bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Primary Imatinib Resistance in Chronic Myelogenous Leukemia Are Distinct From Those in Secondary Imatinib Resistance
Authors: Zhang Wenyong W. , Cortes Jorge E. , Yao Hui , Zhang Li , Reddy Neelima G. , Jabbour Elias , Kantarjian Hagop M. , Jones Dan
Published: June 2009

Purpose

A subset of patients with chronic myelogenous leukemia (CML) do not respond to the tyrosine kinase inhibitor (TKI) imatinib mesylate. Such primary imatinib resistance is distinguished from secondary resistance which reemerges after attainment of cytogenetic remission.

Patients and Methods

We studied gene expression patterns in total WBCs using a panel of 21 genes previously implicated in TKI handling, resistance, or progression comparing patients who had newly diagnosed TKI-naive CML that had optimal (n = 41), or suboptimal (n = 7) responses to imatinib, or primary resistance (n = 20). Expression patterns were compared to those in secondary TKI-resistant chronic phase CML without ABL1 kinase domain mutations (n = 29), and to lymphoid (n = 15) or myeloid blast phase disease (n = 12).

Results

Fifteen genes in the panel distinguished blast phase from chronic phase disease, and 12 genes distinguished newly diagnosed CML from TKI-resistant CML without ABL1 kinase domain mutations, but only a single gene, prostaglandin-endoperoxide synthase 1/cyclooxgenase 1 (PTGS1/COX1; P = .005), differentiated imatinib-responsive from primary imatinib-resistant CML. The association of primary imatinib resistance with higher transcript levels of the drug metabolism gene PTGS1 was confirmed in a separate data set of 68 newly diagnosed, imatinib-treated CML (P = .008). In contrast, up to 11 different genes were identified in a multivariate model that optimally discriminated secondary imatinib resistance lacking ABL1 kinase domain mutation from imatinib-responsive cases, likely related to the more complex pathogenesis of secondary resistance.

Conclusion

Gene expression profiling of CML at diagnosis for PTGS1 may be useful in predicting imatinib response and in selecting alternate therapy.
Pretreatment Prostate-Specific Antigen (PSA) Velocity and Doubling Time Are Associated With Outcome but Neither Improves Prediction of Outcome Beyond Pretreatment PSA Alone in Patients Treated With Radical Prostatectomy
Authors: O'Brien Matthew Frank , Cronin Angel M. , Fearn Paul A. , Smith Brandon , Stasi Jason , Guillonneau Bertrand , Scardino Peter T. , Eastham James A. , Vickers Andrew J. , Lilja Hans
Published: June 2009

Purpose

Controversy exists as to whether current pretreatment prostate-specific antigen (PSA) dynamics enhance outcome prediction in patients undergoing treatment for prostate cancer. We assessed whether pretreatment PSA velocity (PSAV) or doubling time (PSADT) predicted outcome in men undergoing radical prostatectomy and whether any definition enhanced accuracy of an outcome prediction model.

Patients and Methods

The cohort included 2,938 patients with two or more PSA values before radical prostatectomy. Biochemical recurrence (BCR) occurred in 384 patients, and metastases occurred in 63 patients. Median follow-up for patients without BCR was 2.1 years. We used univariate Cox proportional hazards regression to evaluate associations between published definitions of PSADT and PSAV with BCR and metastasis. Predictive accuracy was assessed using the concordance index.

Results

On univariate analysis, two of 12 PSADT and four of 10 PSAV definitions were univariately associated with both BCR and metastasis (P < .05). One PSADT and one PSAV definition had a higher predictive accuracy for BCR over PSA alone, and four PSAV definitions improved prediction of metastasis. However, the improvements in predictive accuracy were small, associated with wide CIs, and markedly reduced if additional predictors of stage and grade were included alongside PSA. Modeling with random variables suggests that similar results would be expected by chance.

