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AIM: Sexual risk behaviour was explored and described using Social Action Theory. BACKGROUND: The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence. DESIGN: Cross-sectional survey. METHODS: Self-report questionnaire administered to adults living with HIV/AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011. FINDINGS: Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use. CONCLUSION: Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk.
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Infecciones por VIH/transmisión , Conductas de Riesgo para la Salud , Sexo Inseguro , Adolescente , Adulto , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Infecciones por VIH/psicología , Humanos , Masculino , Modelos Teóricos , Autoinforme , Parejas Sexuales , Teoría SocialRESUMEN
Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA.
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Empatía , Infecciones por VIH/psicología , Asunción de Riesgos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Psicológicas , Autoimagen , Autoinforme , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricosRESUMEN
The social environment impacts the ability of older adults to interact successfully with their community and age-in-place. This study asked, for the first time, residents of existing Lesbian, Gay, Bisexual, and Transgender (LGBT) senior living communities to explain why they chose to live in those communities and what, if any, benefit the community afforded them. Focus groups were conducted at 3 retirement communities. Analysis found common categories across focus groups that explain the phenomenon of LGBT senior housing. Acceptance is paramount for LGBT seniors and social networks expanded, contrary to socioemotional selectivity theory. Providers are encouraged to develop safe spaces for LGBT seniors.
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Bisexualidad , Homosexualidad Femenina , Homosexualidad Masculina , Viviendas para Ancianos , Personas Transgénero , Anciano , Anciano de 80 o más Años , Bisexualidad/psicología , Femenino , Grupos Focales , Homofobia/psicología , Homosexualidad Femenina/psicología , Homosexualidad Masculina/psicología , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Apoyo Social , Personas Transgénero/psicologíaRESUMEN
BACKGROUND: Human rights approaches to manage HIV and efforts to decriminalize HIV exposure/transmission globally offer hope to persons living with HIV (PLWH). However, among vulnerable populations of PLWH, substantial human rights and structural challenges (disadvantage and injustice that results from everyday practices of a well-intentioned liberal society) must be addressed. These challenges span all ecosocial context levels and in North America (Canada and the United States) can include prosecution for HIV nondisclosure and HIV exposure/transmission. Our aims were to: 1) Determine if there were associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital (resources to support one's life chances and overcome life's challenges), and HIV antiretroviral therapy (ART) adherence among PLWH and 2) describe the nature of associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital, and HIV ART adherence among PLWH. METHODS: We used ecosocial theory and social epidemiology to guide our study. HIV related criminal law data were obtained from published literature. Perceived social capital and HIV ART adherence data were collected from adult PLWH. Correlation and logistic regression were used to identify and characterize observed associations. RESULTS: Among a sample of adult PLWH (n = 1873), significant positive associations were observed between perceived social capital, HIV disclosure required by law, and self-reported HIV ART adherence. We observed that PLWH who have higher levels of perceived social capital and who live in areas where HIV disclosure is required by law reported better average adherence. In contrast, PLWH who live in areas where HIV transmission/exposure is a crime reported lower 30-day medication adherence. Among our North American participants, being of older age, of White or Hispanic ancestry, and having higher perceived social capital, were significant predictors of better HIV ART adherence. CONCLUSIONS: Treatment approaches offer clear advantages in controlling HIV and reducing HIV transmission at the population level. These advantages, however, will have limited benefit for adherence to treatments without also addressing the social and structural challenges that allow HIV to continue to spread among society's most vulnerable populations.
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Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Conducta Social , Adulto , Crimen , Femenino , Infecciones por VIH/transmisión , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , América del NorteRESUMEN
The interaction of PD-L1 with PD-1 is a major immune checkpoint that limits effector T cell function against cancer cells; monoclonal antibodies that block this pathway have been approved in multiple tumor indications. As a next generation therapy, small molecule inhibitors of PD-L1 have inherent drug properties that may be advantageous for certain patient populations compared to antibody therapies. In this report we present the pharmacology of the orally-available, small molecule PD-L1 inhibitor CCX559 for cancer immunotherapy. CCX559 potently and selectively inhibited PD-L1 binding to PD-1 and CD80 in vitro, and increased activation of primary human T cells in a T cell receptor-dependent fashion. Oral administration of CCX559 demonstrated anti-tumor activity similar to an anti-human PD-L1 antibody in two murine tumor models. Treatment of cells with CCX559 induced PD-L1 dimer formation and internalization, which prevented interaction with PD-1. Cell surface PD-L1 expression recovered in MC38 tumors upon CCX559 clearance post dosing. In a cynomolgus monkey pharmacodynamic study, CCX559 increased plasma levels of soluble PD-L1. These results support the clinical development of CCX559 for solid tumors; CCX559 is currently in a Phase 1, first in patient, multicenter, open-label, dose-escalation study (ACTRN12621001342808).
