Demographic correlates of constant condom use among sex workers in Tangail, Dhaka, Bangladesh

Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n = 112; mean age = 25.92 years). The chi2 results indicated that sex workers over 19 years of age were 2.52 times more likely than adolescents under 19 to work on the street rather than at a brothel (chi2 = 8.73, p < .0.01, OR = 2.52, 95% CI = 1.35-4.72). Brothel sex workers aged over 19 years reported 3.26 probability to regularly use condom with clients than those adolescents aged below 19 years (chi2 = 6.23, p < 0.01, OR = 3.26, 95% CI = 1.25-8.53). This study found age to be a significant demographic correlate of regular condom use, particularly, among the brothel workers.     

Suicidal Ideation and Associated Factors Among School-Going Adolescents in Harare,Zimbabwe

This study determined the prevalence and associated factors of suicidal ideation among school-going adolescents in Harare, Zimbabwe. Data on 1970 respondents were obtained from a cross sectional study of the Global School-based health survey. Respondents were selected using a two-stage probability sampling technique. The prevalence of suicidal ideation was 21.6%. Males were less likely to have suicidal ideation than females (OR=0.70; 95% CI 0.54,0.91). Worrying (OR=1.81; 95% CI 1.29,2.56), feeling of loneliness (OR=2.04; 95% CI 1.43,2.90), cigarette smoking (OR=1.87; 95% CI 1.11, 3.16), and drinking alcohol (OR=1.74; 95% CI 1.17, 2.60) were associated with suicidal ideation. Public health programs designed to control cigarette smoking and alcohol use may also impact positively on suicidal ideation.     

Effects of tobacco use on non-adherence to antiretroviral therapy among HIV-positive patients in South Africa

This study aimed to estimate the relationship between tobacco use and non-adherence to antiretroviral therapy (ART) in a South African sample. Participants were 1 963 HIV patients who attended a primary care clinic in Pretoria (female = 68.5%; black African = 99.5%; median age = 37.0 years; tobacco users only = 8.6%, problem drinkers only = 14.9%, and tobacco users and problem drinkers = 10.5%). In adjusted logistic regression analysis, tobacco use only was not significantly associated with non-adherence to ART. Alcohol use only (OR: 1.72; CI: 1.26, 2.36) and tobacco use and problem drinking (OR: 2.31; CI: 1.60, 3.33) were highly associated with non-adherence to ART.     

Post-traumatic stress disorder and health risk behaviour among persons 15 years and older in South Africa

The aim of this study was to investigate the association between post-traumatic stress disorder (PTSD) and health risk behaviours among persons 15 years and older in South Africa. We analysed data from the South African National Health and Nutrition Examination Survey (SANHANES-1, 2012) (N = 15 201; mean age = 36.9 years, SD = 16.5; 2.1% with PSTD, 4.0% with partial PTSD). The survey included questions from validated measures of the following health risk behaviours: problem drinking, current tobacco use, physical activity, sedentary behaviour, vegetable consumption, and fast food and frequent soft drinks consumption. In adjusted logistic regression analysis, only self-reporting with PTSD was associated with problem drinking. The data did not yield significant association between PTSD status and any of the other health risk behaviours (tobacco use, low physical activity, and fast food consumption).     

BDNF is a novel marker of cognitive function in ageing women: the DR's EXTRA Study

Brain-derived neurotrophic factor (BDNF) is one of the key molecules modulating brain plasticity. While low circulating levels of BDNF have been suggested to predispose to Alzheimer's disease, very little data are available on its association with cognitive function in general population. We evaluated the association between plasma BDNF levels and cognition in a representative population sample of ageing men and women. The subjects (n=1389) were participants of the Dose-Responses to Exercise Training (DR's EXTRA) Study and represent a random sample of Eastern Finnish people (684 men and 705 women), 57-79 years of age at baseline of the study. Plasma BDNF levels were measured by enzyme-linked immunosorbent assay (ELISA). Cognitive function was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery. Women had a higher mean (+/-SEM) plasma BDNF level than men (1721+/-55vs. 1495+/-54pg/ml, P<0.001). In women, 1 SD decrease in BDNF increased the risk for a low score in Naming Test by 53% (95% CI 1.21-1.92, P<0.001), in Mini-Mental State Examination by 63% (95% CI 1.21-2.20, P=0.001), in Word List Memory by 56% (95% CI 1.08-2.26, P=0.019), in Word List Recall by 50% (95% CI 1.10-2.05, P=0.010), in Word List Saving by 49% (95% CI 1.12-1.99, P=0.007), and in Word List Recognition by 64% (95% CI 1.19-2.25, P=0.002). Data were adjusted for age, education, depression, impaired glucose metabolism, cardiovascular disease, antihypertensive medication, lipid lowering medication, use of sex hormones, smoking, alcohol consumption, storing time of plasma in the freezer and platelet count. BDNF was not associated with cognition in men. Present data suggest that plasma BDNF is a biomarker of impaired memory and general cognitive function in ageing women.     