Conclusion

We found no clear evidence that any definition of PSA dynamics substantially enhances the predictive accuracy of a single pretreatment PSA alone.
Impact of Androgen Deprivation Therapy on Cardiovascular Disease and Diabetes
Authors: Alibhai Shabbir M.H. , Duong-Hua Minh , Sutradhar Rinku , Fleshner Neil E. , Warde Padraig , Cheung Angela M. , Paszat Lawrence F.
Published: June 2009

Purpose

Use of androgen deprivation therapy (ADT) may be associated with an increased risk of diabetes mellitus but the risk of both acute myocardial infarction (AMI) and cardiovascular mortality remain controversial because few outcomes and conflicting findings have been reported. We sought to clarify whether ADT is associated with these outcomes in a large, representative cohort.

Methods

Using linked administrative databases in Ontario, Canada, men age 66 years or older with prostate cancer given continuous ADT for at least 6 months or who underwent bilateral orchiectomy (n = 19,079) were matched with men with prostate cancer who had never received ADT. Treated and untreated groups were matched 1:1 (ie, hard-matched) on age, prior cancer treatment, and year of diagnosis and propensity-matched on comorbidities, medications, cardiovascular risk factors, prior fractures, and socioeconomic variables. Primary outcomes were development of AMI, sudden cardiac death, and diabetes. Fragility fracture was also examined.

Results

The cohort was observed for a mean of 6.47 years. In time-to-event analyses, ADT use was associated with an increased risk of diabetes (hazard ratio [HR], 1.16; 95% CI, 1.11 to 1.21) and fragility fracture (HR, 1.65; 95% CI, 1.53 to 1.77) but not with AMI (HR, 0.91; 95% CI, 0.84 to 1.00) or sudden cardiac death (HR, 0.96; 95% CI, 0.83 to 1.10). Increasing duration of ADT was associated with an excess risk of fragility fractures and diabetes but not cardiac outcomes.

Conclusion

Continuous ADT use for at least 6 months in older men is associated with an increased risk of diabetes and fragility fracture but not AMI or sudden cardiac death.
Randomized Phase II Trial of Chemoradiotherapy Followed by Either Dose-Dense or Metronomic Temozolomide for Newly Diagnosed Glioblastoma
Authors: Clarke Jennifer L. , Iwamoto Fabio M. , Sul Joohee , Panageas Katherine , Lassman Andrew B. , DeAngelis Lisa M. , Hormigo Adília , Nolan Craig P. , Gavrilovic Igor , Karimi Sasan , Abrey Lauren E.
Published: June 2009

Purpose

Alternative dosing schedules of temozolomide may improve survival in patients with newly diagnosed glioblastoma (GBM) by increasing the therapeutic index, overcoming common mechanisms of temozolomide resistance, or both. The goal of this randomized phase II study was to evaluate two different temozolomide regimens in the adjuvant treatment of newly diagnosed GBM.

Patients and Methods

Adult patients with newly diagnosed GBM were randomly assigned to receive standard radiotherapy with concurrent daily temozolomide followed by six adjuvant cycles of either dose-dense (150 mg/m2 days 1 to 7 and 15 to 21) or metronomic (50 mg/m2 continuous daily) temozolomide. Maintenance doses of 13-cis-retinoic acid were then administered until tumor progression. The primary end point was overall survival (OS) at 1 year. Tumor tissue was assayed to determine O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation status.

Results

Eighty-five eligible patients were enrolled; 42 were randomly assigned to dose-dense and 43 to metronomic temozolomide. The 1-year survival rate was 80% for the dose-dense arm and 69% for the metronomic arm; median OS was 17.1 months (95% CI, 14.0 to 28.1 months) and 15.1 months (95% CI, 12.3 to 18.9 months), respectively. The most common toxicities were myelosuppression (leukopenia, neutropenia, and thrombocytopenia) and elevated liver enzymes. Pseudoprogression was observed in 37% of assessable patients and may have had an impact on estimates of progression-free survival (6.6 months in the dose-dense arm and 5.0 months in the metronomic arm).

