HIV Prevention Method Preferences Within Sexual Partnerships Reported by HIV-Negative MSM and TW in Tijuana, Mexico.

To assess the potential for decreased condom use as pre-exposure prophylaxis (PrEP) is scaled-up in Latin America, we examined HIV prevention method preferences (neither PrEP nor condoms, condoms only, PrEP only, or PrEP with condoms) within 1302 sexual partnerships reported by 397 HIV-negative men who have sex with men (MSM) and transgender women (TW) in Tijuana, Mexico. Using PrEP with condoms (56%) was preferred to using condoms only (24%), using PrEP only (17%), and using neither PrEP nor condoms (3%). Compared to using condoms only, using PrEP only was preferred within primary (adjusted odds ratio [AOR] = 4.13, 95% confidence interval [CI] 1.92, 8.90) and condomless sex practicing (AOR = 6.97, 95% CI 3.92, 12.40) partnerships, suggesting PrEP use may not displace condom use among MSM and TW in Tijuana and other similar settings.

Oral and vaginal HIV pre-exposure prophylaxis product attribute preferences among female sex workers in the Mexico-US border region.

To assess the potential uptake of HIV pre-exposure prophylaxis (PrEP) products among female sex workers (FSWs) vulnerable to HIV infection, we examined the influence of product attributes on willingness to use products among 271 HIV-negative FSWs in Tijuana and Ciudad Juarez, Mexico (2016-2017). Via five-point Likert scale ratings, participants indicated their willingness to use hypothetical products with six attributes: formulation (pill, gel, liquid, or ring), frequency of use (daily, on-demand, or monthly), cost per use (10 or 200 pesos), effectiveness (40% or 80%), side effects (none or mild), and access point (healthcare clinic or non-governmental organization). Conjoint analysis was used to determine the impact of attributes on product ratings and identify preferred product attributes. Multinomial logistic regression was used to identify factors associated with formulation preferences. In both cities, formulation and frequency of use had the greatest impact on ratings. Participants in Ciudad Juarez indicated a strong preference for oral pills, whereas participants in Tijuana indicated roughly equal preferences for oral pills and vaginal gels. Monthly product use was preferred in both cities. Compared to preferring oral pills (38%), preferring vaginal gels (28%) was associated with practicing vaginal lubrication (adjusted odds ratio = 2.08; 95% confidence interval: 1.07-4.04). Oral PrEP may be acceptable to many FSWs in Tijuana and Ciudad Juarez; however, continued development of behaviorally-congruent vaginal PrEP products may also facilitate uptake and ensure sufficient coverage.

Physical activity levels in urban-based South African learners: A cross-sectional study of 7 348 participants.

BACKGROUND: Establishing profiles of physical activity (PA) is critical in tackling the chronic diseases associated with lack of PA and avoiding healthcare costs. OBJECTIVE: To investigate PA levels in urban-based South African (SA) primary school learners. METHODS: The Physical Activity Questionnaire for Older Children was completed by 7 348 learners (3 867 males and 3 481 females) aged 8 - 14 years, of whom 49% were white, 39% black and 12% from other ethnic groups. Differences in PA levels by ethnic origin and province were determined using an analysis of covariance after adjusting for gender (p<0.05). Bonferroni corrections controlled for multiple comparisons. A fitted regression model examined age-related differences in PA adjusting for province. RESULTS: Of SA learners aged 8 - 14 years, 57% (n=4 224) engaged in moderate levels of PA. Thirty-one percent (n=2 247) did not meet internationally recommended amounts of moderate to vigorous physical activity. Overall, males reported higher PA levels than females (p<0.0001). PA levels declined with age from 11 to 14 years by 14% and 20% in males and females, respectively. Black learners had higher PA levels than white learners (p=0.0039). There were also significant differences in PA levels between the provinces (p<0.0001). CONCLUSION: This study provides evidence of differences in PA levels between gender, age and ethnic groups, and between provinces. A targeted approach to increase PA in high-risk populations in SA is warranted. Increased PA will help reduce the risk of chronic diseases and will contribute to the health of SA's population and the growth of the country's economy.

