Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO study)

Female injection drug users (IDUs) represent a large proportion of persons infected with HIV in the United States, and women who inject drugs have a high incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) injection. Therefore, it is important to understand the role of gender in injection risk behavior and the transmission of blood-borne virus. In 2000–2002, 844 young (<30 years old) IDUs were surveyed in San Francisco. We compared self-reported risk behavior between 584 males and 260 female participants from cross-sectional baseline data. We used logistic regression to determine whether demographic, structural, and relationship variables explained increased needle borrowing, drug preparation equipment sharing, and being injected by another IDU among females compared to males. Females were significantly younger than males and were more likely to engage in needle borrowing, ancillary equipment sharing, and being injected by someone else. Females were more likely than males to report recent sexual intercourse and to have IDU sex partners. Females and males were not different with respect to education, race/ethnicity, or housing status. In logistic regression models for borrowing a used needle and sharing drug preparation equipment, increased risk in females was explained by having an injection partner who was also a sexual partner. Injecting risk was greater in the young female compared to male IDUs despite equivalent frequency of injecting. Overlapping sexual and injection partnerships were a key factor in explaining increased injection risk in females. Females were more likely to be injected by another IDU even after adjusting for years injecting, being in a relationship with another IDU, and other potential confounders. Interventions to reduce sexual and injection practices that put women at risk of contracting hepatitis and HIV are needed.     

Ecological contexts in the development of coalitions for youth violence prevention: an organizational network analysis

Community coalitions are a recognized strategy for addressing pressing public health problems. Despite the promise of coalitions as an effective prevention strategy, results linking coalition efforts to positive community outcomes are mixed. To date, research has primarily focused on determining organizational attributes related to successful internal coalition functioning. The authors' research complements and adds to this literature by offering a network conceptualization of coalition formation in which coalition participation is studied within the broader context of local organizational networks both within and beyond a coalition. The authors examine participation in the first year of a youth violence prevention coalition exploring both differences between participating and nonparticipating organizations and levels of participation. Each network variable, reflecting prior collaboration and being viewed by other organizations as a local leader, approximately doubled the explained variance in coalition participation beyond the predictive power of all available organizational attributes combined. Results suggest that initial coalition participation emerged out of a preexisting network of interorganizational relations and provide an alternative perspective on coalition formation that goes beyond conceptual orientations that treat coalitions as bounded organizational entities that exist apart from the communities in which they are embedded.     

Hybrids do it better: Lessons from websites of hybrid organizations in modern health movements

ABSTRACT

Hybrid organizations in modern health movements adopt multiple organizational logistics, allowing them to more effectively achieve social change. We conducted an analysis of 152 probreastfeeding organization websites categorized as institutionalized organizations, grassroots organizations, or hybrid organizations. Through a series of ANOVA analyses, we found that hybrid’s websites provide significantly more useful health care information, better maintained dialogue with members, more efficiently mobilized members, commoditized health care issues less, and created member identity while maintaining institutional ties. Ultimately, hybrids tended to incorporate the positive elements from both grassroots and institutional organizations, while rejecting many of the negative elements.     

Racial and Ethnic Healthcare Disparities in Skin Cancer in the United States: A Review of Existing Inequities,Contributing Factors,and Potential Solutions

Objective Racial and ethnic health disparities affect the diagnosis and management of melanoma and nonmelanoma skin cancers, leading to deleterious outcomes. Non-Hispanic White patients make up the majority of skin cancers cases, yet racial and ethnic minorities have poorer prognoses and outcomes. The skin cancer literature is fragmented with regards to potential contributors to these healthcare disparities. In this article, we provide a comprehensive review of the skin cancer literature to briefly quantify racial and ethnic inequities, highlight contributing factors, and propose practical changes that can be made.MethodsA PubMed search was completed to identify articles related to racial and ethnic health care disparities in the context of melanoma, basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and dermatofibrosarcoma protuberans.ResultsRelative to non-Hispanic White patients, patients of racial and ethnic minorities have differing clinical presentations of skin cancers and genetic risk factors. Insurance, access to specialty care, cultural beliefs, and available educational resources further contribute to racial and ethnic disparities.LimitationsWe are limited to the level of detail provided in the existing literature, and at some times are unable to distinguish race of Hispanic populations. We also acknowledge that there are different nationalities grouped under these broad labels as well as multi-racial populations that may not be accounted for.ConclusionAwareness of and familiarization with innate factors and potentially more modifiable contributors can help inform efforts to close the observed gap in racial and ethnic inequities.     

RF对纳米金标记的RNase-S局部加热效应的研究

目的 在纳米级或微米级结构的线度可以和热辐射波长λ相比拟的状态下的辐射热传导的研究具有重要的实用意义，通过建立生物模型来研究射频电磁辐射(RF)对纳米结构辐射热传导的特征，并探讨微波非热效应的可能作用机制。方法 将制备的纳米金标记的RNase-S样品通过常规的Poly-C水解能力的测定及哪谱的测定分析，确定酶的2级结构的重组成功和活性的存在后，比较RF对样品、水和空气的热效应。结果 通过紫外分光光度计对制备的纳米金标记的RNase-S样品的Poly-C水解能力的测定及谱的测定，表明研究中使用的生物模型和RNase A模拟得十分满意。空气浴中的封装空气样品的散热曲线呈现指数衰减规律，而空气样品的加热过程呈指数增加趋势。空气浴中的双蒸馏水样品的加热过程基本上是线性增加。但是，水浴的纳米金标记的RNase-S样品的加热过程却基本上保持恒定值。结论 RF辐射在实验的条件下会由于被加热介质的不同热物理性质表现为不同的加热效果，对于含有纳米金属的微结构，可能会在局部产生微涡流发热。以纳米颗粒为热源的辐射热传导可能会和生物大分子的结构调整发生谐振从而不表现出样品整体宏观的升温。生物功能性大分子关键部位局部加热的谐振吸收是微波等物理因素的非热生物效应的可能作用机制。     

Chemoradiation followed by chemotherapy before resection for borderline pancreatic adenocarcinoma

BACKGROUND: For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. METHODS: A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. RESULTS: Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis < or = 60% was associated with recurrence and poor survival. CONCLUSIONS: Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival.     

Medical versus surgical management of biliary tract disease in pregnancy

BACKGROUND: The management of symptomatic cholelithiasis during pregnancy remains controversial. We compared outcomes after medical versus surgical management of biliary tract disease in pregnant patients. METHODS: We reviewed the clinical course of patients with symptomatic cholelithiasis during pregnancy from 1992 to 2002 at two university hospitals. RESULTS: Seventy-six women with 78 pregnancies were admitted with biliary tract disease. Of the 63 women who presented with symptomatic cholelithiasis, 10 underwent surgery while pregnant. There were no deaths, preterm deliveries, or intensive care unit admissions. Fifty-three patients were treated medically. Their clinical courses were complicated by symptomatic relapse in 20 patients (38%), by labor induction to control biliary colic (8 patients), and by premature delivery in 2 patients. Each relapse in the medically managed group accounted for an additional five days in hospital. CONCLUSION: Surgical management of symptomatic cholelithiasis in pregnancy is safe, decreases days in hospital, and reduces the rate of labor induction and preterm deliveries.