Sex and substances: Does body image play a role?

ABSTRACT

Objective: Having sex under the influence of alcohol and/or drugs places individuals at high risk for STI transmission and unplanned pregnancy. Although the relationship between body image and sexual behavior has been well established, research on the relationship between body image and sexual behavior under the influence among adolescents is scant. The purpose of this study is to investigate the relationship between body image and unprotected sex and unprotected sex while under the influence among adolescents.

Methods: We conducted logistic regression analyses using data from the Oregon Youth Substance Use Project (N = 937). Measures included body image, unprotected sex, unprotected sex while inebriated, age, sex, and BMI.

Results: Body image was not related to unprotected sex, but was significantly related to unprotected sex while inebriated in the past year and in their lifetime (OR = 2.17, 2.33).

Conclusions: Results suggest substance use may be important to the relationship between body image and sexual behavior among adolescents. Additional research is warranted to inform future interventions.     

Matching total body oxygen consumption and delivery: a crucial objective?

The strength of the rationale for incorporating total body oxygen consumption (VO₂) and delivery (DO₂) into our decision making strategies contrasts with the absence of demonstrated benefits of bedside calculations in clinical practice. This situation mandates a careful reappraisal of the theoretical limitations of bedside calculations of DO₂ and VO₂, including a re-evaluation of the clinical situations in which these calculations are valid. Three levels of complexity can be distinguished when analysing a patients hemodynamic status: 1) simple cases where investigations can be limited to clinical monitoring, including lactate changes over time; 2) intermediate situations requiring invasive investigations in which continuous monitoring of VO₂-related variables such as cardiac output and mixed venous oxygen saturation often provide enough information to guide clinical decision; and 3) complex situations where assessment of VO₂ and VO₂/DO₂ analysis might be recommended. Although studies that support such recommendations are limited they are based on a widely accepted physiological model. VO₂ and DO₂ analysis is also limited by theoretical and technical difficulties. In this article, we discuss the validity of these limitations in the bedside assessment of VO₂ and DO₂, and review data supporting the use of VO₂/DO₂ analysis in the clinical evaluation of complex cases.     

Nurses’ bodywork: is there a body of work?

The work that many nurses do involves the use of their own body as one of the tools of their occupation. Being a nurse, in many cases, means controlled, purposeful use of her or his own body oriented to the patient. This paper discusses some of the ways in which nurses' bodies and the work that those bodies do are represented in professional and academic research accounts and made relevant in literature. Using instances of bodies and bodily activity mentioned in a variety of literature, the paper discusses three categories of accounts of nursing bodywork: those which are problematised and where the nurse's body is seen as a topic for investigation, and those which are unproblematised either explicitly discussing bodily activity (for example, touch) or implicitly dealing with bodywork (for example, taking blood pressure). Four ways in which nurses' bodies are made relevant in accounts are proposed: relational, corporate, instrumental and human. The paper discusses the prominence (or not) nurses' bodies are given in professional and academic accounts, as a contribution to preliminary work of generating a topic for investigation and concludes with some suggestions as to how this investigative project might be taken forward, focusing primarily on an examination of methodic practices, or how bodywork is brought off and executed as a skilled but taken-for-granted activity.     

Whole body hyperthermia: a secure procedure for patients with various malignancies?

Objective: To establish the safety of systemic Cancer Multistep Therapy (sCMT) including whole body hyperthermia, by means of hemodynamic, laboratory and clinical investigations. Design: Prospective study. Setting: University clinic. Patients: 12 patients with various cancers (with sCMT), a second group of 20 patients with colorectal carcinoma treated with chemotherapy (without sCMT). Interventions: 25 treatments with sCMT for 60 min at 41.8 °C (including chemotherapy) were given in addition to induced hyperoxemia and hyperglycemia under general anesthesia. Measurements and results: Invasive monitoring of systemic and pulmonary hemodynamics as well as pulmonary gas exchange was used at 37 °C, 40 °C, 41.8 °C and 39 °C. In addition, laboratory parameters were measured before and within 4 days of therapy. At 41.8 °C, invasive monitoring showed characteristic signs of hyperdynamic circulation. In addition, right-to-left shunt, oxygen consumption, oxygen delivery and lactate levels were significantly different from pretreatment values. At the end of therapy, lactate levels and the extravascular lung water index increased, whereas all other parameters showed a clear tendency to return to initial values. Within the first day after sCMT, we measured a slight but significant reversible increase in serum creatinine compared to pretreatment values, but found no significant alterations of other chemical parameters. Between the sCMT group and controls, there was only a temporary significant difference in aspartate aminotransferase levels 2 days after therapy. Conclusions: sCMT, including whole body hyperthermia, accompanied by suitable anesthesiological management and monitoring, does not lead to any serious or sustained organ dysfunction and can therefore be regarded as a safe therapy. Received: 19 April 1999 Final revision received: 30 June 1999 Accepted: 8 July 1999     

