.08, 0.23 +/- 0.13, and 0.09 +/- 0.04 in groups A, B, and C, respectively. The intestinal permeability in group B was significantly higher than that in group C (p < 0.05). Treatment with FT and CDHP (groups B and C) induced injury to the small intestine and decreased expression of CD44 within the intestinal mucosa, but the extent of damage was reduced by coadministration of Oxo (group C). CONCLUSION: This experimental study suggested that the gastrointestinal toxicity resulting from administration of anticancer drugs is accompanied by an impaired gut barrier function measurable as an increase in intestinal permeability to L/M.

Animals↗
PubMed1997

Determinants for contraceptive use in young, single, Danish women from the general population.

Determinants for contraceptive use were studied in 5031, non-pregnant women aged 20-29 years from the general population in Denmark. Most women (72%) had never been pregnant, 34% had a history of a sexually transmitted disease, and 22% had ever had a legal abortion. Current contraception was most frequently condoms (60%) or oral contraceptives (33%). Among the women who used OCs or IUD, 32% reported additional condom use (double contraception). Important predictors of using one contraceptive method were lifetime number of sexual partners, parity, and age at first sexual intercourse for condoms and age for oral contraceptives. Also, women with a previous legal abortion were more likely to use condoms currently and women with a history of STDs were less likely to use condoms, but more likely to use OCs. Lifetime number of sexual partners was the only predictor of double contraception. Our data suggest a potential for reducing the number of unintended pregnancies and STDs in single women by increasing the information about the double principle in contraception.

Abortion, Induced↗
PubMed1999

Contraceptive use in Australia: evidence from the 1995 National Health Survey.

This paper analyses the patterns of contraceptive use among Australian women, using data from the 1995 National Health Survey. More than 44% of all women aged 18-49 years reported using a method of contraception. Among users, the 2 most commonly reported methods were the pill (60%) and condom (27%); IUD and natural methods accounted for less than 5% each. Sterilizing operations of the women/partner were the most frequently reported reasons for nonuse of contraception in women aged over 35 years, while among the younger women the most reported reasons were pregnancy or trying to get pregnant and not being sexually active. Among pill-users about a quarter were smokers, 20% overweight and 13% reported heart or circulatory disease. These figures were generally lower than in the general population but indicate a need for regular monitoring. The survey demonstrates the continuing evolution in the use of contraception among Australian women.

Adolescent↗
PubMedDate not supplied

Understanding use of condoms among Canadian ethnocultural communities: methods and main findings of the survey.

The aim of this study was to understand the intention to use a condom for each instance of sexual intercourse with a new partner in three of Canada's non-dominant ethnocultural communities: Latin American (N = 346), English-speaking Caribbean (N = 358), and South Asian (N = 355). All respondents were recruited from multiple ethnocultural venues using predetermined sampling frames and quotas for each community. Anonymous questionnaires assessing culturally specific theoretical constructs were completed. This paper presents the methodology and the main findings. The high quality of the results of this study demonstrate the advantage of establishing strong partnerships with members of communities being studied.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Functional characterization and comparison of the outer blood-retina barrier and the blood-brain barrier.

PURPOSE: To determine efflux systems of the outer blood-retina barrier (oBRB) and compare the oBRB with the blood-brain barrier (BBB). METHODS: Porcine oBRB structure and transport characteristics of freshly dissected intact tissue sheets were investigated with scanning electron microscopy, immunocytochemistry, vital dye labeling, and pharmacological agents, using HPLC/mass spectrometry. To compare drug permeation across the oBRB and the BBB, three different systems were used: (1) oBRB tissue sheets in a two-chamber device in vitro; (2) an in vitro BBB model composed of purified astrocytes and brain capillary endothelial cells on transfilter membranes; and (3) an in vivo model based on the brain-plasma ratio of drugs in mice. RESULTS: Efflux pumps (multidrug resistance protein [P-gp] and multidrug resistance-associated protein [MRP]) were demonstrated by antibody staining. Side-specific application of three P-gp and MRP substrates and selective transport inhibition suggested that both membrane proteins were preferentially located on the choroidal side of the oBRB. Therefore, the efflux was directed toward the blood, as in the BBB. To relate the transport characteristics of the oBRB to the BBB, up to nine different test compounds were used. The ranking of the permeability coefficients (P(e)) and the brain-plasma ratios of test compounds indicated that the oBRB has barrier and carrier features similar to those of the BBB in vitro and in vivo. CONCLUSIONS: Despite the fact that epithelial oBRB and endothelial BBB have developed as separate entities with many site-specific functions, their transport and permeation characteristics display surprising similarities, that include the polarized expression of the two major efflux pumps P-gp and MRP.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Changing men's attitudes and behavior: the Zimbabwe Male Motivation Project.

