What factors are important in smoking cessation and relapse in women from deprived communities? A qualitative study in Southeast England.

OBJECTIVES: Women are relatively more susceptible to smoking-related diseases and find it more difficult to quit; however, little research exists on factors associated with smoking cessation and relapse in women. We examined attitudes towards and perceptions of factors associated with smoking cessation and relapse in women from deprived communities. STUDY DESIGN: Qualitative interview study. METHODS: Participants included eleven women, smokers and ex-smokers, from disadvantaged communities in East Sussex, England, who had used the National Health Service (NHS) stop smoking service. Data were collected through a focus group and semi-structured interviews, and subjected to thematic analysis. RESULTS: Participants opined that it is more difficult for women to quit smoking than men. Women felt that postcessation weight gain was inevitable and acted as a barrier to quitting. Hormonal fluctuations during the menstrual cycle and greater levels of stress were perceived as obstacles to quitting and reasons for relapse. Conversely, the women cited effects of smoking on physical appearance, oral hygiene and guilt about exposing children to passive smoke as powerful motivators to quit; and highlighted the impact of public health campaigns that focused on these factors. Views diverged on whether quitting with someone close to you is a help or hindrance. Other themes including alcohol intake, daily routine and being in the presence of smokers emerged as situational triggers of relapse. CONCLUSIONS: Interventions that address women's concerns related to postcessation weight gain, hormonal fluctuations during the menstrual cycle and stress may aid with smoking cessation and reduce relapse. Public health campaigns should consider the impact of smoking on physical appearance and the effect of passive smoke on children.

Computed tomography versus exercise electrocardiography in patients with stable chest complaints: real-world experiences from a fast-track chest pain clinic.

OBJECTIVE: To compare the diagnostic performance of CT angiography (CTA) and exercise electrocardiography (XECG) in a symptomatic population with a low-intermediate prevalence of coronary artery disease (CAD). DESIGN: Prospective registry. SETTING: Tertiary university hospital. PATIENTS: 471 consecutive ambulatory patients with stable chest pain complaints, mean (SD) age 56 (10), female 227 (48%), pre-test probability for significant CAD >5%. INTERVENTION: All patients were intended to undergo both 64-slice, dual-source CTA and an XECG. Clinically driven quantitative catheter angiography was performed in 98 patients. MAIN OUTCOME MEASURES: Feasibility and interpretability of, and association between, CTA and XECG, and their diagnostic performance with invasive coronary angiography as reference. RESULTS: CTA and XECG could not be performed in 16 (3.4%) vs 48 (10.2%, p<0.001), and produced non-diagnostic results in 3 (0.7%) vs 140 (33%, p<0.001). CTA showed > or =1 coronary stenosis (> or =50%) in 140 patients (30%), XECG was abnormal in 93 patients (33%). Results by CTA and XECG matched for 185 patients (68%, p = 0.63). Catheter angiography showed obstructive CAD in 57/98 patients (58%). Sensitivity, specificity, positive and negative predictive value of CTA to identify patients with > or =50% stenosis was 96%, 37%, 67% and 88%, respectively; compared with XECG: 71%, 76%, 80% and 66%, respectively. Quantitative CTA slightly overestimated diameter stenosis: 6 (21)% (R = 0.71), compared with QCA. Of the 312 patients (66%) with a negative CTA, 44 (14%) had a positive XECG, but only 2/17 who underwent catheter angiography had significant CAD. CONCLUSION: CTA is feasible and diagnostic in more patients than XECG. For interpretable studies, CTA has a higher sensitivity, but lower specificity for detection of CAD.

Deterministic teleportation of electrons in a quantum dot nanostructure.

We present a proposal for deterministic quantum teleportation of electrons in a semiconductor nanostructure consisting of a single and a double quantum dot. The central issue addressed in this Letter is how to design and implement the most efficient--in terms of the required number of single and two-qubit operations--deterministic teleportation protocol for this system. Using a group-theoretical analysis, we show that deterministic teleportation requires a minimum of three single-qubit rotations and two entangling (square root SWAP) operations. These can be implemented for spin qubits in quantum dots using electron-spin resonance (for single-spin rotations) and exchange interaction (for square root SWAP operations).

Smoking and erectile dysfunction: findings from a representative sample of Australian men.