Conclusion

Both dose-dense and metronomic temozolomide regimens were well tolerated with modest toxicity. The dose-dense regimen appears promising, with 1-year survival of 80%.
Polymeric nanoparticles of cholesterol-modified glycol chitosan for doxorubicin delivery: preparation and in-vitro and in-vivo characterization
Authors: Yu Jing-Mou , Li Yong-Jie , Qiu Li-Yan , Jin Yi
Published: June 2009

Objectives

Polymeric nanoparticles have been extensively studied as drug carriers. Chitosan and its derivatives have attracted significant attention in this regard but have limited application because of insolubility in biological solution. In this work, we attempted to utilize cholesterol-modified glycol chitosan (CHGC) self-aggregated nanoparticles to increase aqueous solubility, and to reduce side effects and enhance the antitumour efficacy of the anticancer drug doxorubicin.

Methods

CHGC nanoparticles were loaded with doxorubicin by a dialysis method, and their characteristics were determined by transmission electron microscopy examination, light-scattering study, in-vitro drug-release study, pharmacokinetic study in rats and in-vivo antitumour activity in mice.

Key findings

The resulting doxorubicin-loaded CHGC nanoparticles (DCNs) formed self-assembled aggregates in aqueous medium. From the observation by transmission electron microscopy, DCNs were almost spherical in shape. The mean diameters of these nanoparticles determined by dynamic light scattering were in the range of 237–336 nm as the doxorubicin-loading content increased from 1.73% to 9.36%. In-vitro data indicated that doxorubicin release from DCNs was much faster in phosphate-buffered saline at pH 5.5 than at pH 6.5 and 7.4, and the release rate was dependent on the loading content of doxorubicin in these nanoparticles. It was observed that DCN-16 (drug loaded content: 9.36%) exhibited prolonged circulation time in rat plasma and showed higher antitumour efficacy against S180-bearing mice than free doxorubicin.

Conclusions

These results indicated that CHGC nanoparticles had potential as a carrier for insoluble anticancer drugs in cancer therapy.
Synthesis of methoxypoly(ethylene glycol) carbonate prodrugs of zidovudine and penetration through human skin in vitro
Authors: N'Da David D , Breytenbach Jaco C
Published: June 2009

Objectives

The aim of this study was to synthesise a series of novel methoxypoly (ethylene glycol) carbonate prodrugs of the antiretroviral drug zidovudine (azidothymidine, AZT) in an attempt to enhance the physicochemical properties for transdermal delivery, which may reduce the severe side-effects and toxicity associated with high oral doses of AZT.

Methods

Methoxypoly(ethylene glycol) carbonates of AZT were synthesised in two steps: activation of the relevant methoxypoly(ethylene glycol) with p-nitrophenyl chloroformate, followed by reaction with AZT. Analysis of the hydrolytic stability in phosphate buffer at pH 5.0 and 7.4 revealed that all the carbonates were markedly more stable at pH 5.0 than at pH 7.4 (0.01 m), with half-lives ranging from 15 to 44 days at pH 5.0 and from 6 to 24 days at pH 7.4. The potential of the series to penetrate the skin was evaluated in vitro by measuring diffusion through excised abdominal female human skin at pH 5.0.

Key findings

Prodrugs with 1–3 or 8 oxyethylene units in the methoxypoly(ethylene glycol) moiety were found to permeate the skin whereas those with 12 or 17 units did not. The prodrug with eight oxyethylene units was the most effective penetrant, permeating the skin with a mean flux of 53.3 ± 46.5 nmol/cm2 per h, which is 2.4–10.1 times that of AZT (8.55 ± 5.3 nmol/cm2 per h).

