Factors Influencing Adolescent Girls’ Sexual Behavior: A Secondary Analysis of the 2011 Youth Risk Behavior Survey

Adolescence is a tumultuous and challenging time period in life. Sexual risk behavior among adolescents is a widespread topic of interest in the current literature. Two common factors that influence increased sexual risk behavior are symptoms of depression and negative body image. The purpose of this study was to investigate the effect of body image and symptoms of depression upon sexual risk-taking in an adolescent female population. A secondary data analysis of the 2011 Youth Risk Behavior Survey (YRBS) was used to explore girls’ sexual activity, body image, and mental health. There were 7,708 high-school girls who participated in this study. Three questions were used to represent the constructs under investigation. There were significant correlations between sexual activity, body image, and symptoms of depression; only symptoms of depression were significant predictors of both sexual activity and condom usage. Body image was a predictor of sexual activity, but not condom use. Our findings support previous studies that suggested that people with depressive symptoms were more likely to engage in risky sexual behaviors. Our study also supports the idea that a negative body image decreases sexual activity; however, other researchers have reported that negative body image leads to an increase in sexual activity.     

Transplanting the Highly Sensitized Patient: The Emory Algorithm

Renal transplant patients sensitized to HLA antigens comprise nearly one-third of the UNOS wait-list and receive 14% of deceased donor (DD) transplants, a rate half that of unsensitized patients. Between 1999 and 2003, we performed 492 adult renal transplants from DD; 120 patients (approximately 25%) had a panel reactive antibody (PRA) of >30%, with nearly half (n = 58) having a PRA of >80%. Our approach is based upon high-resolution solid-phase HLA antibody analysis to identify class I/II antibodies and a 'virtual crossmatch' to predict compatible donor/recipient combinations. Recipients are excluded from the United Network for Organ Sharing match run if donors possess unacceptable antigens. Thus, when sensitized patients appear on the match run, they have a high probability of a negative final crossmatch. Here, we describe our 5-year experience with this approach. Five-year graft survival ranged from 66% to 70% among unsensitized (n = 272), moderately sensitized (PRA < 30%, n = 100) and highly sensitized (>30% PRA; n = 120) patients, equal to the average national graft survival (65.7%). The application of this approach (the Emory Algorithm) provides a logical and systematic approach to improve the access of sensitized patients to DD organs and promote more equitable allocation to a highly disadvantaged group of patients awaiting renal transplantation.     

Response to treatment with rosiglitazone in familial partial lipodystrophy due to a mutation in the LMNA gene

Background Familial partial lipodystrophy (FPLD) is a monogenic form of diabetes characterised by a dominantly inherited disorder of adipose tissue associated with the loss of subcutaneous fat from the limbs and trunk, with excess fat deposited around the face and neck. The lipodystrophy causes severe insulin resistance, resulting in acanthosis nigricans, diabetes, dyslipidaemia, and increased risk of cardiovascular disease. Preliminary results from animals and man suggest that increasing subcutaneous fat by treatment with thiazolidinediones should improve insulin resistance and the associated features of this syndrome. Case report We report a 24-year-old patient with FPLD caused by a mutation in the LMNA gene (R482W) treated with 12 months of rosiglitazone. Subcutaneous fat increased following rosiglitazone treatment as demonstrated by a 29% generalised increase in skin-fold thickness. Leptin levels increased from 5.8 to 11.2 ng/ml. Compared with treatment on Metformin, there was an increase in insulin sensitivity (HOMA S% 17.2–31.6) but no change in glycaemic control. The lipid profile worsened during the follow-up period. Conclusion This initial case suggests that, for modification of cardiovascular risk factors, there are no clear advantages in treating patients with FPLD with rosiglitazone despite increases in subcutaneous adipose tissue. Larger series will be needed to identify moderate beneficial effects and treatment may be more effective in patients with generalised forms of lipodystrophy.     

An ecologically based examination of barriers to physical activity in students from grade seven through first-year university

PurposeThe first purpose was to identify barriers to physical activity that students in grade seven through first-year university experienced. A second purpose was to classify barriers using an ecological framework and to examine the pattern of barrier categories (i.e., intrapersonal, interpersonal, institutional, community, public policy, and physical environmental) and specific barrier types as grade increased. The use of an ecological model addressed limitations in prior research revolving around the identification of salient barriers in a manner that makes the design of effective interventions difficult.MethodsParticipants in grades 7–8 (n = 35), 9–10 (n = 67), 11–12 (n = 80), and the freshmen year of university (n = 109) listed barriers to physical activity on an open-ended measure.ResultsFindings revealed a trend for the average number of barriers reported per student to increase as grade in school increased. First-year university students reported significantly more barriers than all other grade groupings. The frequency of barriers reported within the ecological categories was dependent on the specific grade groupings. Further, within each ecological category, distinct barriers were reported across the different grade groupings.ConclusionsFindings highlight the utility of using an ecological model to categorize barriers, rather than simply classifying barriers as internal or external to an individual, as done in prior research. Understanding the pattern of ecologically based barrier categories and specific types of barriers will help to inform the content of future research and interventions designed to alleviate salient barriers to physical activity.     

A nursing approach to the management of type IIA hyperlipidemia: case study of a young adult

This case study illustrates the chronic nature of hyperlipidemia type IIa and the important contribution of the nurse in helping the client adjust life style, manage complex health regimes, and cope with the uncertainty of disease progression and its associated risks.     

The influence of stigma on the sexual risk behavior of rural men who have sex with men.

Research investigating predictors of risky sexual behavior of rural MSM is sparse, even though the prevalence of HIV in rural areas has increased. This study explored two sets of predictors of 93 rural MSM's levels of risky sexual behavior: mental health variables and stigma emanating from men's family members, health care professionals, and people in the rural communities in which they live. Over 47% of the men were found to be at modified high to high risk. Logistic regression using a continuation logit model was used to test the relationship of the predictor variables and the four levels of risk. Findings indicate that self-esteem was predictive of the highest sexual risk behavior but not lower levels of risk. Stigma was predictive of modified high sexual risk when compared to low and no risk categories. No variables differentiated men at low risk from men at no risk.