Does physical education influence eye-hand coordination? The Lifestyles of our Kids intervention study.

In Australian government-funded primary schools, the responsibility for physical education (PE) falls mainly on general classroom teachers, many of whom possess limited PE training. This study sought to examine the impact of specialist-taught PE on eye-hand coordination (EHC) development. In this 4-year cluster-randomized intervention, participants were 187 boys and 172 girls initially in grade 2 in 29 primary schools, where no school employed university-trained specialist PE teachers. In 13 (intervention) schools, specialist PE teachers conducted 268 PE classes (two 45-minute sessions/wk) from grade 2 to grade 6. The intervention was based on traditional PE educational objectives, including fundamental motor skills, but did not specifically focus on EHC. The remaining 16 (control) schools continued with common-practice PE taught by general classroom teachers (30-60 min/wk). EHC was measured by a ball throw and wall-rebound catch test and recorded at ages 8, 10, and 12 (SD 0.3) at ends of grades 2, 4, and 6, respectively. There was steady yearly improvement of EHC in both groups, but no evidence of any intervention effect in boys (P=.88) or girls (P=.20). The introduction of specialist-taught PE during 4 years of primary school did not influence EHC development. Considering evidence that classroom teachers make little contribution to PE in this jurisdiction, together with the steady progression of EHC over the 4 years, other influences such as organized sport, after-school activities, natural development, and parental instruction are conceivably more influential factors in EHC development during primary school years.

Antibacterial spectrum and cytotoxic activities of serrulatane compounds from the Australian medicinal plant Eremophila neglecta.

AIMS: To determine the antibacterial spectrum and cytotoxic activities of serrulatane compounds from the Australian plant Eremophila neglecta. METHODS AND RESULTS: Antimicrobial activities of serrulatane compounds 8,19-dihydroxyserrulat-14-ene (1) and 8-hydroxyserrulat-14-en-19-oic acid (2) were tested against Gram-negative and Gram-positive bacteria including human and veterinary pathogens and some multidrug-resistant isolates. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of the compounds were determined by broth microdilution assay. Both compounds exhibited antibacterial activity against all Gram-positive test strains. They showed antimycobacterial activity against isolates of Mycobacterium fortuitum and Mycobacterium chelonae. Of the five Gram-negative bacteria tested, only Moraxella catarrhalis showed susceptibility to the compounds. Cytotoxic activities were tested in the Vero cell line. Compound 1 showed more activity than 2 in both antibacterial and cytotoxicity assays with cytotoxicity at concentrations similar to the MBC. CONCLUSIONS: Serrulatane compounds showed significant activity against medically important bacteria, with 1 exhibiting stronger antibacterial activity. However, they also displayed toxicity to mammalian cells. SIGNIFICANCE AND IMPACT OF THE STUDY: Serrulatanes are of interest as novel antibacterial compounds for use in biomedical applications; this study reports data obtained with a range of bacterial strains and mammalian cells, essential for assessing the capabilities and limitations of potential applicability of these compounds.

Complementary and alternative medicines and dietary interventions in multiple sclerosis: what is being used in South Australia and why?

OBJECTIVES: To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). DESIGN: Self-administered postal survey. SETTING: Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter (n=1230). MAIN OUTCOME MEASURES: Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions. RESULTS: A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use. The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets. The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate 'general' as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility. Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20-49/month. CONCLUSION: This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.