Conclusions

The bioreversible conjugation of the methoxypoly(ethylene glycol) promoiety to AZT appears to be a promising strategy for the transdermal delivery of AZT at a therapeutic dose.
Preparation, physicochemical characterization and biological evaluation of cefodizime metal ion complexes
Authors: Auda Sayed H , Mrestani Yahya , Nies Dietrich H , Groβe Cornelia , Neubert Reinhard H H
Published: June 2009

Objectives

Cefodizime is a broad spectrum cephalosporin belonging to the third generation agents. In this study, attention has been paid to the preparation, physicochemical characterization and biological evaluation of new Cu2+, Zn2+, Fe3+, Co2+ and Al3+ complexes of cefodizime.

Methods

The stoichiometrics and the mode of bonding of the complexes were deduced from their elemental and metal analysis, electrical conductivity measurements, UV-vis, infrared and Raman spectroscopic investigations. Study of the stoichiometry of these complexes referred to the formation of 1: 1 ratios of metal to ligand. Antimicrobial activity of the complexes was determined using two strains of Gram-positive (Bacillus subtilis and Proteus vulgaris) and two strains of Gram-negative (Escherichia coli W3110 and Pseudomonas putida) bacteria. The minimal inhibitory concentration was determined as the lowest concentration inhibiting bacterial growth on solid Luria Bertani medium.

Key findings

The spectra gave evidence as to the position of binding. In addition, the aqueous solubility of cefodizime was strongly reduced by complexation.

Conclusions

The antibacterial activity of cefodizime was not affected by complexation with Al3+ but it was reduced by complexation with the other tested metal ions against the bacteria under study.
Coordinated kinematic modelling for motion planning of heavy-duty manipulators in an integrated open-die forging centre
Authors: Yan C , Gao F , Guo W
Published: June 2009

An integrated open-die forging centre can realize programmed incremental forging processes to improve safety and efficiency; the centre consists of a forging press and one or two heavy-duty manipulators. This paper focuses on the coordinated kinematic modelling of the integrated system. First a newly designed serial—parallel forging manipulator is presented and the closed-form inverse kinematic solution is derived based on homogeneous co-ordinate transformation. Then the deformation of the forged workpiece is investigated by the spread coefficient method of plastic deformation theory, and the relation between the motion of the holding end of the workpiece and the movement of the upper die is formulated. Finally, the coordinated kinematic modelling of the integrated system is established, where the press and the manipulator are coordinated in movement. Simulation of a typical open-die forging process shows that the gripper of the manipulator should have good compliance abilities in horizontal and vertical directions during forging; however, it should have high rotation stiffness with respect to the transverse axis. The automatic programmed forging plan and coordination control strategy can be pre-designed based on this model.
Comparison of polymerase chain reaction primer sets for amplification of rodent Pasteurellaceae
Authors: Boot R , Vlemminx M J , Reubsaet F A G
Published: June 2009

Monitoring of rodents for Pasteurellaceae infection may be carried out by the polymerase chain reaction (PCR). We tested which of 17 rodent Pasteurellaceae strains were detected by three PCR primer sets. By phylogenetic analysis, 12 strains were assigned to the Rodent cluster and five strains to other clusters, namely the Somnus cluster, Pasteurella sensu stricto, Actinobacillus sensu stricto, the Mannheimia and Rossii cluster. A primer set developed to detect biotype Heyl [ Pasteurella] pneumotropica produced amplicons from three strains and appeared specific for this taxon. A primer set developed to detect biotype Jawetz [ P.] pneumotropica produced amplicons from the [ P.] pneumotropica type strain and two other strains within the Rodent cluster. A primer set as described by Bootz and his co-workers (Bootz F, Kirschnek S, Nicklas W, Wyss SK, Homberger FR. Detection of Pasteurellaceae in rodents by polymerase chain reaction analysis. Lab Anim Sci 1998;48:542–6) for the detection of all Pasteurellaceae indeed detected all bacterial strains examined. Bootz's primer set should be used to monitor rodents for Pasteurellaceae infection by PCR as FELASA recommends the monitoring of rodents for all Pasteurellaceae taxa. Health monitoring reports should specify the primer set(s) used for PCR testing rodents for Pasteurellaceae infection.
Vascular ultrasound studies for the non-invasive assessment of vascular flow and patency in experimental surgery in the pig
Authors: Osorio-da Cruz S M , Aggoun Y , Cikirikcioglu M , Khabiri E , Djebaili K , Kalangos A , Walpoth B
Published: June 2009

