Validating a Hazardous Drinking Index in a Sample of Sexual Minority Women: Reliability,Validity, and Predictive Accuracy

Background: Although sexual minority women (SMW) are at increased risk of hazardous drinking (HD), efforts to validate HD measures have yet to focus on this population. Objectives: Validation of a 13-item Hazardous Drinking Index (HDI) in a large sample of SMW. Methods: Data were from 700 adult SMW (age 18-82) enrolled in the Chicago Health and Life Experiences of Women study. Criterion measures included counts of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms, average daily and 30-day ethanol consumption, risky sexual behavior, and Diagnostic and Statistical Manual (DSM-IV) measures of alcohol abuse/dependence. Analyses included assessment of internal consistency, construction of receiver operating characteristic (ROC) curves to predict alcohol abuse/dependence, and correlations between HDI and criterion measures. We compared the psychometric properties (diagnostic accuracy and correlates of hazardous drinking) of the HDI to the commonly used CAGE instrument. Results: KR-20 reliability for the HDI was 0.80, compared to 0.74 for the CAGE. Predictive accuracy, as measured by the area under the receiver operating characteristic curve for alcohol abuse/dependence, was HDI: 0.89; CAGE: 0.84. The HDI evidenced the best predictive efficacy and tradeoff between sensitivity and specificity. Results supported the concurrent validity of the HDI measure. Conclusions: The Hazardous Drinking Index is a reliable and valid measure of hazardous drinking for sexual minority women.     

The Political Matters: Exploring material feminist theories for understanding the political in health,inequalities and nursing

The recent “turn to matter” evident in material feminist theories of the more‐than‐human world offers distinct posthuman understandings of the world as continuously relationally entangled, emergent or materializing. In this paper, I consider how these premises both trouble conventional understandings of matter and/or materials, but likewise potentially revise and revitalize understandings of the political for health and inequalities, and for nursing. This is both timely and much needed given contemporary contexts of austerity‐driven neoliberalism in health care and the unprecedented growth in disparities of wealth and well‐being. I wish to explore whether material feminisms allow us to retheorize connections between abstract theory and material concerns like health and inequalities, differently. This is not theory in opposition to practice or activism, but theory conceptualized as sets of entangled emergent practices, but also what constitutes the political, as more fully relational to and in praxis with health‐related activism. I will argue these theories further justify how practitioners can visibly care for and care more about social and health inequalities. Drawing mainly on the work of material feminist, Karen Barad, and her bringing together of queer and feminist theory, as well as feminist new materialisms and understandings of posthumanism, I discuss how this turn to matter together with meaning might transform understandings of health and inequalities.     

Antinociceptive Interaction of Tramadol with Gabapentin in Experimental Mononeuropathic Pain

Neuropathic pain is the result of injury to the nervous system, and different animal models have been established to meet the manifestations of neuropathy. The pharmacotherapy for neuropathic pain includes gabapentin and tramadol, but these are only partially effective when given alone. The aim of this study was to assess the antinociceptive interaction between both drugs using the isobolographic analysis and changes of the IL‐1β concentration in a mouse model of neuropathic pain (partial sciatic nerve ligation or PSNL). The i.p. administration of gabapentin (5–100 mg/kg) or tramadol (12.5–100 mg/kg) displayed a dose‐dependent antinociception in the hot plate assay of PSNL mice, and effects induced by gabapentin with tramadol were synergistic. Administration of gabapentin or tramadol reversed significantly the increase in the concentration of IL‐1β induced by PSNL after either 7 or 14 days and their combination was significantly more potent in reversing the elevated concentration of IL‐1β. The synergism obtained by the co‐administration of gabapentin and tramadol is proposed to result from action on different mechanisms in pain pathways. Gabapentin or tramadol or their combination modulates the expression of pro‐inflammatory cytokine, IL‐1β, in a model of mice PSNL which could be due to an inhibition of glial function.     

Continued Smoking in Lung Transplant Patients: A Cross Sectional Survey

Introduction

Smoking is associated with a higher incidence of post-lung transplantation complications and mortality. Prior to inclusion on the lung transplant waiting list in the Czech Republic, patients are supposed to be tobacco free for at least 6 months. Our aim was to determine the prevalence of smoking, validated by urinary cotinine, among patients post lung transplantation and prior to inclusion on the transplant waiting list.