Changes in Neutrophil Count; Creatine Kinases and Muscle Soreness after Repeated Bouts of Downhill Running

OBJECTIVE. A primary objective was to examine circulating neutrophil count after repeated bouts of downhill running. An additional aim was to determine creatine kinase (CK)levels during the initial 12 hours; after repeated DHRs. DESIGN. Eleven healthy; untrained Caucasian males performed 2 x 60 min bouts of DHR (-13.5); spaced 14 days apart; at a speed equal to 75VO2max on a level grade. Blood was collected before; after; and every hour for 12 hours; and every 24 hours for 6 days. Absolute neutrophil count; CK; and delayed-onset muscle soreness (DOMS) were assessed. Result were analysed using repeated measures ANOVA (p0.05) with appropriate post hoc tests. RESULT. There were no significant differences in neutrophil count (p

Immunoglobulin responses to a repeated bout of downhill running.

OBJECTIVE: To examine the effect of downhill running on immunoglobulin responses. METHOD: Eleven untrained men performed 2 x 60 minute bouts of downhill running (-13.5% gradient), at a speed eliciting 75% of their vO2peak on a level grade. Two runs were spaced 14 days apart. Serum samples were collected before, after, and every hour for 12 hours and every 24 hours for six days. Serum total creatine kinase and immunoglobulin isotypes and subclasses were measured, and results were analysed using a repeated measures analysis of variance (12 hour period, 2 x 14; 24 hour intervals, 2 x 6, p < or = 0.05). RESULTS: There was a significant interaction effect for creatine kinase (activity lower after run 2 than after run 1, 6-24 h) and exercise effect, with the serum concentrations of IgG1, IgG2, IgG4, and IgE lower, and IgM higher, after run 2. CONCLUSION: Lower concentrations of IgG1, IgG2, and IgE after run 2 may reflect a dampened autoimmune inflammatory response to autoantigens and enhanced autoantigen clearance mediated by the upregulation of IgM.

Changes in mucosal and humoral atopic-related markers and immunoglobulins in elite cyclists participating in the Vuelta a España.

Atopic-related factors, humoral and mucosal immunoglobulins (Ig), and cortisol were measured in 17 professional cyclists competing in the 2003 Vuelta a España (a three-week multi-stage race). Venous blood and saliva samples were obtained the morning before the start of the race (T0), on the first rest day after 10 days of racing (T1), and before the start of the last stage after 21 days of racing (T2). Atopic-related factors, IgE, eosinophil cationic protein (ECP), and eosinophils, were significantly altered during the race. Serum IgE (T1: + 10 %) and ECP (salivary, T1: 113 % and serum, T2: 155 %) were significantly increased, while eosinophils (T1: - 32 %, T2: - 55 %) were significantly lower, than pre-race levels. Salivary sIgA secretion rate was significantly decreased at T2 (- 36 %). Pearson product-moment correlations revealed a modest correlation between salivary sIgA and salivary ECP (T1: r = 0.30; T2: r = 0.48; p < 0.01). Serum IgM, total IgG, IgG1, IgG2, IgA levels, at T1 and T2, and cortisol at T2, were significantly lower than pre-race levels. In conclusion, the elevation in IgE and ECP suggests an up-regulation of atopic-related factors in professional cyclists participating in the Vuelta a España. The correlation between salivary sIgA and salivary ECP indicates a role for sIgA in mediating mucosal inflammation. The alterations in Ig levels may indicate Ig isotype switching. An increasing state of hormonal fatigue may have influenced the observed immune alterations.

Serum concentrations of C reactive protein, alpha1 antitrypsin, and complement (C3, C4, C1 esterase inhibitor) before and during the Vuelta a Espana.