The rapid-smoking technique: Therapeutic effectiveness

The study examined the effectiveness of the rapid-smoking technique in terms of two measures of outcome—post-treatment abstinence rate and reduction in smoking achieved by non-abstinent subjects. A total of 75 volunteers (40 men and 35 women) participated in treatment and were randomly allocated to one of four conditions—rapid-smoking alone; rapid-smoking and relaxation training; rapid-smoking, relaxation and contingency contracting; or contingent rapid-smoking. No significant differences between treatment conditions were obtained. For the total sample, abstinence was achieved by 64% of the subjects immediately post-treatment but the probability of remaining abstinent 12 months later was only 0.33. Immediately post-treatment the non-abstinent subjects reduced their rate of cigarette consumption to 34.2% (SD = 29.3) of baseline smoking but by 12 months average consumption had increased to 82.4% (SD = 28.3) of baseline. It is concluded that rapid-smoking gives rise to substantial short-term changes in smoking behaviour but these effects are not sustained.     

The role of coping in the relationship between stressful life events and quality of life in persons with cancer

Objective: Stressful life events (SLEs) impact the quality of life (QOL) of cancer patients. This study investigated the mediation of the relationship between SLEs and QOL (Model 1: Emotional-EQOL and Model 2: Physical/Functional-PFQOL by three types of coping: Action/Planning, Support/Advise-Seeking, and Disengagement/Denial). Design and Main Measures: 662 persons with cancer completed a Stressful Life Events Checklist, the Brief COPE scale, the FACT Emotional, Physical, and Functional Scales, and the Physical Impact Scale of the Sickness Impact Profile. Results: SLEs were positively associated with Action/Planning (Model 1: B?=?0.195, 95% CI = [0.089, 0.304]; Model 2: B?=?0.192, 95% CI = [0.086, 0.289]) and Disengagement/Denial (Model 1: B?=?0.394, 95% CI = [0.281, 0.513]; Model 2: B = .392, 95% CI = [0.285, 0.508]) but not Support/Advice-Seeking; however, only Disengagement/Denial was related to Emotional-QOL (Model 1: B = ?0.659, 95% CI = [?0.848, ?0.498]) and Physical/Functional-QOL (Model 2: B = ?1.460, 95% CI = [?1.856, ?1.069]). Thus, only Disengagement/Denial mediated the relationship between SLEs and QOL. Conclusions: The results indicated that SLEs represent a class of events for which there may be only one dominant coping response, disengagement. SLEs may not be controllable or predictable and reduce capacity for active coping with serious illness. However, SLEs may be detected at any point in the cancer trajectory so that supportive services might be provided.     

A longitudinal study on depressive symptoms and physical activity during the Spanish lockdown

Background/Objective: The aim was to evaluate the evolution of depressive symptoms and to explore the influence of physical activity (PA) practice during the home confinement due to the COVID-19 outbreak in Spain. Method: Information was collected from 595 confined participants who reported personal and contextual information, depressive symptoms and PA levels at four time points. Results: The changes in depressive symptoms were analyzed using a linear mixed model with cubic splines. Results showed a significant increase, with a significant rise between T1 and T2 (OR = 2.38, 95% CI = 1.83-3.10). It continued growing until T4 (OR = 2.93, 95% CI = 1.97-4.38). A negative relationship was observed between the increase in depressive symptoms and moderate-to-vigorous physical activity (MVPA) levels, with a significant slope up to 4 hours of MVPA per week (OR = 0.51, 95% CI = 0.29-0.90) that tended to increase until 16 hours per week of MVPA (OR = 0.41, 95% CI = 0.20-0.87). Conclusions: Results from a partition model showed that moderate intensity of PA could be enough to prevent an increase of depressive symptoms during home isolation.     

Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue.

CONTEXT: Fatigue is among the most common and distressing symptoms experienced by cancer patients. OBJECTIVE: This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients. DATA SOURCES: MEDLINE, PsycINFO, and CINAHL. STUDY SELECTION: Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed. EXTRACTION: Forty-one trials were reviewed and 30 were included in a meta-analysis. DATA SYNTHESIS: Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02- .16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d-sub(w) = .10, 95% CI = .02-.18) but not activity-based interventions (d-sub(w) = .05, 95% CI = -.08 - .19). CONCLUSIONS: Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base.     