OBJECTIVES: To examine whether there is an association between smoking and erectile dysfunction in a representative sample of Australian men. DESIGN: Secondary analysis of cross-sectional survey data from the Australian Study of Health and Relationships. PARTICIPANTS: 8367 Australian men aged 16-59 years. MAIN OUTCOME MEASURES: Erectile dysfunction was identified in men who reported having had trouble keeping an erection when they wanted to, a problem which persisted for at least one month over the previous year. Variables examined in multivariate logistic regression analyses included age, education, presence of cardiovascular disease and diabetes, and current alcohol and tobacco consumption. RESULTS: Almost one in 10 of the respondents (9.1%) reported erectile dysfunction that lasted for at least one month over the previous year. More than a quarter (27.2%) of respondents were current smokers, with 20.9% smoking < or = 20 cigarettes per day, and 6.3% smoking > 20 cigarettes per day. Compared with non-smokers, the adjusted odds ratios for erectile dysfunction were 1.24 (95% confidence interval (CI) 1.01 to 1.52, p = 0.04) for those smoking < or = 20 cigarettes per day and 1.39 (95% CI 1.05 to 1.83, p = 0.02) for those smoking > 20 cigarettes per day, after adjusting for other confounding factors. Older age, low level of education, and taking medications for cardiovascular disease were also independently and positively associated with erectile dysfunction. In contrast, moderate alcohol consumption (1-4 drinks per day) significantly reduced the likelihood of having erectile dysfunction. CONCLUSIONS: Erectile dysfunction is a significant health concern affecting around one in 10 Australian men aged 16-59 years. Current smoking is significantly associated with erectile dysfunction in Australian males. This association was strengthened as the number of cigarettes smoked increased. Health promotion programmes could use the link between smoking and erectile dysfunction to help reduce smoking levels among men.

Delayed application of condoms, withdrawal and negotiation of safer sex among heterosexual young adults.

The aim of this study was to examine delayed application of condoms and withdrawal among heterosexual young adults. Seven focus group discussions were conducted with heterosexual men and women aged 18-25 in Melbourne, Australia. The data revealed that delayed application of condoms and withdrawal are widespread. Delayed application of condoms can be divided into two categories--condom use 'after limited unprotected penetration' and condom use 'for ejaculation only'. The data reveal parallels between withdrawal and condom use 'for ejaculation only'. These two behaviours share the goal of avoiding unprotected ejaculation inside a partner, while allowing some unprotected intercourse. They are both more likely to occur in regular relationships than casual encounters, both are likely to be negotiated and both occur when there is no perceived risk of STI infection. In contrast, condom use 'after limited unprotected penetration' was likely to occur in casual encounters, and was likely to be unplanned and not negotiated. There is a need to ensure that heterosexual young adults use condoms and use them correctly. There is also a need to ensure that heterosexual young adults have the required skills to negotiate sexual activity and to negotiate condom use.

Use of alternative therapies by people living with HIV/AIDS in Australia.

Few studies of use of complementary and alternative medicine (CAM) among people living with HIV/AIDS (PLWHA) have been conducted since combination antiretroviral (ARV) drug therapy became widespread. In the context of changing ARV treatment options, it is important to consider the prevalence and correlates of use of CAM. In this study, a sample of 924 Australian PLWHA completed a self-administered survey that included questions on use of CAM. Half (55%) of the respondents reported using CAM. Most PLWHA did not choose CAM as an alternative to ARV drugs, but use CAM to complement ARV drugs. Use of CAM was not related to measures of progression of HIV/AIDS disease. In contrast, CAM use was related to characteristics of the ways respondents live with HIV/AIDS, and their attitudes toward treatment. The popularity of CAM among PLWHA highlights a need to ensure that PLWHA can make informed choices about CAM use.

Relationship between sexual partners influences rates and correlates of condom use.

A common finding in studies of heterosexual young adults is that condom use is more likely with casual partners than with regular partners. However, few studies have examined whether correlates of condom use differ with different partners. In this study, 103 heterosexual men and women completed a condom use diary for a period of up to 6 months. Condom use during sexual encounters with regular partners was mainly determined by established patterns of behavior. In contrast, condom use with casual partners was determined by the interaction between the sexual partners during the encounter, and was not influenced by the attitudes and beliefs of the individual. These differences have implications for interventions. They suggest that condom use with casual partners may be increased by furnishing young adults with skills and confidence for negotiating condom use. For young adults in regular relationships, we must ensure that routine patterns of condom use are appropriate for the levels of risk to which the partners are exposed.

