Side-Effects and Social Norms Influencing Family Planning Use in Nepal.

Background Effective family planning (FP) programs promote modern contraceptives and help individuals achieve their reproductive goals. Despite Nepal's relatively high contraceptive prevalence rate (50%), 27% of married women have an unmet need for FP, and almost half of Nepalese women give birth by the age of 20. This formative study explored the factors that influence the use of contraceptives in Nepal. Objective To provide information about barriers to family planning use, general fertility awareness, and barriers to family planning use among difficult to reach groups communities. Method This qualitative study was implemented in five districts in Nepal. A total of 36 focus group discussions, 18 participatory group discussions, and 144 in-depth interviews were conducted. Participants included young married women, men and FP service providers in eight village development committees and two municipalities. The interviews were digitally recorded, transcribed in Nepali and then translated into English. Data was organized using Atlas Ti 7 and coded using a thematic analysis. Result Four key themes emerged from the analyses: 1) limited knowledge on fertility awareness and family planning methods, 2) religious-cultural factors including social norms impediments contraceptives use, 3) fear of side-effects, myths and misconceptions about modern contraceptives, and 4) structural barriers such as limited family planning services, and lack of same gender providers make it difficult for many women to access modern contraceptives services. Conclusion Continuing Nepal's recent gains in contraceptives prevalence rate will require strong educational interventions addressing fertility awareness, social norms around son preference, dispelling fear of side-effects while increasing the family planning method-mix. Health service providers should continue counseling clients on the management of potential side-effects and ensure accurate information about modern contraceptives.

Cross-validation of Peak Oxygen Consumption Prediction Models From OMNI Perceived Exertion.

This study cross-validated statistical models for prediction of peak oxygen consumption using ratings of perceived exertion from the Adult OMNI Cycle Scale of Perceived Exertion. 74 participants (men: n=36; women: n=38) completed a graded cycle exercise test. Ratings of perceived exertion for the overall body, legs, and chest/breathing were recorded each test stage and entered into previously developed 3-stage peak oxygen consumption prediction models. There were no significant differences (p>0.05) between measured and predicted peak oxygen consumption from ratings of perceived exertion for the overall body, legs, and chest/breathing within men (mean±standard deviation: 3.16±0.52 vs. 2.92±0.33 vs. 2.90±0.29 vs. 2.90±0.26 L·min(-1)) and women (2.17±0.29 vs. 2.02±0.22 vs. 2.03±0.19 vs. 2.01±0.19 L·min(-1)) participants. Previously developed statistical models for prediction of peak oxygen consumption based on subpeak OMNI ratings of perceived exertion responses were similar to measured peak oxygen consumption in a separate group of participants. These findings provide practical implications for the use of the original statistical models in standard health-fitness settings.

MicroRNA-145 expression in the plasma of patients with benign and malignant bone tumors and its effects on osteosarcoma cell proliferation and migration.

BACKGROUND: The present study intends to investigate microRNA-145 expression level in the plasma and tissue of patients with benign and malignant bone tumors and its effects on the proliferation and migration of osteosarcoma cells. METHODS: Thirty-four cases of patients with bone tumors (malignant) and twenty cases with osteochondroma (benign) in the hospital were enrolled into the study. Meanwhile, thirty cases of healthy subjects admitted to the hospital for physical examination in the same period were selected as the control group. MicroRNA-145 expression levels in the plasma of patients in three groups were detected using real-time quantitative RT-PCR. The difference in microRNA-145 expression level in the tissue between patients with benign and malignant bone tumors were compared and analyzed. Human osteosarcoma cell line OS-732 was used for high and low expressions of microRNA-145. Its effect on osteosarcoma cell proliferation level was observed using CCK8 method, and its osteosarcoma cell invasion level was observed using Transwell method. RESULTS: MicroRNA-145 expression level in the plasma of patients with malignant bone tumors was significantly lower than that of patients with benign bone tumors; microRNA-145 expression level in the plasma of patients with benign bone tumors was significantly lower than that of healthy subjects; the differences were statistically significant (P<0.05). MicroRNA-145 expression level in the tissue of patients with malignant bone tumors was significantly lower than that of patients with benign bone tumors; the difference was statistically significant (P<0.05). Cell proliferation level of human osteosarcoma cell line OS-732 interfered with microRNA-145 was significantly increased, and its cell invasion capacity was also significantly increased; the differences were statistically significant (P < 0.05). However, cell proliferation level of OS-732 with microRNA-145 overexpression was significantly decreased, and OS-732 cell invasion capacity was also significantly decreased; the differences were statistically significant (P<0.05). CONCLUSIONS: Low expression of microRNA-145 in patients with malignant bone tumors may be involved in cell proliferation and invasion of malignant bone tumors like osteosarcoma as a tumor suppressor.

