The Coraliance study: non-compliant behavior. Results after a 6-month follow-up of patients on oral contraceptives

Objectives This follow-up study was planned to establish the frequency with which women miss their contraceptive pill, and to observe their behavior when they forget it. In those women who changed from a continuous cycle to an interrupted type of cycle, or vice versa, the study also aimed to evaluate the impact of this change on the pattern of omission of pills. Methods The longitudinal, prospective cohort study included healthy women of child-bearing age for whom a change of pill was being prescribed by their gynecologist. Data were recorded during the 6 months preceding inclusion in the study, and for the 6 months of follow-up; the women were asked to complete a diary in which they recorded the number and exact times of pill omission, and their behavior at each omission. Results A total of 617 gynecologists included 3316 women into the study; of these, a group of 2418 (73%) revisited the same gynecologist at follow-up. The groups who either visited the same or a different gynecologist were similar with respect to age, oral contraception type, omission type and frequency. A large non-compliance rate and women's difficulties in maintaining safe contraception after missing a pill were observed in the group with follow-up. Women were never risk-free when they missed a pill; they turned to numerous sources for discordant or conflicting information; 15% of 'not-forgetting' women at the pre-inclusion cycle recorded at least one omission at the last cycle of the 6-month follow-up period. Omission fluctuations during the observational period make it difficult to designate 'forgetful' or 'non-forgetful' classes of women. Administration of the pill in a continuous cycle, and probably 'study' and 'auto-questionnaire' effects, contributed to an improvement in compliance. In the group taking the continuous cycle pill, the omission number slightly decreased, particularly on the first day and week of the cycle, irrespective of the initial cycle type. Conclusions The importance of the phenomenon of non-compliance rate is confirmed as well as women's difficulties in knowing how to maintain contraceptive safety. The continuous cycle regimen is likely to improve women's compliance during the critical period of the cycle.     

Effect of vitrification of mouse oocyte on the behavior of adult offspring

Objective

To evaluate the effect of vitrification of mouse oocytes on the behavior of adult offspring.

Study design

Oocytes from mice were vitrified, warmed and inseminated, and two-cell embryos were transferred to foster mothers. The behavioral characterization of the offspring was detected by the Morris water maze test, forced swimming test, and elevated plus maze test, and compared to that of offspring from fresh oocytes.

Results

Offspring produced by vitrified oocytes showed normal motor function. In the Morris water maze test of spatial learning there was a slightly decreased time spent in the quadrant containing the platform relative to mice from fresh oocytes, but the difference did not reach statistical significance. In addition, offspring from vitrified oocytes did not exhibit alterations in emotional behavior.

Conclusion

No alterations were found in the behavioral characterization of adult offspring from vitrified oocytes compared with those from fresh oocytes.     

Expanding the criteria for defining success when evaluating weight loss intervention programs

In order to evaluate outcomes among former participants in a residential weight loss program, attendees were surveyed from 1 to 5 years post-intervention. A total of 187 respondents were studied for weight changes and behavioral practices. Diet practices were assessed by number of servings per day using the Food Guide Pyramid recommendations as a guideline for indicating fruit and vegetable intake. Exercise behaviors were measured in frequency, duration, and intensity, and a weighted score was computed to obtain units for describing physical activity. Maintaining a 10% weight loss from the program entry weight, consuming five or more servings per day of fruits and/or vegetables (5-a-day) and maintaining an "active" level of physical activity were included in criteria for describing intervention success. Those meeting two of the three criteria were categorized as "successful," which included 35.8% of the study population. Because each of these behaviors (5-a-day, active lifestyle, and modest weight loss maintenance) result in independent risk reduction, it is recommended that future weight loss intervention evaluations expand the criteria for describing successful impacts and outcomes to include not only weight maintenance, but also physical activity and diet compliance behaviors.     

Psychophysiological insomnia: combined effects of pharmacotherapy and relaxation-based treatments

Objective: To compare treatment outcomes associated with combined pharmacologic and non-pharmacologic treatments for psychophysiological insomnia.Background: Treatments for insomnia have included a variety of pharmacotherapy and cognitive–behavioral interventions, although few studies have investigated the combined efficacy of drug and non-drug therapy.Methods: Forty-one patients with primary insomnia were randomly assigned to one of three treatment groups: (i) estazolam + muscle relaxation, (ii) estazolam + guided imagery, and (iii) estazolam + sleep education. After 4 weeks of active treatment, subjects were withdrawn from medication and followed for an additional 6 months.Results: Significant improvements were observed in self-report measures of total sleep time, sleep efficiency, and wakefulness after sleep onset in the combined drug and relaxation groups, compared to a significant improvement in total sleep time only in the educational control group. At follow-up, all three groups showed significant improvements across the major sleep measures. Positive changes were also observed in quality of life measures, including mood state and self- ratings of daytime arousal.Conclusions: These findings provide support for the value of combined pharmacotherapy and relaxation training in the treatment of psychophysiological insomnia.     