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Antígeno B7-H1 , Neoplasias , Humanos , Ratones , Animales , Antígeno B7-H1/metabolismo , Inhibidores de Puntos de Control Inmunológico , Receptor de Muerte Celular Programada 1 , Macaca fascicularis , Anticuerpos Monoclonales , Neoplasias/tratamiento farmacológico , Inmunoterapia/métodosRESUMEN
The identification of novel peptide hormones by functional screening is challenging because posttranslational processing is frequently required to generate biologically active hormones from inactive precursors. We developed an approach for functional screening of novel potential hormones by expressing them in endocrine host cells competent for posttranslational processing. Candidate preprohormones were selected by bioinformatics analysis, and stable endocrine host cell lines were engineered to express the preprohormones. The production of mature hormones was demonstrated by including the preprohormones insulin and glucagon, which require the regulated secretory pathway for production of the active forms. As proof of concept, we screened a set of G-protein-coupled receptors (GPCRs) and identified protein FAM237A as a specific activator of GPR83, a GPCR implicated in central nervous system and regulatory T-cell function. We identified the active form of FAM237A as a C-terminally cleaved, amidated 9 kDa secreted protein. The related protein FAM237B, which is 64% homologous to FAM237A, demonstrated similar posttranslational modification and activation of GPR83, albeit with reduced potency. These results demonstrate that our approach is capable of identifying and characterizing novel hormones that require processing for activity.
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Hormonas Peptídicas/aislamiento & purificación , Biblioteca de Péptidos , Transporte de Proteínas/genética , Receptores Acoplados a Proteínas G/genética , Humanos , Ligandos , Hormonas Peptídicas/genética , Hormonas Peptídicas/inmunología , Unión Proteica/genética , Transporte de Proteínas/inmunología , Receptores Acoplados a Proteínas G/antagonistas & inhibidores , Receptores Acoplados a Proteínas G/inmunología , Transducción de Señal/genética , Linfocitos T/inmunología , Linfocitos T/metabolismoRESUMEN
The HIV epidemic in the United States is not abating, and sexual activity is the transmission-risk factor most frequently reported among those newly infected. Many HIV-positive persons have difficulty disclosing their serostatus to sex partners (SPs) and may not use condoms consistently. The aims of the research were to explore patterns of disclosure to SPs among HIV-positive men (N = 93) and women (N = 23) living in Hawaii, and to explore factors influencing disclosure and condom use. Using a survey design, participants were asked about their sexual activity during a three-month recall period, including detailed information for up-to-three most recent SPs. A variety of demographic, HIV-illness, self-efficacy, and contextual variables were examined as potential factors influencing disclosure. A total of 278 SPs were reported with rates of disclosure and of condom use near 50% for both genders. Perceived self-efficacy (SE) for disclosure decision-making was associated with disclosure for both men and women. Not discussing a SP's serostatus was associated with nondisclosure for both men and women. Additional factors influencing disclosure for men included cocaine and marijuana use, and years since diagnosis. Being transgendered was associated with less disclosure, but the small sample size for women precludes generalization of findings. There was an association between disclosure and condom use for men but not for women. Nurses must routinely assess for client HIV transmission-risk behaviors, and encourage disclosure of serostatus to SPs. It is also essential to offer clients behavioral strategies that can enhance their intentions to use condoms.
