Addressing the costs of quitting' smoking: a health promotion issue for adolescent girls in Canada

While intense efforts have been implemented to address the problemof cigarette smoking, the prevalence of tobacco use among adolescents,in particular young women, remains high. Older adolescent girlsare joining their younger counterparts in taking up the smokinghabit. The literature has examined the reasons for young peoplestarting to smoke; however, little is known about the smokingcessation process in adolescents. This paper reports findingsfrom an in-depth qualitative study of 25 girls ages 18 and 19which uncovered the struggles young women experience as theyattempt to quit smoking. These struggles and losses are referredto as the ‘costs’ of quitting smoking. The ‘costs’reflect not only their ‘real’ experiences when attemptingto quit smoking, but also reflect ‘anticipated’struggles and losses. The study addressed the ‘costs’in relation to the social, emotional and physiological domainsof the adolescent girl's life. Findings from this research projectprovide theoretical direction for the development of comprehensivehealth promotion interventions. If health care professionalsare to assist in reducing cigarette smoking among young women,the ‘costs’ which girls see to quitting smokingmust be considered.     

妇科针灸适应病症的临床及实验研究现状

目的 综述针灸对妇科适应病症作用机理研究概况。方法 通过针灸对妇科适应病症在下丘脑、垂体、卵巢各水平激素的影响进行综合分析。结果 针灸治疗妇科疾症主要是通过激活下丘脑－垂体－卵巢轴,机体的免疫机制,神经＝生殖内分泌－免疫调控,对女性生殖系统发挥双向调整使用,达到治疗疾病的目的。结果 脑－痛－冲任－胞宫轴与中枢－下丘脑－垂休－卵巢轴相应为中西医治疗和研究妇科疾病提供了理论依据,有待进一步探讨。     

核素输卵管显像诊断不孕症的价值

目的通过对31例不孕症妇女(60侧输卵管)行改进的核素输卵管造影(RNHS),评价该方法对判断不孕症妇女输卵管通畅程度的价值。资料与方法一次性导尿管直接插入宫腔,37MBq99mTcO4经导管注入后动态采集,同时缓慢加压注入生理盐水,然后行静态采集。其中10例(20侧输卵管)行X线子宫输卵管碘油造影进行对照。结果RNSH示输卵管通41例,阻塞19侧。以子宫输卵管碘油造影为诊断标准,RNHS灵敏度为85.7％,特异性为84.6％。结论RNHS有效,安全,无创,值得在临床推广应用。     

Declines in violence and police arrest among female sex workers in Karnataka state,south India,following a comprehensive HIV prevention programme

Introduction

Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact.

Methods

As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non-partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors.

Results

5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p<0.001), being arrested in the past year [adjusted odds ratio (AOR) 0.57 (0.35, 0.93), p=0.025] and being beaten in the past six months by a non-partner (clients, police, pimps, strangers, rowdies) [AOR 0.69 (0.49, 0.95), p=0.024)] (IBBA). The proportion drinking alcohol (during the past week) also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001). Violence by non-partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), p<0.001; AOR 2.79 (1.93, 4.04), p<0.001, respectively], reduced condom self-efficacy with clients [AOR 0.36 (0.27, 0.47), p<0.001; AOR 0.62 (0.39, 0.98), p=0.039, respectively], symptomatic STI (during the past year) [AOR 2.62 (2.07, 3.30), p<0.001; AOR 2.17 (1.51, 3.13), p<0.001, respectively], gonorrhoea infection [AOR 2.79 (1.51, 5.15), p=0.001; AOR 2.69 (0.96, 7.56), p=0.060, respectively] and syphilis infection [AOR 1.86 (1.04, 3.31), p=0.036; AOR 3.35 (1.78, 6.28), p<0.001, respectively], but not with exposure to peer education, community mobilization or HIV testing uptake. Mediation analysis suggests that alcohol use and STIs may partially mediate the association between violence or arrests and HIV prevalence.

Discussion

Violence by non-partners and arrest are both strongly associated with HIV infection among FSWs. Large-scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.     

壮骨止痛胶囊调控自噬相关蛋白对去卵巢大鼠骨髓间充质干细胞增殖与骨向分化的影响

目的 观察壮骨止痛胶囊调控自噬相关蛋白Beclin1、p62、LC3对去卵巢雌性大鼠骨向分化的影响.方法 去除大鼠双侧卵巢进行造模,造模成功后分为模型组、壮骨止痛胶囊组、雷帕霉素(RAPA)组和3-甲基腺嘌呤(3-MA)组,另设空白组、假手术组(仅去除卵巢周围相应体积脂肪),每组7只.通过骨髓间充质干细胞(BMMSCs...     

女性假两性畸形诊断和治疗

目的 探讨先天性肾上腺皮质增生所致女性假两性畸形的诊断和治疗方法。方法 对5例先天性肾上腺皮质增生所致女性假两性畸形的临床资料进行回顾性分析。结果 5例患者,社会性别女性4例,男性1例,年龄6～21岁,平均13岁,1例有母系两性畸形家族史。5例均外阴发育异常。实验室检查血皮质醇均低,促肾上腺皮质激素、睾酮升高,性染色体核型均为46XX,B超检查可见子宫、卵巢,未见睾丸。5例患者均行女性外阴整形术和糖皮质激素的综合治疗,术后外阴外观满意,第二性征接近女性。结论 女性假两性畸形患者应尽早诊治。外生殖器畸形矫形术和皮质激素补充治疗可使患者获得满意治疗效果和生活质量。     

Magnetic Resonance Imaging of Benign and Malignant Adnexal Diseases: A Review

The authors describe the objectives of performing magnetic resonance imaging in the diagnosis of a variety of common and uncommon benign and malignant adnexal diseases. Depending on the clinical findings, the utility of magnetic resonance imaging is campared with ultrasound, computed tomography, laparoscopy, and surgery. The differentiating points between benign and malignant tumours are emphasized in detail. The classification of the ovarian tumours and the staging system of ooarian malignancy are revisited.     

Brief Report: Prosocial option increases women’s entry into competition

We provide evidence that women enter competitions at the same rate as men when the incentive for winning includes the option to share part of the rewards with the losers (i.e., when the incentive system is socially oriented). Using an experiment (with N = 238 subjects from three laboratories), we find that about 16% more men than women choose to compete in the standard tournament; this gender gap is eliminated in the socially oriented incentive treatment. While men’s choice to compete remains unchanged, at around 52% in both conditions, women increase their entry rate from 35% in the standard tournament to 60% when the incentive includes a socially oriented option.     

Reconstructing Sexuality after Excision: The Medical Tools

ABSTRACT

Clitoral reconstructive surgery is not sufficient to restore women’s sexual pleasure after excision. If the surgical technique aims at reconstructing the cut clitoris after type 2 female genital mutilation, the surgery alone cannot reconstruct other dimensions invoked by women in their requests for the procedure. In France, where clitoral reconstructive surgery since 2004 has been entirely covered by national insurance, a multidisciplinary approach precedes the surgery. Ethnographic fieldwork in one public hospital contributes a wider comprehension of the entire process of clitoral reconstruction, as well as the tools elaborated by the medical team. In particular, analysis of the assessments of the psychologist and sex therapist compiled in the medical folders shows how the multidisciplinary medical team developed specific tools. These tools are oriented at reconstructing the patient’s sexual sensibility, at breaking through psychological blocks such as self-esteem and body image, and/or at addressing abusive intimate relationships.