Influence of testing sequence on a child's ability to achieve maximal anaerobic and aerobic power.

The aim of the study was to examine the order of testing sequence on a child's ability to achieve maximal anaerobic and aerobic power. Thirty-two children (20 females, 12 males) between 7 - 11 years of age participated in this study. All subjects were tested on three separate occasions as follows: anaerobic power session - Wingate Anaerobic Test (WAnT) only; aerobic power session - maximal oxygen consumption (V.O (2max)) test only; and experimental session - WAnT followed by a V.O (2max) test (WAnT/V.O (2max)) or a V.O (2max) test followed by a WAnT (V.O (2max)/WAnT), each with 20 minutes of rest between the assessments. No significant differences were observed between the baseline WAnT or V.O (2max) between the two groups. No significant differences were observed for WAnT power values in either group regardless of testing sequence. Children in the WAnT/V.O (2max) group had significantly lower experimental V.O (2max) (38.6 +/- 7.6 vs. 40.6 +/- 7.4 mL . kg (-1) . min (-1); p < 0.05), RER (1.10 +/- 0.08 vs. 1.13 +/- 0.07; p < 0.05), and exercise time (472 +/- 87 vs. 511 +/- 79 s; p < 0.01) values when compared to the baseline V.O (2max) test. The results of this study indicate that when assessing a child's anaerobic and aerobic power during the same testing session, the testing sequence is of importance. However, it appears that a V.O (2max) test can be performed 20 minutes prior to the WAnT without affecting anaerobic power in children.

Atovaquone: a review.

OBJECTIVE: To review the chemistry, pharmacology, pharmacokinetics, clinical efficacy, and safety of atovaquone. DATA IDENTIFICATION: An English-language literature search using MEDLINE (1984-1993), programs and abstracts of the 30th, 31st, and 32nd Interscience Conferences on Antimicrobial Agents and Chemotherapy, program and abstracts of the VIII International Conference on AIDS, and unpublished information from Burroughs Wellcome, the manufacturer of atovaquone. STUDY SELECTION: All available pharmacokinetic and clinical trials were reviewed. DATA EXTRACTION: Study quality was assessed by a critical appraisal of study design and methods. Pharmacokinetic studies were evaluated for sampling, methods used to determine pharmacokinetic properties, and the presence of concentration-response and concentration-toxicity relationships. Clinical trials were assessed primarily for comparative efficacy and toxicity. RESULTS: Atovaquone is a novel hydroxynaphthoquinone with potent activity against Pneumocystis carinii and Toxoplasma gondii. Its pharmacokinetic properties are characterized by relatively poor bioavailability, excretion almost exclusively through the feces, lack of hepatic metabolism and urinary excretion, low steady-state plasma concentrations, high protein binding, and a long elimination half-life (50-70 h). Results from comparative clinical trials in AIDS patients with mild-to-moderate P. carinii pneumonia (PCP) reveal similar overall treatment success rates for atovaquone, trimethoprim/sulfamethoxazole (TMP/SMX), and pentamidine. Treatment failure because of lack of therapeutic response was significantly greater in patients who received atovaquone compared with those treated with TMP/SMX (p = 0.002). More atovaquone-patients experienced treatment failure compared with their pentamidine-treated counterparts, although statistical significance was not achieved. Treatment failure secondary to drug toxicity was significantly higher in the TMP/SMX- and pentamidine-treated patients (p < or = 0.01). Atovaquone has not been studied for PCP prophylaxis. Limited data exist on the use of atovaquone for toxoplasmic encephalitis (TE); however, results from an open trial reveal that the drug may be useful in treating this disorder. To date, atovaquone has been well tolerated by most patients administered the drug. The most common adverse effects include maculopapular rash, gastrointestinal disturbances, and fever. Atovaquone is considerably more costly than other oral agents used to treat PCP. CONCLUSIONS: Atovaquone appears to be better tolerated but less effective than TMP/SMX and pentamidine in the treatment of mild-to-moderate PCP. There is not enough information available on the use of atovaquone for PCP prophylaxis or the treatment of TE to definitively describe its efficacy. Comparative clinical trials are needed to assess its role in this clinical setting.