A multimedia communication campaign was conducted between 1988 and 1989 to promote family planning among men in Zimbabwe. The campaign consisted of a 52-episode semiweekly radio soap opera, about 60 motivational talks, and two pamphlets about contraceptive methods. Changes over time were measured by comparing a subset of a follow-up survey conducted from October to December 1989 to a baseline survey conducted from April to June 1988. Men exposed to the campaign were also compared to men who were not exposed. The follow-up survey revealed that the campaign reached 52 percent of men aged 18 to 55. Among married Shona-speaking men, use of modern contraceptive methods increased from about 56 percent to 59 percent during the campaign. Condom use increased from about 5 percent to 10 percent. Awareness and current use of modern contraceptives was also higher among men exposed to the campaign, primarily because of their greater awareness of condoms. Men exposed to the campaign were significantly more likely than other men to make the decision to use family planning and to say that both spouses should decide how many children to have.

Adolescent↗
PubMed1993

Sustaining safe sex: a longitudinal study of a sample of homosexual men.

OBJECTIVE: TO assess the maintenance of safe sexual practice. (We use the term 'safe' sex throughout the paper, since 'safe' is the term adopted by the Australian National Committee on AIDS). DESIGN: Maintenance was assessed by comparing sexual behaviour with both regular and casual partners reported in a 1986/1987 survey (time 1) with behaviour reported in a second survey in 1991 (time 2). METHOD: The 145 homosexually active participants were a non-clinical sample recruited in 1986/1987 by advertisement and followed-up in 1991. A structured questionnaire was administered at both times. Items included questions about the nature of the men's sexual relationships and their sexual practices. RESULTS: Our findings indicate that the majority of men had sustained safe sex practices. HIV prevention strategies adopted included condom use, avoidance of anal intercourse and negotiated safety (i.e., the negotiated practice of unprotected anal intercourse within regular partnerships of concordant serostatus). CONCLUSIONS: Negotiated safety is not the same as relapse.

AIDS Serodiagnosis↗
PubMed2003

In situ blood-brain barrier transport of nanoparticles.

PURPOSE: Two novel types of nanoparticles were evaluated as poten tial carriers for drugs across the blood-brain barrier (BBB). METHODS: Nanoparticles were composed of biocompatible materials including emulsifying wax (E. Wax) or Brij 72. Brij 78 and Tween 80 were used as surfactants for E. Wax nanoparticles (E78 NPs) and Brij 72 nanoparticles (E72 NPs), respectively. Both nanoparticle formulations were prepared from warm microemulsion precursors usin melted E. Wax or Brij 72 as the oil phase. Nanoparticles were radio-labeled by entrapment of [3H]cetyl alcohol, and entrapment efficiency and release of radiolabel were evaluated. The transport of E78 and E72 NPs across the BBB was measured by an in situ rat brai perfusion method. RESULTS: Both formulations were successfully radiolabeled by entrapment of [3H]cetyl alcohol; -98% of radiolabel remained associated with nanoparticles at experimental conditions. The transfer rate (Kin) of E78 NPs from perfusion fluid into the brain was 4.1 +/- 0.5 x 10(-3) ml/s/g, and the permeability-surface area product (PA) was 4.3 +/- 0.7 x 10(-3) ml/s/g. The values for Kin and PA for E72 NPs were 5.7 +/- 1.1 x 10(-3) ml/s/g and 6.1 +/- 1.4 x 10(-3) ml/s/g, respectively. CONCLUSIONS: For both nanoparticle types, statistically significant uptake was observed compared to [14C]sucrose, suggesting central nervous system uptake of nanoparticles. The mechanism underlying th nanoparticle brain uptake has yet to be fully understood.

Animals↗
PubMed1994

PrepCom III ends with no consensus on reproductive health and rights.

The third and final session of the Preparatory Committee (PrepCom III) for the International Conference on Population and Development (ICPD) came to a close on April 22 without agreement on the language of the draft Program of Action on Population and Development. Although PrepCom III was intended as a forum for reaching world consensus on the document, an intense campaign led by the Vatican has left key segments in dispute. The Vatican effort centered on attacking terms that it believed included the possibility of abortion. As a result, "reproductive health," "sexual health," "sexual and reproductive rights," "safe motherhood," "fertility regulation," and "family planning" now appear in brackets indicating that they are disputed terms. The Vatican and its allies also proposed replacing the term "individuals and couples" with "men and women" because the former could be interpreted to allow adolescents the right to reproductive and sexual health and to information about these issues. Finally, the Vatican opposed references to "condoms" in a segment addressing HIV transmission, contending that abstinence is the only effective method of preventing sexual transmission of the virus. The resulting lack of consensus on the document may force ICPD participants to focus more on abortion specifically than on the broader issues of population and development emphasized by the draft Program. Regarded as an enlightened document that departs from its predecessors, the draft focuses on the centrality of women to the issues of population and development. In addition to moving beyond traditional notions of family planning, the draft recommends the initiation of programs to promote gender equity in health, economic opportunity education, and property rights. CRLP's International Program is currently preparing a fact sheet on the politics of choice in preparation for the ICPD.

Condoms↗