性行为越轨的边界

轨是维护社会运行以及能否得到社会群体默认、接受或认可的潜在或现实规则、规范。性越轨的判定标准既有不确定性,又有确定性。衡量性行为是否越轨的标准包括:统计标准、医学标准、伦理标准和法律标准。这四个标准是不可分割的,同时又具有相对独立性。判断性行为是否越轨应遵循三个原则:无伤害原则、自愿原则和私事原则。笔者按照这三个原则,对传统意义上的几种性越轨行为应重新进行梳理和判定,以期在社会运行的不同层面重建性秩序,维护社会生活的良性运行与和谐发展。     

Practical approaches to the treatment of severe pediatric obesity

Pediatric obesity is a major public health threat. Obese children and adolescents are at increased risk for many medical and surgical conditions. These conditions may affect their quality of life and life expectancy. The rapidly progressive nature of type 2 diabetes mellitus within the first 5?years?of obesity diagnosis is particularly concerning. Because health risk increases with degree of obesity, adolescents who may be eligible for more aggressive obesity treatment should be identified and counseled.     

The effects of maternal stress and child language ability on behavioral outcomes of children with congenital hearing loss at 18-24months

Background

Prior studies have shown that children with congenital hearing loss have increased rates of behavior disorders. Child hearing loss has also been reported to be associated with increased maternal stress. Little is known about the behavior or the predictors of behavioral outcomes of children with hearing loss identified early and receiving Early Intervention services.

Aim

The objective of this study was to identify the behavioral outcomes in early identified children with hearing loss and control hearing children at 18-24 months of age and to examine the impact of stress on early behavior development. It was hypothesized that children with hearing loss will have more behavior problems, and maternal stress will be associated with child behavior problems.

Study design

Prospective observational.

Subjects

Children with and without congenital hearing loss and their mothers.

Outcome measures

The Parenting Stress Index and the Child Behavior Checklist.

Results

Children with hearing loss had increased scores for withdrawn and internalizing behavior. In multivariate analyses after adjusting for hearing loss, Neonatal Intensive Care Unit stay, and socioeconomic status, maternal stress independently contributed to higher scores for internalizing behavior, externalizing behavior, and total behavior problems.

Conclusion

Maternal stress is an important correlate of behavior problems for children with hearing loss and should be considered by Early Intervention providers.     

913名吸毒人员HIV感染的相关行为调查

目的:分析广东省中山市吸毒人群HIV感染的相关行为、态度、知识,为制定预防措施提供依据。方法:采用访谈、问卷调查和血清流行病学对吸毒者进行横断面调查。结果:HIV感染率为5.37％。静脉注射吸毒占吸毒人员的49.9％;静脉注射吸毒共用针具率为64.19％;96.60％的人对艾滋病知识有一定的了解,但不全面。结论:针对该人群特点,采取有效的健康教育和干预措施,预防HIV在该人群中流行。     

广州市部分高校学生性病艾滋病知识、性态度及性行为状况调查分析

目的:了解当代高校学生性病艾滋病防治知识知晓程度及性态度、性行为现状,为制订性病艾滋病宣传教育及干预工作措施提供参考。方法:以问卷形式对本市几间高校不同专业学生进行调查,并对获得的数据进行统计分析。结果:共调查2 656人,接受调查的高校学生对性病艾滋病知识掌握不全面,在6种性病中,平均能正确鉴别(2.86±1.65)种;性观念趋于开放化,性行为发生率较高(971/2 656,占36.56%),但安全套使用率低,部分大学生还存在多性伴、从事或接受商业性服务、饮酒或服用精神毒品类药物后性行为等高危行为。结论:应在高校中进一步加强性病艾滋病宣传教育,普及性病艾滋病防治知识和生殖健康知识,纠正学生的错误理解和认识误区,提高自我保护的意识和技能,使大学生在获得知识的基础上发生态度及行为的改变,控制性病艾滋病在青年学生群体中的传播。