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Seropositividad para VIH/psicología , Hombres/psicología , Autorrevelación , Conducta Sexual/psicología , Parejas Sexuales/psicología , Mujeres/psicología , Adulto , Análisis de Varianza , Actitud Frente a la Salud , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Seropositividad para VIH/complicaciones , Seropositividad para VIH/diagnóstico , Seropositividad para VIH/transmisión , Hawaii , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Evaluación en Enfermería , Investigación Metodológica en Enfermería , Teoría Psicológica , Asunción de Riesgos , Autoeficacia , Factores Sexuales , Conducta Sexual/estadística & datos numéricos , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología , Encuestas y CuestionariosRESUMEN
This paper describes the HIV/AIDS epidemic in Hawai'i over the last decade and identifies characteristics of those infected, including race/ethnicity, age, and risk behaviors related to HIV acquisition. State-based HIV/AIDS surveillance and counseling and testing data were reviewed, along with a comprehensive review of HIV/AIDS-related literature and reports emerging from agencies in Hawai'i. Recent legislative measures concerning HIV testing, counseling and HIV reporting were reviewed and summarized. Hawai'i continues to have low HIV/AIDS prevalence compared to other US states. There have been continuing changes in the face of HIV/AIDS in Hawai'i over the last decade, including increased number of AIDS cases among Hispanics and African Americans and a decreased percentage of cases among Caucasians and also among men who have sex with men. Legislative and policy changes have been implemented with the intent of enhancing the efficiency and quantity of HIV testing, and of strengthening the HIV prevention and care services offered in the State.
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Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Tamizaje Masivo , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/etnología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adulto , Etnicidad , Femenino , Infecciones por VIH/etnología , Hawaii/epidemiología , Humanos , Masculino , Factores de Riesgo , Adulto JovenRESUMEN
Music has been shown to reduce rating of perceived exertion, increase exercise enjoyment and enhance exercise performance, mainly in low-moderate intensity exercises. However, the effects of music are less conclusive with high-intensity activities. The purpose of this with-participant design study was to compare the effects of high tempo music (130 bpm) to a no-music condition during repeated high intensity cycling bouts (80% of peak power output (PPO)) on the following measures: time to exercise end-point, rating of perceived exertion (RPE), heart rate (HR), breathing frequency, ventilatory kinetics and blood lactate (BL). Under the music condition, participants exercised 10.7% longer (p = 0.035; Effect size (ES) = 0.28) (increase of 1 min) and had higher HR (4%; p = 0.043; ES = 0.25), breathing frequency (11.6%; p < 0.001; ES = 0.57), and RER (7% at TTF; p = 0.021; ES = 1.1) during exercise, as measured at the exercise end-point. Trivial differences were observed between conditions in RPE and other ventilatory kinetics during exercise. Interestingly, 5 min post-exercise termination, HR recovery was 13.0% faster following the music condition (p < 0.05) despite that music was not played during this period. These results strengthen the notion that music can alter the association between central motor drive, central cardiovascular command and perceived exertion, and contribute to prolonged exercise durations at higher intensities along with a quicken HR recovery.
RESUMEN
Parkinson's disease (PD) is associated with oxidative stress and decreased nigral glutathione (GSH), suggesting that therapies that boost GSH may have a disease-modifying effect. Intravenous administration of a high dose of N-acetylcysteine (NAC), a well-known antioxidant and GSH precursor, increases blood and brain GSH in individuals with PD and with Gaucher disease and in healthy controls. To characterize the pharmacokinetics of repeated high oral doses of NAC and their effect on brain and blood oxidative stress measures, we conducted a 4-week open-label prospective study of oral NAC in individuals with PD (n = 5) and in healthy controls (n = 3). Brain GSH was measured in the occipital cortex using 1 H-MRS at 3 and 7 tesla before and after 28 days of 6000 mg NAC/day. Blood was collected prior to dosing and at predetermined collection times before and after the last dose to assess NAC, cysteine, GSH, catalase, malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE) concentrations and the reduced-to-oxidized GSH ratio (GSH/ glutathione disulfide [GSSG]). Symptomatic adverse events were reported by 3 of the 5 subjects with PD. NAC plasma concentration-time profiles were described by a first-order absorption, 1-compartment pharmacokinetic model. Although peripheral antioxidant measures (catalase and GSH/GSSG) increased significantly relative to baseline, indicators of oxidative damage, that is, measures of lipid peroxidation (4-HNE and MDA) were unchanged. There were no significant increases in brain GSH, which may be related to low oral NAC bioavailability and small fractional GSH/GSSG blood responses. Additional studies are needed to further characterize side effects and explore the differential effects of NAC on measures of antioxidant defense and oxidative damage.
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Acetilcisteína/farmacología , Antioxidantes/farmacología , Encéfalo/efectos de los fármacos , Glutatión/metabolismo , Enfermedad de Parkinson/metabolismo , Administración Oral , Anciano , Anciano de 80 o más Años , Encéfalo/metabolismo , Catalasa/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Estrés Oxidativo/efectos de los fármacosRESUMEN
This case series investigates reports of 20 patients with colitis temporally associated with alpelisib use.