Vascular ultrasound is a reliable non-invasive tool used for the routine assessment of vascular flow and patency in human recipients. We describe the use at three different time points (immediately, 1 week and 4 weeks postsurgery) of ultrasound studies and its validation by angiographic studies in 37 swine undergoing carotid graft replacement. We calculated predictive values (>92%), sensitivity (>85%) and specificity (>92%) with high results at all time points. Ultrasound appeared as an accessible non-invasive technique, providing rapid, safe, repeatable and reliable results. It is an excellent alternative to angiography, avoiding risks inherent to invasive methods and therefore contributing to animal welfare.
Characterization of a rodent model for the study of arterial microanastomoses with size discrepancy (small-to-large)
Authors: Rickard R F , Wilson J , Hudson D A
Published: June 2009

Microsurgical autotransplantation of tissues is employed clinically to reconstruct defects following burns, trauma and surgical cancer ablation, and to correct congenital abnormalities. Transplant vessels of <3 mm are anastomosed by hand under the microscope. Experimentally, anastomotic patency rates decrease with increasing vessel diameter mismatch, and clinically, ratios of 3:1 or greater lead to unacceptably low arterial patency rates. A number of surgical techniques for dealing with size mismatch are described, but no one method has found favour, and few controlled studies of technique are reported. In this report, a rodent superficial caudal epigastric artery (SCEA)/femoral artery (FA) model for the study of these techniques is described in detail. The diameter ratio between these vessels lies in the clinically relevant range of 1:1.5–1:2.5. In the male Wistar rat, external vessel diameters were not found to increase markedly in size between animal weights of 300 and 500 g. The length of FA distal to the origin of the SCEA, which is important in allowing undisturbed distal run-off, was found to be negatively associated with animal body weight, implying that a smaller animal would be better for this model. Mean femoral arterial flow rate, measured by transit-time ultrasound, was noted to be statistically and physiologically significantly higher in the right artery when compared with the left. This model has advantages over interposition vein graft models in that it minimizes vessel compliance mismatch, and avoids the need for a second anastomosis.
Book Reviews
Authors: Lev Benjamin
Published: June 2009

In Book Reviews, we review an extensive and diverse range of books. They cover theory and applications in operations research, statistics, management science, econometrics, mathematics, computers, and information systems. In addition, we include books in other fields that emphasize technical applications. However, we do not review software. To submit a book for review, please send it to me at the above address. Although we cannot review all books because of space limitations, we do list all books that we receive. We commission all book reviews and do not accept unsolicited reviews. To become a reviewer, please send me your name, address, and specific areas of expertise. We encourage readers to suggest books for review or to ask publishers to send copies of such books.

The authors or editors of books we review in this issue are Frada Burstein, Clyde W. Holsapple, John W. Chinneck, Michael C. Ferris, Olvi L. Mangasarian, and Stephen J. Wright.
Practice Abstracts
Authors: Denton Brian T.
Published: June 2009

The goal of “Practice Abstracts” is to present interesting, topical, and novel applications of operations research methodology to a wide range of industrial applications. “Practice Abstracts” are intended to provide Interfaces readers with short (2–4 page) descriptions of the most relevant aspects of operations research-based projects, in a form that is accessible to academics and practitioners in other organizations. Contributions should be sent for evaluation to the editor of “Practice Abstracts,” Brian T. Denton, Edward P. Fitts Department of Industrial and Systems Engineering, 376 Daniels Hall, North Carolina State University, 111 Lampe Drive, Campus Box 7906, Raleigh, North Carolina 27695-7906, bdenton@ncsu.edu.
Pregnancy Intentions and Happiness Among Pregnant Black Women at High Risk for Adverse Infant Health Outcomes
Authors: Blake Susan M. , Kiely Michele , Gard Charlotte C. , El‐Mohandes Ayman A. E. , El‐Khorazaty M. Nabil ,   the NIH‐DC Initiative
Published: June 2009