More cautious, more optimistic: Australian people living with HIV/AIDS, 1997-1999.

The aim of this study was to assess whether the lives of Australian people living with HIV/AIDS (PLWHA) have improved to the extent hoped for following the introduction of new antiretroviral (ARV) drugs for HIV. In 1997, 925 Australian PLWHA completed the first national survey of the social impacts of HIV/AIDS. In 1999, 924 Australian PLWHA were recruited for a repeat of the survey. Study participants completed an anonymous self-administered questionnaire. The data revealed that although new ARV drugs have improved the clinical profiles of many PLWHA, there have not been corresponding improvements in the physical well-being, levels of employment, or financial circumstances of many PLWHA. Nevertheless, PLWHA express favourable attitudes toward ARV drugs. Australian PLWHA have a complex relationship with their ARV medication that is likely to change over time as their HIV disease progresses and new treatments become available.

Alternative or complementary? Nonallopathic therapies for HIV/AIDS.

CONTEXT: Many people with HIV/AIDS use alternative therapies. Do they choose alternative therapies instead of allopathic therapies? OBJECTIVE: To examine patterns of use of allopathic therapies and alternative therapies among people living with HIV/AIDS. DESIGN: Cross-sectional survey of convenience sample. SETTING: Nonclinical setting in Australia. PARTICIPANTS: 925 men and women living with HIV/AIDS in Australia. MAIN OUTCOME MEASURES: Correlates of choice of therapy included demographic variables, sources of information about treatment, and attitudes toward treatments and health management. RESULTS: 56% of people living with HIV/AIDS in Australia use alternative therapies. Attitudes toward both allopathic and alternative therapies were positive. The choice of allopathic and/or alternative therapies was related to disease progression. Choice of therapy was also related to attitudes toward allopathic and alternative therapies. Many users of alternative therapies believe that such therapies can alleviate the side effects of antiretroviral drugs. CONCLUSIONS: The results of this study suggest that rather than being used as an alternative to allopathic medicine, nonallopathic therapies are used by people living with HIV/AIDS as complementary therapies.

When always isn't enough: implications of the late application of condoms for the validity and reliability of self-reported condom use.

Condoms are most effective when they are applied before intercourse. This study assessed the prevalence of 'condom cheats'--instances of condom use in which the condom is put on after initial penetration. As part of a prospective study of safer sexual behaviour, 103 heterosexual tertiary students completed a condom use diary over a period of up to 6 months. Of the 464 condoms used by study participants, 13% were put on after initial penetration. Thirty-eight percent of condom users reported at least one instance of late application of a condom. Late application of condoms is common and places individuals at risk of infection with HIV and many other STDs. The widespread practice of this behaviour casts doubt on the validity of self-reports of condom use. Assessments of risk based on self-reported condom use may lead to underestimates of the risk entailed in heterosexual young adults' condom use behaviour, and may also lead to underestimates of condom efficacy.

PIP: This prospective study assessed the prevalence of late application of condoms among heterosexual tertiary students in Melbourne, Australia. As part of the study, a condom use diary was used to eliminate recall biases and cost-effectively increase the sample size. About 103 heterosexual students completed the diary over a period of 6 months. Findings indicated that of the 464 condoms used by study participants, 13% were put on after initial penetration. On the other hand, 38% of condom users reported at least one instance of late condom application. Late application of condoms is common and places individuals at risk of infection with HIV and many other sexually transmitted diseases. The widespread practice of this behavior casts doubt on the validity of self-reports of condom use. Furthermore, assessments of risk based on self-reported condom use may lead to underestimates of the risk entailed in heterosexual young adults' condom use behavior and would eventually lead to underestimates of condom efficacy.

Personal and social factors influencing age at first sexual intercourse.

Early initiation of sexual activity is a concern, in part because of increased risk of sexually transmitted diseases, including HIV, and unwanted pregnancies among young people. In this study, 241 high schoolers were administered a questionnaire to establish the relationships between age at first sexual intercourse and personal qualities (sexual style, attractiveness, physical maturity, restraint, autonomy expectations, and attitudes to gender roles), smoking and drug use, and aspects of the social context (social activities, media impact, peer norms). There were few effects of sex of respondent and none in which respondents' sex impacted on age of initiation. Overall (and among the male sample), perceptions of greater physical maturity, greater use of uncommon (mostly illicit) drugs, and expectations of earlier autonomy significantly differentiated between early and later initiators. This group of factors tends to confirm the view that early experience of sexual intercourse is correlated with problem behaviors and a press toward "adult" behaviors. For girls, this pattern was even clearer, with use of uncommon drugs being replaced as a significant contributor to early sexual experience by relative lack of restraint. We conclude that the desire to achieve the transition to adulthood at an earlier age than their peers constitutes a powerful incentive for young people to become sexually active.