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Colitis , Tiazoles , Humanos , Estados Unidos/epidemiología , United States Food and Drug Administration , Protocolos de Quimioterapia Combinada Antineoplásica , Colitis/inducido químicamenteRESUMEN
PURPOSE OF THE STUDY: Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. DESIGN AND METHODS: We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. RESULTS: Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. IMPLICATIONS: By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed.
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Depresión/epidemiología , Identidad de Género , Salud Mental , Calidad de Vida , Estigma Social , Personas Transgénero/estadística & datos numéricos , Veteranos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/psicología , Femenino , Estado de Salud , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Personas Transgénero/psicología , Estados Unidos/epidemiologíaRESUMEN
Medication adherence is the "Plus" in the global challenge to have 90% of HIV-infected individuals tested, 90% of those who are HIV positive treated, and 90% of those treated achieve an undetectable viral load. The latter indicates viral suppression, the goal for clinicians treating people living with HIV (PLWH). The comparative importance of different psychosocial scales in predicting the level of antiretroviral adherence, however, has been little studied. Using data from a cross-sectional study of medication adherence with an international convenience sample of 1811 PLWH, we categorized respondent medication adherence as None (0%), Low (1-60%), Moderate (61-94%), and High (95-100%) adherence based on self-report. The survey contained 13 psychosocial scales/indices, all of which were correlated with one another (p < 0.05 or less) and had differing degrees of association with the levels of adherence. Controlling for the influence of race, gender, education, and ability to pay for care, all scales/indices were associated with adherence, with the exception of Berger's perceived stigma scale. Using forward selection stepwise regression, we found that adherence self-efficacy, depression, stressful life events, and perceived stigma were significant predictors of medication adherence. Among the demographic variables entered into the model, nonwhite race was associated with double the odds of being in the None rather than in the High adherence category, suggesting these individuals may require additional support. In addition, asking about self-efficacy, depression, stigma, and stressful life events also will be beneficial in identifying patients requiring greater adherence support. This support is essential to medication adherence, the Plus to 90-90-90.
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Fármacos Anti-VIH/uso terapéutico , Depresión/complicaciones , Infecciones por VIH/tratamiento farmacológico , Cumplimiento de la Medicación/psicología , Aislamiento Social/psicología , Estigma Social , Adulto , Estudios Transversales , Depresión/psicología , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/virología , Humanos , Acontecimientos que Cambian la Vida , Modelos Logísticos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Autoeficacia , Autoinforme , Apoyo Social , Factores Socioeconómicos , Estrés Psicológico , Encuestas y Cuestionarios , Carga ViralRESUMEN
We have studied lethal mutations in the single calmodulin gene (Cam) of Drosophila to gain insight into the in vivo functions of this important calcium sensor. As a result of maternal calmodulin (CaM) in the mature egg, lethality is delayed until the postembryonic stages. Prior to death in the first larval instar, Cam nulls show a striking behavioral abnormality (spontaneous backward movement) whereas a mutation, Cam7, that results in a single amino acid change (V91G) produces a very different phenotype: short indented pupal cases and pupal death with head eversion defects. We show here that the null behavioral phenotype originates in the nervous system and involves a CaM function that requires calcium binding to all four sites of the protein. Further, backward movement can be induced in hypomorphic mutants by exposure to high light levels. In contrast, the V91G mutation specifically affects the musculature and causes abnormal calcium release in response to depolarization of the muscles. Genetic interaction studies suggest that failed regulation of the muscle calcium release channel, the ryanodine receptor, is the major defect underlying the Cam7 phenotype.
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Calmodulina/genética , Drosophila/genética , Músculos/metabolismo , Mutación , Sistema Nervioso/metabolismo , Animales , Drosophila/crecimiento & desarrollo , Drosophila/fisiología , Fenotipo , Canal Liberador de Calcio Receptor de Rianodina/genéticaRESUMEN
Calcineurin is a Ca(2+)-calmodulin-activated, Ser-Thr protein phosphatase that is essential for the translation of Ca(2+) signals into changes in cell function and development. We carried out a dominant modifier screen in the Drosophila eye using an activated form of the catalytic subunit to identify new targets, regulators, and functions of calcineurin. An examination of 70,000 mutagenized flies yielded nine specific complementation groups, four that enhanced and five that suppressed the activated calcineurin phenotype. The gene canB2, which encodes the essential regulatory subunit of calcineurin, was identified as a suppressor group, demonstrating that the screen was capable of identifying genes relevant to calcineurin function. We demonstrated that a second suppressor group was sprouty, a negative regulator of receptor tyrosine kinase signaling. Wing and eye phenotypes of ectopic activated calcineurin and genetic interactions with components of signaling pathways suggested a role for calcineurin in repressing Egf receptor/Ras signal transduction. On the basis of our results, we propose that calcineurin, upon activation by Ca(2+)-calmodulin, cooperates with other factors to negatively regulate Egf receptor signaling at the level of sprouty and the GTPase-activating protein Gap1.
