Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years

Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n?=?138) or SCT (n?=?96) (age 18–35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p?=?.004) but not intention (p?=?.18) or behavior (p?=?.69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p?=?.04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.     

On Bourbaki’s axiomatic system for set theory

In this paper we study the axiomatic system proposed by Bourbaki for the Theory of Sets in the Éléments de Mathématique. We begin by examining the role played by the sign \(\uptau \) in the framework of its formal logical theory and then we show that the system of axioms for set theory is equivalent to Zermelo–Fraenkel system with the axiom of choice but without the axiom of foundation. Moreover, we study Grothendieck’s proposal of adding to Bourbaki’s system the axiom of universes for the purpose of considering the theory of categories. In this regard, we make some historical and epistemological remarks that could explain the conservative attitude of the Group.     

Median decision techniques as an alternative to the classical statistical inference test

In the research area, the criterion to test a hypothesis is frequently the distance of each subject from the mean of the distribution. This concept of distance is constantly used and re-used as a source of evidence in the search for significant contrasts with respect to models of theoretical probability. This paper proposes a number of ideas regarding the use of new distance indicators related to statistics that rely less heavily on parametric assumptions, in particular, the use of median confidence intervals. We have simulated via EXCEL different data samples for a design of two independent groups under 15 different conditions in two different situations: mean equality and mean differences. The results showed the high sensitivity of the comparison of the confidence intervals, especially if a strict decision criterion is used. However, we did not obtain good results for sensitivity. In fact, in some cases, the comparison of the confidence intervals of the mean worked better than those of median.     

Time-dependent modulation of inhibitory avoidance memory by spermidine in rats

The polyamines, spermine, spermidine, and putrescine, are a group of aliphatic amines that may act as physiological modulators of N-methyl-D-aspartate (NMDA) receptors. Although the modulatory role of polyamines in NMDA receptor function has long been known, the effects of polyamines on learning and memory only recently began to be unraveled. In the present study, we investigated the effect of bilateral infusions of spermidine (0.02-2 nmol), a polyamine agonist, into the CA1 region of the rat dorsal hippocampus on inhibitory avoidance learning 30 min pre-training, immediately post-training, 6 h post-training, or 10 min pre-test. Bilateral microinjections of 0.2 nmol spermidine prolonged step-down latencies compared to the respective control group when administered 30 min pre-training or immediately post-training. These results provide evidence that the modulatory effects of spermidine on the acquisition and/or early consolidation of memory of inhibitory avoidance tasks in the hippocampus occur within a limited time window.     

Depression: avoidance learning and physiological correlates in clinical and analog populations

The behavioral and physiological components of depression were investigated in two experiments comparing eight student and seven non-student depressed females with an equal number of students and non-student controls on avoidance tasks and electrodermal responsivity to an aversive audiotape. Avoidance behavior was assessed in both active and passive paradigms where the correct response or response suppression, respectively, function to avoid a noxious buzzer. Physiological activity and reactivity were compared using measurements of skin resistance level and SRR fluctuations during resting and aversive tape periods. It was found that the depressed groups showed inferior active and superior passive avoidance learning as compared to controls. Depressed subjects were also more emotionally responsive (showed a greater number of SRR) during presentation of the audiotape. A passive avoidance model for depression is suggested for the explanation of the phenomena observed. A distinct difference was also found between student and non-student populations. The utility of college student analogs for depression is questioned.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.