Body Mass Index and functional impairment: the explanatory role of anxiety sensitivity among treatment-seeking smokers

Obesity and smoking are highly prevalent public health concerns in the United States. Data indicate that elevated Body Mass Index (BMI) is related to functional impairment. However, there is limited understanding of mechanisms that may explain their comorbidity among smokers. The current study sought to test whether anxiety sensitivity explained the relation between BMI and functional impairment among 420 (46.9% females; M_age = 38 years, SD = 13.42) treatment-seeking, adult smokers. Results indicated that BMI yielded a significant indirect effect through anxiety sensitivity for functional impairment, b = 0.01, SE = .01, 95% CI = [.002, .021]. These findings remained significant after controlling for participant sex, negative affectivity, tobacco dependence, psychopathology, and medical conditions (i.e. hypertension, heart problems, respiratory disease, asthma). Such data provide novel empirical evidence that, among smokers, BMI may be a risk factor for functional impairment indirectly through anxiety sensitivity. Overall, such findings could potentially inform the development of personalized interventions among this particularly vulnerable segment of the smoking population.     

Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke

Abstract

Objective: To assess levels of self-efficacy for health-related behaviour change and its correlates in patients with TIA or ischemic stroke.

Methods: In this prospective cohort study, 92 patients with TIA or ischemic stroke completed questionnaires on self-efficacy for health-related behaviour change and fear, social support and depressive symptoms. Relations between fear, social support, depressive symptoms, cognitive impairment, vascular risk factors and history and demographic characteristics and low-self-efficacy were studied with univariable and multivariable logistic regression.

Results: Median total self-efficacy score at baseline was 4 (IQR 4–5). Older age (OR 1.05, 95% CI 1.01–1.09), depressive symptoms (OR 1.09, 95% CI 1.03–1.16), presence of vascular history (OR 2.42, 95% CI 0.97–6.03), higher BMI (OR 1.15, 95% CI 1.01–1.30), fear (OR 1.06, 95% CI 1.01–1.12) and low physical activity (OR 1.49, 95% CI 1.01–2.21) were significantly associated with low self-efficacy.

Conclusion: Patients with recent TIA or ischemic stroke report high self-efficacy scores for health-related behaviour change. Age, vascular history, more depressive symptoms, higher BMI, less physical activity and fear were correlates of low self-efficacy levels.

Practice implications: These correlates should be taken into account in the development of interventions to support patients in health behaviour change after TIA or ischemic stroke.     

Cognitive impairment and the 10-year survival probability of a normal 62-year-old population

The predictive value of cognitive impairment together with demographic and health factors on long-term survival was evaluated. The population sample comprised 389 subjects, all 62 years old. Cognitive performances were measured using verbal, visuomotor and memory tests. Cognitive impairment was determined by comparing performances with norms derived from healthy controls. Ten years after testing, the probability of survival was 89% for the cognitively preserved subjects, 80% for those with mild impairment, and 71% for those with moderate impairment (p = 0.009). Relative risk (RR) for shortened survival was 1.7 (95% CI 0.9-3.2) for the mildly, and 2.6 (95% CI 1.4-4.8) for the moderately impaired. Perceived health problems were, as expected, related to reduced survival (p < 0.001, RR 3.6, 95% CI 2.1-6.0), and there was an association between cognitive impairment and impaired perceived health (p = 0.040). Multivariate analyses with Cox's regression models showed that cognitive impairment, in particular, impaired episodic memory had an association with survival, in addition to the expected effects. Thus, memory impairment may reflect very early signs of underlying disease, and so the findings provide predictive validity for the cognitive methods used.     

Mortality and Causes of Death in a 10-Year Follow-Up of Patients Treated for Self-Poisonings in Oslo

The present 10-year follow-up study includes all patients (N = 926; 50% females) treated in the medical departments in Oslo for self-poisonings during one year (1980). Seventeen percent were considered suicidal attempts upon admission, 25% among the non-substance abusers and 8% among the abusers. At follow-up, 207 patients (22%) were dead (62% males). The mortality rate was highest among the abusers. The most common causes of death were suicide (21%), heart disease (17%), opiate abuse (15%), and accidents/wounds (13%). Forty-one percent of the suicides occurred during the first two years of the follow-up period. The suicides were by poisoning (57%), hanging (20%), and other methods (23%). The female mortality rate decreased in the second half of the follow-up period whereas the male rate did not change. The risk of death within 10 years after discharge increased with age and was higher in men and in abusers, whereas social group and motive for suicide were not predictive factors. The females had an excess suicide rate of 182 (36–327, 95% CI) in the first year after the self-poisoning and 61 (36–87, 95% CI) in the total period. The corresponding figures for males were 70 (19–122) and 21 (12–30). The only factor associated with an increased suicide rate was a suicidal motive upon the admission for self-poisoning with a 3.1 (1.7–5.8, 95% CI) times increased risk of suicide in the 10-year follow-up period.     