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Calcineurina/metabolismo , Proteínas de Drosophila , Drosophila/metabolismo , Receptores ErbB/metabolismo , Animales , Cruzamientos Genéticos , Proteínas de Unión al ADN/genética , Regulación hacia Abajo , Drosophila/crecimiento & desarrollo , Regulación del Desarrollo de la Expresión Génica , Proteínas Tirosina Quinasas Receptoras/genética , Transducción de Señal/fisiología , Alas de Animales/patologíaRESUMEN
HIV-positive men face multiple challenges when deciding whether to disclose their serostatus to sex partners. The purpose of this literature review (1996-2004) is to identify valid and reliable research results that identify factors influencing serostatus disclosure to sex partners by men who are HIV-positive. Articles included in the review were identified through an electronic search using pertinent terms related to disclosure to sex partners, followed by a search of references for additional articles. A compilation of research results for 17 articles is presented under the headings of background, contextual, and psychosocial factors influencing disclosure. An analysis of the data suggests that differences in disclosure rates vary based on sex partner factors including serostatus, relationship status, and number of sex partners. Rates of disclosure to primary sex partners ranged from 67% to 88%, suggesting that nearly one third of main sex partners were not disclosed to and were at risk of contracting HIV, whereas a pattern of lower disclosure among casual partners was evident. As the number of sex partners increased, the likelihood of disclosure to all sex partners decreased, ranging from one quarter (25%) to slightly over half (58%). In addition, perceived efficaciousness and positive outcome expectations were the most frequent theoretical constructs embedded in the research associated with disclosure, suggesting that these factors play an important role in the process of disclosure to sex partners. Interpersonal factors that positively influenced self-disclosure included spousal support, emotional investment, and communication about safe sex, including asking about a partner's serostatus. Self-disclosure was not consistently associated with safer sex. Recommendations for future research are presented, based on the results included in this review.
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Comunicación , Seropositividad para VIH , Hombres/psicología , Autorrevelación , Parejas Sexuales/psicología , Factores de Edad , Actitud Frente a la Salud , Escolaridad , Seropositividad para VIH/diagnóstico , Seropositividad para VIH/psicología , Homosexualidad Masculina/psicología , Humanos , Relaciones Interpersonales , Masculino , Motivación , Rol de la Enfermera , Proyectos de Investigación , Asunción de Riesgos , Sexo Seguro/psicología , Autoeficacia , Abstinencia Sexual/psicología , Apoyo Social , Factores Socioeconómicos , Estereotipo , Trastornos Relacionados con Sustancias/psicología , Estados UnidosRESUMEN
CONTEXT: Roller massagers are used as a recovery and rehabilitative tool to initiate muscle relaxation and improve range of motion (ROM) and muscular performance. However, research demonstrating such effects is lacking. OBJECTIVE: To determine the effects of applying a roller massager for 20 and 60 seconds on knee-joint ROM and dynamic muscular performance. DESIGN: Randomized controlled clinical trial. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: Ten recreationally active men (age = 26.6 ± 5.2 years, height = 175.3 ± 4.3 cm, mass = 84.4 ± 8.8 kg). INTERVENTION(S): Participants performed 3 randomized experimental conditions separated by 24 to 48 hours. In condition 1 (5 repetitions of 20 seconds) and condition 2 (5 repetitions of 60 seconds), they applied a roller massager to the quadriceps muscles. Condition 3 served as a control condition in which participants sat quietly. MAIN OUTCOME MEASURE(S): Visual analog pain scale, electromyography (EMG) of the vastus lateralis (VL) and biceps femoris during roller massage and lunge, and knee-joint ROM. RESULTS: We found no differences in pain between the 20-second and 60-second roller-massager conditions. During 60 seconds of roller massage, pain was 13.5% (5.7 ± 0.70) and 20.6% (6.2 ± 0.70) greater at 40 seconds and 60 seconds, respectively, than at 20 seconds (P < .05). During roller massage, VL and biceps femoris root mean square (RMS) EMG was 8% and 7%, respectively, of RMS EMG recorded during maximal voluntary isometric contraction. Knee-joint ROM was 10% and 16% greater in the 20-second and 60-second roller-massager conditions, respectively, than the control condition (P < .05). Finally, average lunge VL RMS EMG decreased as roller-massage time increased (P < .05). CONCLUSIONS: Roller massage was painful and induced muscle activity, but it increased knee-joint ROM and neuromuscular efficiency during a lunge.