Methods

Between 2009 and 2012, we conducted a cross-sectional survey of urinary cotinine to assess tobacco exposure in 203 patients in the Lung Transplant Program in the Czech Republic. We measured urinary cotinine in 163 patients prior to inclusion on the transplantation waiting list, and 53 patients post bilateral lung transplantation.

Results

15.1% (95% CI 0.078 to 0.269) of all lung transplant recipients had urinary cotinine levels corresponding to active smoking; and a further 3.8% (95% CI 0.007 to 0.116) had borderline results. Compared to patients with other diagnoses, patients with COPD were 35 times more likely to resume smoking post- transplantation (95% CI 1.92 to 637.37, p-value 0.016). All patients who tested positive for urinary cotinine levels were offered smoking cessation support. Only one Tx patient sought treatment for tobacco dependence, but was unsuccessful.

Conclusion

Smoking resumption may be an underrecognized risk for lung transplantation recipients, particularly among patients with chronic obstructive pulmonary disease. More rigorous screening, as well as support and treatment to stop smoking among these patients are needed.     

A Parent-Based Intervention to Reduce Sexual Risk Behavior in Early Adolescence: Building Alliances Between Physicians,Social Workers,and Parents

PurposeTo evaluate the efficacy of a parent-based intervention to prevent sexual risk behavior among Latino and African American young adults. This was delivered to mothers while waiting for their adolescent child to complete an annual physical examination.MethodsA randomized clinical trial was conducted with 264 mother–adolescent dyads in New York City. Adolescents were eligible for the study only if they were African American or Latino and aged 11–14 years, inclusive. Dyads completed a brief baseline survey and were then randomly assigned to one of the following two conditions: (1) a parent-based intervention (n = 133), or (2) a “standard care” control condition (n = 131). Parents and adolescents completed a follow-up survey nine months later. The primary outcomes included whether the adolescent had ever engaged in vaginal sexual intercourse, the frequency of sexual intercourse, and the frequency of oral sex.ResultsRelative to the control group, statistically significant reduced rates of transitioning to sexual activity and frequency of sexual intercourse were observed, with oral sex reductions nearly reaching statistical significance (p < .054). Specifically, sexual activity increased from 6% to 22% for young adults in the “standard of care” control condition, although it remained at 6% among young adults in the intervention condition at the 9-month follow-up.ConclusionsA parent-based intervention delivered to mothers in a pediatric clinic as they waited for their child to complete a physical examination may be an effective way to reduce sexual risk behaviors among Latino and African American middle-school young adults.     

Assessment of Student Interprofessional Education (IPE) Training for Team-Based Geriatric Home Care: Does IPE Training Change Students’ Knowledge and Attitudes?

Our study assesses changes in students’ knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.     

Factors Associated with Obesity in an Adult Mediterranean Population: Influence on Plasma Lipid Profile

Objective: The aim of the study was to identify factors associated with obesity, and their influence on plasma lipid profile in an adult Mediterranean population.

Design: The data were obtained from a cross-sectional epidemiological survey.

Setting: The study population resided in Andalusia, a western Mediterranean region in southern Spain.

Subjects: The survey was carried out with a random sample of 3421 subjects (1747 men, 1674 women) between 25 and 60 years of age. Blood samples were obtained for biochemical assays in a random subsample of 340 subjects (167 men, 173 women).

Interventions: Food consumption was assessed by 48-h recall. Height, weight, triceps, biceps, subscapular and suprailiac skinfolds, mid-upper arm, waist (WC) and hip circumferences, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were measured. Information about lifestyles was obtained with a questionnaire.

Results: Of the adult population we studied, 18.9% were obese (body mass index [BMI] ≥ 30 kg/m²). A larger proportion of men than women were overweight, but the opposite was found for obesity. Mean plasma lipid values were not modified significantly by obesity or lifestyle factors, and were within the normal range. Sex, age, physical exercise and lower educational level were associated directly with the risk of obesity, and smoking was associated inversely with the risk of obesity. In obese smokers WC and waist-hip ratio were larger, and levels of HDL-cholesterol were lower (p < 0.05) than in obese nonsmokers. Glucemia was higher in obese persons who consumed alcohol (p < 0.05) than in obese persons who did not consume alcohol. The risk of hypercholesterolemia and high levels of LDL-cholesterol was associated only with age, and the risk of low levels of HDL-cholesterol was associated only with high WC.