CONTEXT:  Unintended pregnancy is associated with risk behaviors and increased morbidity or mortality for mothers and infants, but a woman’s feelings about pregnancy may be more predictive of risk and health outcomes than her intentions.

METHODS:  A sample of 1,044 black women who were at increased risk were enrolled at prenatal care clinics in the District of Columbia in 2001–2003. Bivariate and multivariate analyses assessed associations between pregnancy intentions or level of happiness about being pregnant and multiple psychosocial and behavioral risk factors, and identified correlates of happiness to be pregnant.

RESULTS:  Pregnancy intentions and happiness were strongly associated, but happiness was the better predictor of risk. Unhappy women had higher odds than happy women of smoking, being depressed, experiencing intimate partner violence, drinking and using illicit drugs (odds ratios, 1.7–2.6). The odds of being happy were reduced among women who had other children or a child younger than two, who were single or did not have a current partner, who had had more than one sexual partner in the past year and who reported that the baby’s father did not want the pregnancy (0.3–0.6). In contrast, the odds of being happy were elevated among women who had better coping strategies (1.03), who had not used birth control at conception (1.6) and who had 1–2 household members, rather than five or more (2.1).

CONCLUSIONS:  Additional psychosocial screening for happiness about being pregnant and for partner characteristics, particularly the father’s desire to have this child, may help improve prenatal care services and prevent adverse health outcomes.
The Quality of Family Planning Services in the United States: Findings from a Literature Review
Authors: Becker Davida , Koenig Michael A. , Mi Kim Young , Cardona Kathleen , Sonenstein Freya L.
Published: June 2009

CONTEXT:  Family planning services are frequently used and important services for American women, yet little is known about their quality. Service quality has important implications for women’s reproductive health. If women do not receive adequate information and tools, and learn appropriate skills, from their providers, they may be hampered in their efforts to control their fertility.

METHODS:  A variety of strategies, including database, journal and Internet searches, were used to identify published and unpublished U.S. studies on family planning service quality that came out between 1985 and 2005. Studies were categorized by their focus, and key points of their methodologies and findings were assessed.

RESULTS:  Twenty‐nine studies were identified, most of which were based on client surveys. Most conceptualized quality as a multidimensional construct, but a uniform definition of quality is lacking, and the domains studied have not been consistent. The available studies focus on four areas: assessments of quality, its correlates, its consequences for client behavior and attitudes, and clients’ values and preferences regarding services. Relations between clients and service facility staff have typically been rated favorably, but communication, patient‐centeredness and efficiency have been rated more poorly. Service quality varies by characteristics of the facility, provider, client and visit. Research on the consequences of service quality for clients’ contraceptive behavior or risk of unintended pregnancy has been very limited and yielded mixed results.

CONCLUSIONS:  Studies that assess service quality need stronger designs and greater consistency in measures used so that results are comparable.
Legal Abortion Worldwide: Incidence and Recent Trends
Authors: Sedgh Gilda , Henshaw Stanley K. , Singh Susheela , Bankole Akinrinola , Drescher Joanna
Published: June 2009

CONTEXT:  Information on abortion levels and trends can inform research and policies affecting maternal and reproductive health, but the incidence of legal abortion has not been assessed in nearly a decade.

METHODS:  Statistics on legal abortions in 2003 were compiled for 60 countries in which the procedure is broadly legal, and trends were assessed where possible. Data sources included published and unpublished reports from official national reporting systems, questionnaires sent to government agencies and nationally representative population surveys. The completeness of country estimates was assessed by officials involved in data collection and by in‐country and regional experts.