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Articulación de la Rodilla , Masaje , Dolor Musculoesquelético , Músculo Cuádriceps , Rango del Movimiento Articular/fisiología , Adulto , Electromiografía/métodos , Diseño de Equipo , Humanos , Contracción Isométrica/fisiología , Articulación de la Rodilla/fisiología , Articulación de la Rodilla/fisiopatología , Masculino , Masaje/efectos adversos , Masaje/instrumentación , Masaje/métodos , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/etiología , Dolor Musculoesquelético/fisiopatología , Dimensión del Dolor , Músculo Cuádriceps/fisiología , Músculo Cuádriceps/fisiopatología , Muslo/fisiología , Muslo/fisiopatología , Factores de Tiempo , Resultado del TratamientoRESUMEN
Using semi-structured interviews with adults living with or at-risk for HIV and interviews and focus groups with key informants, the present study examined risk for HIV transmission among women living in Hawaii. Key research findings suggest that women in Hawaii are at risk for HIV infection primarily through sexual contact with their male sex partners, including bisexual and injection drug using (IDU) men. A significant factor in women's HIV risk is sex and gender role dynamics in the context of their relationships with men. Recommendations support primary prevention services for HIV-positive men who have sex with men and women, and IDU men who also have sex or share needles with women. Collaborative efforts between health care professionals and HIV/AIDS agencies to integrate gender-specific and culturally appropriate HIV prevention interventions are recommended.
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Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Femenino , Hawaii , Humanos , Masculino , Compartición de Agujas/efectos adversos , Factores de Riesgo , Conducta Sexual/psicologíaRESUMEN
OBJECTIVE: To explore the relationships among contextual, environmental, and regulatory factors with antiretroviral (ARV) medication adherence to assist care providers in improving care for women living with HIV. DESIGN: Descriptive, multicenter study. SETTING: Sixteen HIV clinics and service organizations in North America. PARTICIPANTS: This convenience sample was drawn from a larger study of 2,182 persons living with HIV recruited from clinics and service from September 2009 to January 2011. We included 383 women living with HIV who were taking ARV medications. METHODS: We assessed the relationship of contextual, environmental, and psychological factors specific to women living with HIV in relation to adherence to ARV medication. Descriptive and multivariate statistics were used to examine the effects of these factors on self-reported ARV drug adherence. RESULTS: Age, depression symptoms, stigma, engagement with health care provider, and four psychological factors were correlated with self-reported ARV medication adherence (p = .01). Regression analysis indicated that adherence self-efficacy and depression symptoms accounted for 19% for 3-day and 22% for 30-day self-reported medication adherence. CONCLUSIONS: Adherence self-efficacy and depression symptoms predict ARV medication adherence in women and should be evaluated by nurses. Future research is needed to identify antecedents to and interventions that support adherence self-efficacy and decrease depression symptoms.
Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Infecciones por VIH/tratamiento farmacológico , Cumplimiento de la Medicación/etnología , Cumplimiento de la Medicación/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Estudios de Cohortes , Estudios Transversales , Escolaridad , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Seropositividad para VIH/tratamiento farmacológico , Seropositividad para VIH/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Evaluación de Necesidades , América del Norte , Educación del Paciente como Asunto/organización & administración , Análisis de Regresión , Medición de Riesgo , Autoeficacia , Factores Socioeconómicos , Adulto JovenRESUMEN
We report herein the identification of MK-4409, a potent and selective fatty acid amide hydrolase (FAAH) inhibitor. Starting from a high throughput screening (HTS) hit, medicinal chemistry efforts focused on optimizing of FAAH inhibition in vitro potency, improving the pharmacokinetic (PK) profile, and increasing in vivo efficacy in rodent inflammatory and neuropathic pain assays.