Poverty, disease progression and employment among people living with HIV/AIDS in Australia.

A national survey of 925 people living with HIV/AIDS (PLWHA) in Australia is used to examine the relationship between disease progression, employment status, poverty and economic hardship. While disease progression has some impact on economic hardship, employment status is found to be the strongest determinant of both poverty and economic hardship. The most commonly cited reasons for leaving work were psychosocial (71%), with declining health cited by half of respondents. It is therefore argued that psychosocial issues are at least as important as changes in health in causing unemployment and therefore poverty and economic hardship among PLWHA in Australia.

Fluxes of reserve-derived and currently assimilated carbon and nitrogen in perennial ryegrass recovering from defoliation. The regrowing tiller and its component functionally distinct zones

The quantitative significance of reserves and current assimilates in regrowing tillers of severely defoliated plants of perennial ryegrass (Lolium perenne L.) was assessed by a new approach, comprising 13C/12C and 15N/14N steady-state labeling and separation of sink and source zones. The functionally distinct zones showed large differences in the kinetics of currently assimilated C and N. These are interpreted in terms of "substrate" and "tissue" flux among zones and C and N turnover within zones. Tillers refoliated rapidly, although C and N supply was initially decreased. Rapid refoliation was associated with (a) transient depletion of water-soluble carbohydrates and dilution of structural biomass in the immature zone of expanding leaves, (b) rapid transition to current assimilation-derived growth, and (c) rapid reestablishment of a balanced C:N ratio in growth substrate. This balance (C:N, approximately 8.9 [w/w] in new biomass) indicated coregulation of growth by C and N supply and resulted from complementary fluxes of reserve- and current assimilation-derived C and N. Reserves were the dominant N source until approximately 3 d after defoliation. Amino-C constituted approximately 60% of the net influx of reserve C during the first 2 d. Carbohydrate reserves were an insignificant source of C for tiller growth after d 1. We discuss the physiological mechanisms contributing to defoliation tolerance.

Antiretroviral uptake in Australia: medical, attitudinal and cultural correlates.

The objective of this study was to describe the medical, attitudinal and cultural correlates of antiretroviral uptake amongst people living with HIV/AIDS (PLWHA) in Australia. Stratified purposive sampling produced a sample of 925 PLWHA, which represents 8.3% of the current population of PLWHA in Australia. Respondents completed a self-administered questionnaire which revealed that 78% of respondents were using antiretroviral drugs for HIV/AIDS. Logistic regression revealed that PLWHA were more likely to use antiretroviral drugs if they had more favourable attitudes toward antiretroviral drugs, if they had been diagnosed with an AIDS-defining illness, and if they had ever had a CD4/T-cell count below 400 copies/ml blood. Women were less likely than men to use antiretroviral drugs, and logistic regression revealed different predictors of antiretroviral drug use amongst men and women. Given the importance of attitudes toward antiretroviral drugs, it is likely that if the current confidence in antiretroviral drugs were to change, this would be reflected in an equally rapid cessation of treatment amongst many PLWHA.

Employment, accommodation, finances and combination therapy: the social consequences of living with HIV/AIDS in Australia.

The research reported here is of a study of the psychosocial impact of living with HIV/AIDS in Australia focusing on employment, accommodation and income in the environment of new treatments for HIV/AIDS. Many people experience profound changes to their lifestyle as a result of living with HIV/AIDS. In addition to detrimental changes in their health, many people experience major changes in their employment, accommodation, finances and relationships. The research highlights the significance of psychosocial factors along with changes in physical health in shaping PLWHAs (People Living with HIV/AIDS) changes in employment and accommodations. The new treatments now available for HIV/AIDS are further transforming people's attitudes, with many PLWHA considering returning to employment.

Australian and South African undergraduates' HIV-related knowledge, attitudes, and behaviors.