Detection of body packing by magnetic resonance imaging: a new diagnostic tool?

Purpose

In this study, we aimed to describe non-contrast abdominal MRI findings in body packers and emphasize the role of this imaging technique in diagnosis of body packing.

Materials and methods

Non-contrast abdominopelvic MRI was performed at the radiology department in 16 suspected body packers that were brought to our hospital, and 13 of them were diagnosed with body packing. We evaluated the presence, location, and shapes of packets as well as signal characteristics on T1- and T2-weighted images.

Results

We came across two types of packets: those containing solid substances (10 cases) and those filled with liquid cocaine (3 cases). Both types were accurately diagnosed with the help of MRI. Only 1 suspected body packer received a false positive diagnosis.

Conclusion

Abdominopelvic MRI is a reliable and valuable method of diagnosing body packing.     

The effect of whole body vibration in common neurological conditions – a systematic review

Abstract

Background: Whole body vibration (WBV) is a new therapeutic tool used to improve muscle strength, power and postural control in various healthy and pathological populations.

Aim: The aim of this systematic review was to summarise and evaluate the available literature on the effectiveness of WBV in neurological conditions.

Method: A systematic review of the literature was performed to identify randomised controlled trials (RCTs) examining the effect of WBV on common neurological conditions. The methodological quality of the studies was systematically assessed using the PEDro rating scale. Reported outcomes were assessed for differences between the experimental and control groups and effect sizes were calculated.

Results: Five RCTs and two pseudo RCTs were included. Methodological scores ranged from 1 to 9 (maximum 11) with a mean score of 5˙71 (SD 2˙69). There is weak to moderate evidence for positive effects on postural control, mobility, motor function and strength following the single application of WBV in neurological populations. A paucity of available literature into repeated WBV training prevents the drawing of firm conclusions regarding long-term treatment effectiveness.

Conclusion: Despite being a new technique, there is early evidence that WBV applied to neurological populations has positive effects on postural control, mobility, motor function and strength. Further studies into the effectiveness of WBV in neurological populations are warranted.     

The effects of lingual intervention in a patient with inclusion body myositis and Sjögren's syndrome: a longitudinal case study

Malandraki GA, Kaufman A, Hind J, Ennis S, Gangnon R, Waclawik A, Robbins J. The effects of lingual intervention in a patient with inclusion body myositis and Sjögren's syndrome: a longitudinal case study.ObjectiveTo report the 5-year course of a patient's swallowing disorder in the context of progressive neuromuscular disease and the effectiveness of a lingual strengthening treatment program.DesignThis is a case report that describes a lingual treatment protocol that was repeated 3 times over a 5-year period with and without maintenance periods.SettingThe study was completed in 2 settings—an outpatient swallowing clinic at an acute care hospital and the patient's home.ParticipantThe subject was a 77-year-old woman who was diagnosed with inclusion body myositis and Sjögren's syndrome.InterventionThe patient participated in an intensive 8-week lingual strengthening protocol 3 times (at years 1, 4, and 5) and a subsequent maintenance program twice (at years 4 and 5).Main Outcome MeasuresThree outcome measures were collected during the study: (1) lingual manometric pressures at the anterior and posterior tongue, measured by using a lingual manometric device, (2) airway invasion measured by using an 8-point Penetration-Aspiration Scale, and (3) clearance of the bolus measured by using a 3-point residue scale.ResultsIsometric lingual strengthening was effective in maintaining posterior tongue lingual pressure and Penetration-Aspiration Scale scores during the treatment periods. Residue scale scores did not significantly change during treatment.ConclusionsWe conclude that, in this patient, lingual strengthening slowed the progression of disease-related lingual strength loss and extended functional swallowing performance. Thus, this type of intervention may hold promise as an effective swallowing treatment option for patients with neurodegenerative inflammatory diseases such as inclusion body myositis and Sjögren's syndrome.     