Conclusion: Our results provide an estimate of the prevalence of obesity in the adult population in southern Spain, and of the associated factors. Sex, age, leisure-time physical exercise and educational level appear to influence obesity. Only age and WC but not BMI were associated with a risk of dyslipidemia. No dietary associations were observed between energy or macronutrient intake and plasma lipid concentrations in overweight or obese persons.     

Validación de la versión española de las formas cortas del Urogenital Distress Inventory (UDI-6) y del Incontinence Impact Questionnaire (IIQ-7) en mujeres embarazadas

Objective

To validate two measurement instruments, the UDI-6 and the IIQ-7, for the study of urinary incontinence and its impact on the quality of life of pregnant women.

Methods

We carried out a validation study of a diagnostic tool. A total of 181 pregnant women completed the UDI-6 and IIQ-7 questionnaires. Feasibility, internal consistency, reliability, and construct and criteria validity were analyzed.

Results

Self-administration of the short forms of the UDI-6 and IIQ-7 questionnaires took less than 5 minutes and the maximum rate of no answer per item was 3.3%. Cronbach's alpha was 0.667 for the UDI-6 and was 0.910 for the IIQ-7. The reliability of the UDI-6 in the diagnosis of urinary incontinence showed Kappa statistic values of between 0.856 and 0.966, and the intra-class correlation coefficients of the UDI-6 and IIQ-7 were 0.902 and 0.954, respectively. Average values of the UDI-6 and IIQ-7 were higher in women with mixed incontinence, were lower in women with stress incontinence and increased with daily losses (p < 0.01). The correlation between the UDI-6 and the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) (CCI = 0.497; 95% CI: 0.326-0.625) and between the IIQ-7 and ICIQ-SF (CCI = 0.472; 95% CI: 0.268-0.619) was moderate. The sensitivity and specificity of the UDI-6 for the diagnosis of urinary incontinence was 98.9% and 86.5%, respectively.

Conclusions

The Spanish versions of the IIQ-7 and UDI-6 are feasible, reliable, consistent and valid in the measurement of symptoms and quality of life in pregnant Spanish women with urinary incontinence.     

Effects of the anti-neoplastic agent ET-18-OCH3 and some analogs on the biophysical properties of model membranes

The effect of 1-O-octadecyl-2-O-methyl-sn-glycero-3-phosphocholine (ET-18-OCH(3), edelfosine), and six other analog asymmetric phosholipids on the physical properties of 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) model membranes was studied using differential scanning calorimetry (DSC), (31)P-nuclear magnetic resonance ((31)P NMR) and X-ray diffraction. DSC data revealed that, at concentrations of 40mol% and higher, a new type of mixtures with higher T(c) and narrower transitions appeared with all the asymmetric lipids studied. At very high concentrations of these lipids (50-80 mol%), destabilization was observed in the systems probably because of the formation of micelles or small vesicles. In all cases, the asymmetric lipids at concentrations of 40 mol% induced the formation of interdigitated structures in the lamellar gel phase, as deduced from X-ray diffraction. The asymmetric phospholipids were also added to 1,2-dielaidoyl-sn-glycero-3-phosphoethanolamine (DEPE) model membranes and DSC data revealed that the lipids primarily affected transition from the lamellar gel (L(beta)) to the lamellar liquid crystalline (L(alpha)) phase in two aspects: the transition temperature was reduced, and the transition itself became broader and smaller. The lamellar liquid crystalline (L(alpha)) to inverted hexagonal phase (H(II)) transition was also affected, as detected by DSC and (31)P NMR data. Increasing concentrations of the asymmetric lipids reduced the formation of inverted hexagonal phases, which were completely inhibited in the case of ET-18-OCH(3). Since these compounds have been shown to have important biological actions through the plasma membrane, these results may help to understand the mechanism of action of these compounds. In addition these asymmetric lipids were tested for their capacity to induce cell apoptosis, and only ET-18-OCH(3) was found to have a clear effect, thus suggesting that the apoptotic effect is not exerted through changes in the biophysical properties of model membranes.