OBJECTIVES: To determine serum concentrations of proinflammatory (C reactive protein, complement C3 and C4) and anti-inflammatory (alpha(1) antitrypsin, C1 esterase inhibitor (C1-INH)) acute phase proteins in elite cyclists before and during a three week cycle tour. METHODS: Seventeen professional cyclists participating in the Vuelta a Espana volunteered for the study. Their mean (SD) physical characteristics were: age 28 (1) years; height 1.7 (0.06) m; weight 65 (7) kg; body fat 7.6 (0.8)%; Vo(2)max 75.3 (2.3) ml/kg/min. Venepuncture was performed on each subject 24 hours before the tour began (T0), on day 11 (the first rest day; T1) and day 21 (the second to last stage of the tour; T2). Samples at T1 and T2 were taken about 17 hours after the previous stage. Analysis of variance was used to determine changes over time. Where significance was found, a Tukey post hoc test was performed. RESULTS: C reactive protein concentrations were consistently within the normal range, although there was a 228%, non-significant increase at T1. C3 concentrations fell within the normal range at all times assessed. C4 concentrations before the race were within the normal range and were significantly increased 10 days (T1) into the race. C1-INH concentrations did not change significantly throughout the race. alpha(1) Antitrypsin concentration before the race was at the lower end of the normal range and was only significantly raised at T2. CONCLUSIONS: Although not as pronounced as those reported in marathon/ultramarathon runners, elite cyclists participating in a three week cycle tour experienced increases in selected proinflammatory and anti-inflammatory acute phase proteins, indicating an acute phase/inflammatory response. It is tenable that the increase in alpha(1) antitrypsin and C1-INH (anti-inflammatory mediators) at T2 served to attenuate the acute phase/inflammatory response. The lower than normal resting concentrations of the acute phase proteins supports the notion that chronic aerobic exercise induces an anti-inflammatory state.

Influence of ultra-endurance exercise on immunoglobulin isotypes and subclasses.

BACKGROUND: Strenuous exercise is associated with tissue damage. This activates the innate immune system and local inflammation. Interaction between innate and adaptive immunity is essential for maintaining health, suggesting that the adaptive immune system may also be altered by exercise. OBJECTIVES: To determine exercise induced changes in the adaptive immune system by measuring the immunoglobulin isotype and subclass response to an ultra-marathon. METHODS: Venepuncture was performed on 11 experienced volunteers (six men, five women; mean (SD) age 43 (9.8) years) 24 hours before the projected finishing time and immediately after and 3, 24, and 72 hours after an ultra-marathon (90 km). Serum was stored at -80 degrees C. IgM, IgD, IgA, IgG, IgG1, 2, 3, and 4, and total IgE were measured. RESULTS: The following immunoglobulins were significantly (p< or =0.05) altered after the race: IgD, immediately (-51%) and 24 hours (-41%) after; IgM 24 hours after (-23%); total IgG immediately after (+12%). There were no reports of symptoms of upper respiratory tract infections after the ultra-marathon. CONCLUSIONS: In experienced ultra-endurance runners, alterations in immunoglobulin concentrations after a race suggest an enhanced immune response, including isotype switching, interactions with the innate immune system, and a secondary antibody response. These alterations may have a role in the maintenance of subject health after an ultra-marathon.

HIV-positive gay and bisexual men: predictors of unsafe sex.

This paper describes the sexual risk practices of 322 HIV-positive gay and bisexual men who reported having unprotected anal, oral or vaginal sex with an HIV-negative or unknown status partner(s) during the previous four months. Descriptive data on type of sex, partner types and number of partners are presented. Determinants of unprotected anal and oral intercourse were examined using a social cognitive framework. More unprotected anal sex was associated with having a steady versus a casual partner, not being on triple drug therapy, increased use of drugs and alcohol, and lower outcome expectancies for condom use and negotiation of safer sex practices. Unprotected oral sex was associated with partner type; men with casual partners had less unprotected oral sex as compared to men with steady partners. Findings are discussed in relation to the development of sexual risk reduction interventions for HIV-positive individuals.

Antibacterial activity of traditional Australian medicinal plants.