Developmental Origins of Health and Disease – from a small body size at birth to epigenetics

The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that several non-communicable diseases have their origins in prenatal life and in early childhood. This is believed to work through programming, an insult, taking place at a sensitive period of development, may have lifelong consequences, increasing and programming disease risk later in life. The Helsinki Birth Cohort Study (HBCS) has been focusing upon the importance of factors active during periods in early life and their influence on later health in 20,431 people born 1924–44. This review will focus upon findings from the HBCS over the past 20 years. Early growth patterns associated with coronary heart disease, type 2 diabetes and other health outcomes are described. The long-term health impact of maternal adiposity is also discussed. Potential underlying mechanisms explaining the associations are discussed including epigenetic factors.

• Key messages

• Several non-communicable diseases – including coronary heart disease and type 2 diabetes – have their origins in early life.

• Early life programming during sensitive periods of development may permanently program future health and disease risk.

• Optimizing the health and lifestyle of women of reproductive age will have positive health consequences for their offspring.

     

Whole body vibration: a new therapeutic approach to improve muscle function in cystic fibrosis?

Disease progression in cystic fibrosis (CF) leads to muscle wasting and loss of muscle function. The aim of this prospective pilot study was to evaluate the effects of whole body vibration (WBV) on muscle function in adult patients with CF. Ten patients (three males; seven females) of the CF Center Cologne, Germany, have completed the 3-month study (age: 24-47 years; forced expiratory volume in 1 s (FEV1) 17-109% predicted (49+/-29) and body mass index (BMI) 16.6-24.4 kg/m2 (19.3+/-2.5). WBV was provided by a vibration platform (Galileo 2000). The patients were standing in an upright position receiving vertical vibration of frequencies between 20 and 25 Hz. The vibration exercise evokes muscle contractions via stretch reflexes improving muscular activity. The training schedule consisted of three 3-min sessions twice a day, 5 days per week for 3 months. Every 4 weeks the following tests were carried out: FEV1, forced vital capacity (FVC), BMI, chair-rising test (CRT), one-leg and two-leg jump test as well as maximal isometric grip force. The study has been approved by the local ethics committee. After 3 months of WBV all parameters in the CRT significantly improved: chair-rising time (P=0.03), maximal force (P=0.02), maximal power (P=0.01) as well as velocity (P=0.02). The peak jump force (P=0.02) and velocity (P=0.01) of the two-leg jump significantly improved. Parameters in the one-leg jump as well as maximal isometric grip force showed no significant improvement. Weight and BMI showed a slightly positive trend whereas FEV1 and FVC did not significantly change. Any change in mechanographic parameters did not correlate with FEV1 or FVC in this study. These results demonstrate that WBV can improve muscle function in CF patients.     

Do fibromyalgia patients display hypervigilance for innocuous somatosensory stimuli? Application of a body scanning reaction time paradigm

This study tested the hypothesis that fibromyalgia patients display hypervigilance for somatosensory signals. Hypervigilance was operationalized as the detection of weak electrocutaneous stimuli. Innocuous electrical stimuli gradually increasing in strength were administered to one of four different body locations. A reaction time paradigm was used in which subjects had to respond as fast as possible to stimulus detection by pressing a button corresponding to the correct body location. The detection task was presented first under single task conditions and subsequently under dual task conditions, in combination with a second (visual) reaction time task. It was predicted that hypervigilance would be most prominent under dual task conditions, where subjects can choose to allocate attention selectively to one of the tasks. Questionnaires on general body vigilance, pain vigilance, pain related-fear and pain catastrophizing were also administered. Thirty female fibromyalgia patients were compared to 30 healthy controls matched on age, sex and educational level. No evidence for hypervigilance for innocuous signals was found: patients did not show superior detection of electrical stimuli either under single or dual task conditions. Also, no differences were found between patients and controls on the body vigilance questionnaire. Detection of electrical stimuli was, however, predicted by pain-related fear and pain vigilance.     