To understand safe sex behavior in two countries which have been differentially affected by the HIV/AIDS epidemic, the present study compared the AIDS-related knowledge, attitudes, and behaviors of 920 heterosexual undergraduate students in Australia and 228 heterosexual undergraduate students in South Africa. South African students were found to have significantly less knowledge about HIV/AIDS, and significantly less favorable attitudes toward safe sex behavior than their Australian counterparts. They were also more likely to report that they have avoided various groups of people for fear of contracting AIDS. Experience from Australia over the period 1986-1995 suggests that significant improvements in the AIDS-related knowledge, attitudes, and behaviors of South African undergraduates are achievable.

Young people's condom use: an event specific analysis.

PIP: Event-specific analysis was used to identify relationships between condom use and situational variables in a sample of 244 students aged 15-18 years in metropolitan Melbourne, Australia. The 99 male and 145 female participants were recruited for the longitudinal study in 1994-95 from 4 secondary schools in the city. 81% reported using a condom during their most recent sexual encounter, with 93% of the men and 70% of the women reporting condom use, a significant difference. The young women, however, were more knowledgeable about STDs than were the young men. 61% of both sexes reported discussing condom use with their most recent sex partner. Age was the only variable associated with young men's condom use, although there was no clear pattern of association. For young women, the probability of condom use was positively associated with discussion about condom use, and negatively associated with partner's increasing age and use of other contraceptives. Condom use was not related to reported alcohol or drug use on the part of the respondent or their partner, levels of knowledge about sexually transmitted diseases, or type of relationship.^ieng

[Tongue prosthesis]. / De tongprothese.

Surgical treatment for tumors of the tongue and floor of the oral cavity often results in impaired swallowing and speech function. A method is described to improve oral functions after total glossectomy by constructing a removable tongue prosthesis in a multidisciplinary clinical practice.

Control of Seed Respiration and Growth in Vicia faba by Oxygen and Temperature: No Evidence for an Oxygen Diffusion Barrier.

The rate of dry matter accumulation by seeds of Vicia faba L. cv. Minica increases with temperature in the range of 16 to 26 degrees C. The duration of dry matter accumulation decreases with temperature, resulting in a decrease of final seed dry weight. In this study we test the hypothesis that a diffusion barrier for O(2), located in the seed coat, inhibits seed respiration and growth. The rate of O(2) uptake of intact seeds and of excised embryos and seed coats (separated seeds) was measured in air and buffer at 16, 20, and/or 26 degrees C at various O(2) concentrations and developmental stages. Oxygen uptake rates of intact seeds in buffer were only 9 to 15% of those in air. In buffer, the respiration rate of intact seeds decreased at a pO(2) below air saturation (21 kilopascals), whereas separated seeds showed a decline of O(2) uptake only below 80% of air saturation. In air, embryo excision had no effect on the sensitivity of seed respiration to pO(2), at both 20 and 26 degrees C. In air at 20 degrees C, separated and intact seeds showed similar rates of O(2) uptake. Oxygen uptake by intact seeds, both halfway and beyond the linear growth phase, showed a temperature coefficient Q(10) of 2.3 and was insensitive to pO(2) in the range of 80 to 100% of ambient. These results indicate that V. faba seed respiration in air is not limited by the diffusion of O(2) into the seed.

Ethylene Production by Attached Leaves or Intact Shoots of Tobacco Cultivars Differing in Their Speed of Yellowing during Curing.

Using an open air flow system, differences in the yellowing rate of leaves during curing were assessed in relation to ethylene production by shoots of intact seedlings or attached mature leaves of 60 day old tobacco (Nicotiana tabacum L.) plants. The rate of ethylene evolution from the leaves of the fast yellowing cultivars was significantly higher than in the slow yellowing ones. The same differences were obtained with shoots of intact seedlings. The findings suggest that it is possible to use ethylene production by seedlings as a selection criterion in screening for genotypic differences in the rate of yellowing. The ability of carbon dioxide (1%) to enhance ethylene production by attached leaves was significant in a slow, but not in a fast yellowing cultivar. However, similar amounts of ethylene were produced on administration of 1-aminocyclopropane-1-carboxylic acid to a slow and a fast yellowing cultivar. Exposure of attached leaves to exogenous ethylene (0.1 microliter per liter) accelerated the loss of chlorophyll and protein. This treatment was effective only for slightly yellow leaves and not for fully expanded green ones. The significance and possible use of ethylene in the flue-curing process are discussed.