Fifty-six ethanolic extracts of various parts of 39 plants used in traditional Australian Aboriginal medicine were investigated for their antibacterial activities against four Gram-positive (Bacillus cereus, Enterococcus faecalis, Staphylococcus aureus and Streptococcus pyogenes) and four Gram-negative (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Salmonella typhimurium) bacterial species. In a plate-hole diffusion assay, 12 extracts inhibited the growth of one or more of the bacteria, with five extracts showing broad spectrum antibacterial activity against Gram-positive bacteria. B. cereus was the most susceptible bacterium, with all 12 extracts displaying activity against this organism. Extracts from the leaves of Eremophila species (Myoporaceae) were the most active, with Eremophila duttonii exhibiting the greatest activity (against Gram-positive bacteria). The antibacterial effects of E. duttonii were further investigated by time-course growth assays which showed that significant growth inhibition was observed in cultures incubated in the presence of the extract within 1 h for B. cereus, E. faecalis and S. aureus and 2 h for S. pyogenes.

In vitro antiviral activity of the anthraquinone chrysophanic acid against poliovirus.

Chrysophanic acid (1,8-dihydroxy-3-methylanthraquinone), isolated from the Australian Aboriginal medicinal plant Dianella longifolia, has been found to inhibit the replication of poliovirus types 2 and 3 (Picornaviridae) in vitro. The compound inhibited poliovirus-induced cytopathic effects in BGM (Buffalo green monkey) kidney cells at a 50% effective concentration of 0.21 and 0.02 microgram/ml for poliovirus types 2 and 3, respectively. The compound inhibited an early stage in the viral replication cycle, but did not have an irreversible virucidal effect on poliovirus particles. Chrysophanic acid did not have significant antiviral activity against five other viruses tested: Coxsackievirus types A21 and B4, human rhinovirus type 2 (Picornaviridae), and the enveloped viruses Ross River virus (Togaviridae) and herpes simplex virus type 1 (Herpesviridae). Four structurally-related anthraquinones--rhein, 1,8-dihydroxyanthraquinone, emodin and aloe-emodin were also tested for activity against poliovirus type 3. None of the four compounds was as active as chrysophanic acid against the virus. The results suggested that two hydrophobic positions on the chrysophanic acid molecule (C-6 and the methyl group attached to C-3) were important for the compound's activity against poliovirus.

The sexual negotiation behavior of HIV-positive gay and bisexual men.

This study describes the sexual negotiation practices of 256 HIV-positive gay and bisexual men enrolled in a sexual risk reduction intervention. Negotiation behavior was associated with sexual risk practices. Men who abstained from anal sex and those who had unprotected anal sex had the lowest negotiation scores. Negotiations occurred most often with steady partners and least often with anonymous partners. A logistic regression to predict high versus low frequency negotiators revealed the significance of self-efficacy for condom use and number of months HIV-positive. Findings are discussed in terms of the development of sexual risk reduction interventions for HIV-positive gay and bisexual men.

Psychosocial predictors of unprotected anal intercourse in a sample of HIV positive gay men who volunteer for a sexual risk reduction intervention.

This study used logistic regression analysis to identify psychosocial predictors of unprotected anal intercourse in a sample of 212 HIV positive gay men who were enrolled in a sexual risk reduction intervention. A combination of five psychosocial variables (i.e., age, avoidant coping, loneliness, depressive symptoms, and impulsivity) reliably discriminated between men who had engaged in unprotected anal intercourse (UAI) with HIV negative or serostatus unknown partners and those who had not engaged in this high risk behavior. Avoidant coping emerged as the best psychosocial predictor that distinguished between the two groups. Men who had UAI during the previous 4 months had significantly higher scores on avoidant coping as compared with the no-UAI group. These findings suggest the need to design intervention programs for HIV positive gay men that addresses coping strategies in the context of high-risk sexual behaviors.

Partner type and sexual risk behavior among HIV positive gay and bisexual men: social cognitive correlates.

This study used elements of social cognitive theory to examine the relationship between partner type and sexual risk behavior in a sample of HIV positive gay and bisexual men. Self-efficacy captures one's perceived ability to perform a behavior; outcome expectancies are estimations that a behavior will result in a given outcome. An examination of sexual risk behavior revealed that men with steady partners and men with anonymous partners had the most unprotected anal intercourse (UAI), while men with casual partners had the least. Men with anonymous partners had the lowest scores on self-efficacy and outcome expectancies for condom use, negotiation, and disclosure. Outcome expectancies for negotiation of safer sex were inversely related to UAI for men with steady partners. Self-efficacy for condom use and negotiation were inversely related to UAI for men with casual partners. These findings suggest the need to consider partner type in the development of sexual risk reduction interventions.