Acute cholinergic syndrome in a patient with mild Alzheimer’s type dementia who had applied a large number of rivastigmine transdermal patches on her body

Case presentation: A 91-year-old woman was transferred to our Emergency Medical Center and Poison Center with somnolence, hypertension (186/61?mm?Hg), and repeated vomiting. Three hours later, 10 transdermal patches, each containing 18?mg of rivastigmine (9.5?mg/24?h), were found on her lower back and both thighs, when miosis, facial and trunk sweating, enhanced bowel sound, hypertension, and sinus tachycardia were noted. She was diagnosed with acute cholinergic syndrome due to rivastigmine poisoning. Her hypertension and sinus tachycardia peaked 8 and 5?h after all the patches were removed, respectively. Her symptoms subsided spontaneously after 17?h.

Discussion: In the present case, our patient was presented with acute cholinergic syndrome due to carbamate intoxication after massive transdermal exposure to rivastigmine. Toxicological analysis revealed a remarkably high estimated serum rivastigmine concentration (150.6?ng/ml) and notably low serum butyrylcholinesterase activity (35?IU/l) on admission, with a markedly prolonged calculated elimination half-life of 6.5?h.

Conclusions: Emergency physicians should consider acetylcholinesterase inhibitor exposure (e.g., rivastigmine) when patients are present with acute cholinergic syndrome.     

The effect of a pelvis-concentrated exercise program on male college students’ body alignment and foot base pressure

[Purpose] The aim of this study was to examine the effect of a pelvis-concentrated exercise program and walking on the changes in body shape and foot base pressure. [Subjects and Methods] Thirty adults from K University in Busan, Republic of Korea, were randomly divided into the Swiss-ball exercise group and McKenzie exercise group, and they conducted exercise for 40 min 3 times a week for 6 weeks. [Results] Global postural system results and foot base pressure significantly decreased in both groups. A comparison of foot base pressure after the intervention between the two groups revealed that the Swiss-ball exercise group exhibited a greater reduction than the McKenzie exercise group. [Conclusion] The results of this study indicated that the Swiss-ball exercise may improve posture and foot base pressure in male adults.Key words: Pelvic exercise, Body alignment, Foot pressure     

Patient education and basic body awareness therapy in hip osteoarthritis – a qualitative study of patients’ movement learning experiences

Background: Osteoarthritis (OA) is associated with pain, dysfunction and reduced quality of life. Patient education (PE) followed by 12 weekly sessions of Basic Body Awareness Therapy (BBAT) was offered to patients with hip OA, aiming to strengthen their ability to move and act functionally in daily life.

Aim: To explore how patients described their experiences and outcome from participating in PE and BBAT.

Method: Individual, semi-structured interviews with five patients, aged 52-78 years, were performed after PE and BBAT at four and ten months. Interview data were analyzed by systematic text condensation.

Results: Three main themes emerged. “Becoming motivated and involved” reflected experiences of encouragement and support from information given and communication with group members. In “Movement awareness learning” patients described becoming aware of and improving functional movement, alleviating symptoms and increasing daily functioning. “Movement and disease in a long-term perspective” reflected patient? experience of increased self-awareness and taking better care of themselves at 10 months after baseline. Practicing basic movement principles, they felt empowered to handle daily life challenges in more functional and energy-economical ways.

Conclusion: PE followed by BBAT in groups may be beneficial to patients with hip OA, and provide lasting benefits regarding daily life function.

• Implications for Rehabilitation

• Insight into disease process and relationship to functional movement gained through patient education may empower patients with hip osteoarthritis in management of daily life

• Movement awareness and exploration of movement quality using principles from Basic Body Awareness Therapy was found to support patients in finding resources for functional movement, implemented in daily actions

• Movement strategies characterized by adjustment rather than force was experienced by the patients to support their general functioning, despite of prevailing hip pain

• Implementing group therapeutic factors (Yalom) in physiotherapy was found to strengthen patients’ motivation and belief in functional improvement