Understanding gender differences in condom use self-efficacy among youth in urban Cameroon.

The aim of this study was to understand gender differences in components of condom use self-efficacy to inform the design of effective reproductive health interventions for youth. Data stem from a July to August 2000 reproductive health survey among youth aged 15-24. Gender differentials in self-efficacy are analyzed using logistic regression. Perceived ability to discuss and negotiate condom use is high for both sexes. Women are less likely than men to know correct condom use (58% vs. 80%, p<.01) but are more likely to be shy buying condoms (67% vs. 50%, p<.01). Prior experience buying and using condoms, parental support, and condom promotion affect perceived ability to correctly use condoms and shyness buying condoms. Programs aiming to increase self-efficacy in condom use should focus on increasing confidence in youth's ability to buy condoms and to use them correctly, especially for young women. There is a need for programs that publicize and/or increase access to youth-friendly outlets and increase the acceptability of young women buying condoms.     

Can we import quality tools? a feasibility study of European practice assessment in a country with less organised general practice

Background  

Quality is on the agenda of European general practice (GP). European researchers have, in collaboration, developed tools to assess quality of GPs. In this feasibility study, we tested the European Practice Assessment (EPA) in a one-off project in Belgium, where general practice has a low level of GP organisation.     

The subjective quality of life in deficit and nondeficit schizophrenic patients.

We assessed the subjective quality of life (QOL) of 30 deficit schizophrenic patients compared to 112 nondeficit schizophrenic patients. The deficit patients did not differ in term of QOL, total score of positive symptoms, general psychopathology from the nondeficit patients. This result suggested an absence of impact of primary negative symptoms on the subjective QOL in schizophrenic patients.     

The effects ofN-methyl-d-aspartate and kainate lesions of the rat striatum on striatal ornithine decar☐ylase activity and polyamine levels

The intrastriatal injection ofN-methyl-d-aspartate (NMDA) (250 nmol) produced a delayed and marked increase in striatal ornithine decar☐ylase (ODC) activity and putrescine levels which peaked 6–15 h following the injection of NMDA. Striatal ODC activity subsequently returned to normal values while putrescine levels remained significantly elevated for up to 4 days following the lesion. NMDA produced an early and progressive decline in striatal spermine and spermidine levels, preceding the increase in ODC activity, with a maximum effect 2 h following injection. Spermidine levels returned to normal 6 h post-NMDA infusion, and subsequently increased to above normal levels 36 h and 4 days after the infusion of NMDA. This late increase in striatal spermidine levels paralleled an increase in the binding of the glial cell/macrophage marker [³H]PK 11195. Spermine levels tended to return to normal values 6 h after the injection of NMDA but may be further depressed at later intervals (15 h to 4 days). The intrastriatal injection of saline also resulted in a delayed increase in striatal ODC activity and putrescine levels, but these changes were minor compared to those produced by NMDA. Intrastriatal saline injection provoked no consistent change in striatal spermine or spermidine levels. The changes in polyamine metabolism produced by the instriatal injection of kainic acid (4 nmol) were only analysed at 6 and 15 h following injection but were qualitatively similar to those produced by NMDA although perhaps following a slightly more delayed time-course. Neurotoxic lesions of the striatum thus provoke changes in ODC activity and increased levels of putrescine that follow closely the time-course of similar events in the ischaemic brain. The initial early changes in spermine and spermidine levels induced by NMDA could perhaps alter the functioning of the NMDA receptor itself via its polyamine-sensitive modulatory site and contribute to a feed-forward activation of NMDA receptors and prolonged NMDA receptor-mediated toxicity.     

Influence of epidermal growth factor on photodynamic therapy of glioblastoma cells in vitro

Photodynamic therapy (PDT) could be a useful adjuvant in glioblastoma treatment. The fact that epidermal growth factor (EGF) and its receptor are involved in glioblastoma growth control led us to investigate the relationships between EGF and PDT with respect to three different glioma cell lines (C6, T98 G, U87 MG) responsive to growth stimulation by EGF. Flow cytometric analysis revealed that each cell line expressed EGF receptors. PDT was then applied to the cells using haematoporphyrin derivative (HPD) as photosensitizer and argon laser irradiation. When cells were incubated for 2 h with HPD (0.1–10 μg/ml) and then laser-irradiated (λ = 514 nm; energy density 25 J/cm²), all three cell lines showed photosensitivity. The median lethal dose was respectively 3, 4.5 and 2.7 μg/ml for C6, T98 G and U87 MG. EGF (2–50 ng/ml) had no effect on HPD- and laser-induced toxicity when added to cells before PDT, whereas toxicity decreased for all three cell lines when EGF was added after PDT. HPD (1–2 μg/ml, incubation times 30–180 min) also induced an increase in EGF receptor expression for the C6 line.     

Prevention of acquired infections in intubated patients with the combination of two decontamination regimens

OBJECTIVE: The use of topical polymyxin and tobramycin to prevent intensive care infections is controversial. Moreover, these antibiotics are ineffective against methicillin-resistant Staphylococcus aureus. A decontamination regimen using mupirocin and chlorhexidine could prevent acquired infections, including those involving S. aureus. Because these two regimens could have a complementary role, we evaluated their effects when given both alone and combined. DESIGN: The authors conducted a multiple-center, placebo-controlled, randomized, double-blind study performed according to a 2 x 2 factorial design. SETTING: The study was conducted at three polyvalent medical intensive care units at university-affiliated hospitals in France. PATIENTS: Adult patients (age, > or =18 yrs) intubated for <48 hrs who were likely to be ventilated for >48 hrs. INTERVENTION: Two regimens were used: topical administration of polymyxin/tobramycin (or placebo) and nasal mupirocin with chlorhexidine body washing (or nasal placebo with liquid soap). The patients (n = 515) received polymyxin/tobramycin alone (n = 130), mupirocin/chlorhexidine alone (n = 130), both regimens (n = 129), or all placebos (n = 126) for the period of mechanical ventilation plus 24 hrs. MEASUREMENTS AND MAIN RESULTS: The incidence of total infections acquired from the date of randomization until the termination date of study treatments plus 48 hrs was assessed. There were fewer acquired infections with both regimens than with polymyxin/tobramycin alone (odds ratio, 0.44; 95% confidence interval, 0.26-0.75; p = .003), mupirocin/chlorhexidine alone (0.43; 0.25-0.73; p = .002), or all placebos (0.42; 0.25-0.72; p = .001). There were no differences between polymyxin/tobramycin alone (0.95; 0.59-1.54; p = .84) and mupirocin/chlorhexidine alone (0.98; 0.60-1.58; p = .92) vs. all placebos. The probability of freedom from infection was higher with both regimens than with polymyxin/tobramycin alone (p = .002), mupirocin/chlorhexidine alone (p < .001), or all placebos (p < .001). Infection rates were also significantly lower with both regimens than with polymyxin/tobramycin alone (p = .017), mupirocin/chlorhexidine alone (p < .001), or all placebos (p < .001). CONCLUSION: Acquired infections were substantially reduced by mupirocin/chlorhexidine plus polymyxin/tobramycin, whereas each regimen given alone was ineffective. Whether both regimens could increase Candida infections deserves further investigation.