Use of community support services by middle-aged and older patients with psychotic disorders.

OBJECTIVE: The study sought to determine the degree to which use of community services is related to predisposing, enabling, and need factors among older patients with psychotic disorders who live in the community and to assess whether high use of community services is associated with improving or declining psychopathology. METHODS: The sample consisted of 89 middle-aged and elderly community-dwelling patients with schizophrenia or other psychotic disorders. Assessments at baseline and two follow-ups at six-month intervals included measures of psychopathology, well-being, and social adjustment, in addition to the frequency of use of 17 formal community services in three categories-psychological, social, and daily living services. RESULTS: Ninety-two percent of patients reported use of community support services. The mean number of annual service contacts per patient was 36.6 for psychological services, 81 for social services, and 39.7 for daily living services. High users of psychological services were younger and experienced more severe positive psychotic symptoms and depressive symptoms. High users of social services were of higher socioeconomic status, more likely to be female, and had a longer history of psychosis, more cognitive deficits, and more severe negative psychotic and depressive symptoms. Patients who used daily living services were older, had poorer functional health status and more cognitive deficits, and had more severe negative psychotic and depressive symptoms. A trend was noted for high users of social services to experience relief from depressive symptoms over time. CONCLUSIONS: Use of community services is common among older outpatients with psychotic disorders, but its frequency varies as a function of patient characteristics.

Self-perceived interpersonal competence in older schizophrenia patients: the role of patient characteristics and psychosocial factors.

OBJECTIVE: This study compared older schizophrenia patients with normal subjects in terms of their perceived interpersonal competence. METHOD: A total of 95 middle-aged and elderly schizophrenia patients and 85 age-matched normal subjects completed the Interpersonal Competence Questionnaire. RESULTS: Patients scored significantly lower than normal subjects on initiation, provision of emotional support, and conflict management. Severity of psychiatric symptoms and other patient characteristics were examined as predictors of interpersonal competence among patients. Negative symptoms were inversely related to interpersonal competence, whereas emotional support from others and a positive appraisal coping style both yielded positive associations. CONCLUSION: These findings suggest the need for clinical interventions designed to enhance the interpersonal skills of older schizophrenia patients, particularly those with marked negative symptoms.

Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers.

The purpose of this study was to determine whether the stress of caregiving for the Alzheimer's disease (AD) patient accelerates the likelihood of exceeding hypertensive blood pressure (BP) criteria in periodic longitudinal home assessments. In this cohort study, participants consisted of spousal caregivers of AD patients (n = 144) and demographically equivalent non-caregiving controls (n = 47). Thirty percent of caregivers and 33% of controls were receiving antihypertensive treatment at study entry. Supine systolic and diastolic blood pressure (SBP and DBP) was assessed by semi-automated recordings taken in the home every 6 months for 2 to 6 years. Survival analyses (Cox proportional hazards models) were used to determine whether the hazard for developing hypertension (DBP>140, SBP>90) was greater in caregivers than in controls, and whether increased hazards were related to background characteristics or the extent of caregiving demands. Based on periodic 6-month assessments of BP over 6 years, the hazards of meeting criteria for borderline hypertension were greater for caregivers than for controls (Cox Proportional Hazards, chi2 [1, N = 174] = 4.86, p = 0.03). This difference remained statistically significant (p<0.05) after controlling for age, gender, education, socioeconomic status, body mass index, and use of antihypertensive medications. Increased risk of hypertension was not related to the extent of daily living assistance provided, patient problem behaviors, or caregiver distress. The chronic stress of caring for an AD spouse may have adverse effects on blood pressure; however, the mechanism for this relationship remains unclear.