Assault victimization and suicidal ideation or behavior within a national sample of U.S. adults

Data from a nationally representative sample of 5,238 U.S. adults were used to examine the extent to which physical assault victimization was associated with suicidal ideation or behavior (SIB). The results from multivariable logistic regression analyses indicate that physical assault victimization was positively associated with SIB after adjusting for sociodemographic characteristics and alcohol use (OR = 3.6; 95% CI = 2.4-5.5). Those who were injured during the most recent physical assault (OR = 2.7; 95% CI = 1.2-6.0) and those who were assaulted by a relative (OR = 3.4; 95% CI= 1.0-11.0) or intimate partner (OR = 7.7; 95% CI = 2.7-22.5) were significantly more like to report SIB than victims who were not injured or were assaulted by a stranger. Also, those who were victimized but not injured (OR = 5.6; 95% CI = 3.8-8.2) and those who were victimized by a stranger (OR = 2.9; 95% CI = 1.4-6.0) were more likely to report SIB than non-victims. These results highlight the need for legal, medical, mental health, and social service providers to address the co-occurrence of violent victimization and suicidal ideation, particularly, but not exclusively, victimization by family members and intimates.     

Parental, Behavioral, and Psychological Factors Associated with Cigarette Smoking among Secondary School Students in Nanjing, China

We designed this study to assess parental, behavioral, and psychological factors associated with tobacco use among Chinese adolescents. The data were collected from 995 middle school students in Nanjing, China. Both smoking experimentation and current smoking (smoking in the past 30 days) were assessed among the study sample. Psychosocial measures include family structure, problem behaviors, social influence of smoking (both parental and friends’ approval of smoking), depressive symptoms, social alienation, self-esteem, parental monitoring (social monitoring and academic monitoring) and parenting style (responsiveness and demandingness). Among the study sample (mean age 15.16 years and 50% females), 24% ever smoked and 15% smoked in the past 30 days. Advanced age, male gender, low family SES, low school performance and low educational aspiration were associated with both smoking experimentation and current smoking. Depressive symptoms, social alienation, low self-esteem, low social and academic monitoring, problem behaviors, low maternal and paternal responsiveness, peer smoking, parent smoking, and parental and friends’ approval of smoking were positively associated with current smoking among Chinese adolescents. Future tobacco use prevention efforts among Chinese adolescents need to consider the parental, behavioral, and psychological correlates identified in the current study.     

Reaction times and electromechanical delay in reactions of increasing and decreasing force

The purpose of this study was to compare reaction times and electromechanical delay between reactions to increase force from rest and reactions to decrease force from an active state in the quadriceps femoris of healthy young adults. Force, position, and electromyographic data were recorded from 35 subjects reacting to a forced knee-flexion perturbation. Electromechanical delay was assessed through cross-correlation of the filtered EMG and force data. Reaction time to increase force (M= 159.9 msec., 95% CI= 149.9-169.9 msec.) was significantly longer than RT to decrease force (M= 124.4 msec., 95% CI= 118.7-130.1 msec.). This difference was partially caused by a difference in electromechanical delay (RT to increase force electromechanical delay was 63 msec., 95% CI=60-67 msec., greater than the RT to decrease force electromechanical delay of 49 msec., 95% CI=46-52 msec.). This difference in reaction time could be important in identifying and interpreting physiologically meaningful changes in muscle force and in intermuscular coordination during movement.     

Concurrent alcohol and tobacco use among school-going adolescents in Namibia: Prevalence and risk factors

The aim of this study was to investigate the prevalence and risk factors for concurrent alcohol and tobacco use among school-going adolescents in Namibia. Data were from a sample of 4 531 Namibian middle school children (females = 53.1%; mean age = 15.8 years, SD = 1.8 years). They completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Overall, 74.4% of alcohol users in the past month were frequent tobacco users; whereas 40.5% of tobacco users in the past month were frequent alcohol users. Compared to students who were neither alcohol nor tobacco users (63.1%), concurrent alcohol and tobacco users were more likely to self-report with a lack of parent support, to have used illicit drugs, to have engaged in school truancy, to be sedentary in behaviour, to have engaged in a physical fight, and to have had two or more sexual partners. Substance use prevention and treatment programmes with adolescents should routinely address their risk for comorbid tobacco and alcohol use.     

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n?=?107) or head and neck cancers (n?=?99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs.

Methods: Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses.

Results: More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption.

Conclusions: Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.