Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms.

BACKGROUND: Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. METHOD: HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. RESULTS: There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. CONCLUSIONS: The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. TRIAL REGISTRATION: ClinicalTrials.gov NCT02546271.

Multi-wavelength pulse oximeter is not suitable for adjusting D(LCO) measurements.

BACKGROUND: Diffusing capacity of the lung for carbon monoxide (D(LCO)) can be affected by abnormal hemoglobin (Hb) or carboxyhemoglobin (COHb) levels. Predicted D(LCO) can be adjusted to reflect abnormal Hb or COHb levels. Until recently, blood sampling was required to determine Hb and COHb levels, but a new pulse oximeter, the Masimo RAD-57, can measure Hb and COHb noninvasively. We hypothesized that there would be no significant difference between the invasive and noninvasive Hb and COHb measurements for adjusting D(LCO). METHODS: In patients referred to our university hospital for D(LCO) testing, we simultaneously took arterial blood gas samples and measured Hb and COHb with the RAD-57 (SpHb and SpCOHb, respectively). We analyzed the paired values and the Hb-adjusted and COHb-adjusted predicted D(LCO) values with t tests and Bland-Altman plots. We compared the differences in predicted D(LCO) to a clinical threshold of 3 mL/min/mm Hg. RESULTS: SpHb differed from Hb measured via arterial blood analysis (12.1 ± 2.4 g/dL vs 13.3 ± 2.1 g/dL, P < .001). SpCOHb did not differ significantly from COHb (ie, measured via arterial blood analysis) (2.1 ± 4.0 vs 2.5 ± 2.3, P = .25), but there was wide variability. There were small but statistically significant differences in the adjusted predicted D(LCO), depending on whether blood or pulse oximetry values were used. Predicted D(LCO) adjusted for both Hb and COHb was 22.5 ± 4.8 mL/min/mm Hg measured with the RAD-57 and 23.5 ± 4.5 mL/min/mm Hg via arterial blood analysis (P < .001). The limits of agreement for pulse oximetry adjusted D(LCO) exceeded the clinical threshold of 3 mL/min/mm Hg for Hb adjustments and combined Hb + COHb. Predicted D(LCO) values differed by > 3 mL/min/mm Hg in 17% of patients. CONCLUSIONS: Pulse oximetry may be of limited usefulness for adjusting either predicted or measured D(LCO) values, but might be useful to screen patients for invasive testing, particularly if the D(LCO) is close to the lower limit of normal.