RESULTS:  In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each, on average, in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world’s legal abortions in 1996. Trends in the abortion rate differed across age‐groups in some countries.

CONCLUSIONS:  The abortion rate varies widely across the countries in which legal abortion is generally available and has declined in many countries since the mid‐1990s.
The Association of Health Insurance with Use of Prescription Contraceptives
Authors: Culwell Kelly R. , Feinglass Joe
Published: June 2009

CONTEXT:  Given that substantial proportions of women of reproductive age lack health insurance coverage, it is important to assess whether lack of insurance is associated with the use of prescription contraceptives, which are the most expensive but also the most effective methods for preventing pregnancy.

METHODS:  Data from 26,674 females aged 18–44 who participated in the 2002 Behavioral Risk Factor Surveillance System survey (representing more than 25 million women in the U.S. population) were used to assess risk of unintended pregnancy, prescription contraceptive use and health insurance status. Logistic regression models tested the likelihood of prescription contraceptive use among insured versus uninsured respondents after controlling for socioeconomic characteristics and self‐reported overall health.

RESULTS:  A significantly higher proportion of insured women than of uninsured women reported use of prescription contraceptives (54% vs. 45%). In multiple regression analysis, women lacking health insurance were 30% less likely to report using prescription contraceptive methods than were women with private or public health insurance. Results were similar across racial, age and income subgroups.

CONCLUSIONS:  Lack of health insurance is associated with reduced use of prescription contraceptives. Universal insurance coverage is needed to ensure access to the most effective contraceptive methods for all women in need.
Prior Pill Experiences and Current Continuation Among Pill Restarters
Authors: Kalmuss Debra , Koenemann Shelly , Westhoff Carolyn , Heartwell Stephen , Edwards Sharon , Zieman Mimi , Cushman Linda , Robilotto Christina , Stuart Gretchen
Published: June 2009

CONTEXT:  Discontinuation of oral contraceptives often puts women at risk for unintended pregnancies. Understanding why a woman discontinued pill use can provide insight into her risk of discontinuation if she restarts use.

METHODS:  Women younger than 25 obtaining oral contraceptives at three university health centers in 2003–2005 were recruited to participate in a randomized trial; 628 former users were interviewed about their previous experience with the method, and were followed up three months after restarting use. Bivariate and multinomial logistic regression analyses were used to assess the relationship between prior reasons for stopping pill use and method continuation.

RESULTS:  Women who had discontinued using oral contraceptives because of side effects were less likely to be very sure about restarting the pill at baseline (73%) than were those who had stopped for logistical or fertility‐related reasons (88–94%). They also were less likely to have been satisfied with the pill in the last use interval (49% vs. 95–98%) and less likely to be satisfied with it in the three months after restarting (76% vs. 89–93%). These women were more likely to report a short duration of use than an intermediate duration or continuous use during follow‐up (odds ratios, 2.5 and 4.5).

CONCLUSIONS:  When counseling women who are restarting pill use, providers should ask about their experiences with the method and reasons for discontinuation; counseling for women who discontinued because of side effects should address their risk factors for early discontinuation and informing them about other contraceptive choices.
Recent Evaluations of the Peer‐Led Approach in Adolescent Sexual Health Education: A Systematic Review
Authors: Kim Caron R. , Free Caroline
Published: June 2009

CONTEXT:  Peer‐led interventions have become a popular method of providing sexual health education to adolescents, but the efficacy of this approach and the methodological quality of recent trials have not been systematically reviewed.

METHODS:  Electronic and hand searches were conducted to identify quasi‐randomized and randomized controlled trials of peer‐led adolescent sexual health education published from 1998 to 2005. Studies were eligible if they had an appropriate comparison group, provided preintervention and postintervention data, and reported all outcomes. Study results were summarized and, where appropriate, pooled; in addition, 10 aspects of studies’ methodological quality were assessed.

RESULTS:  Thirteen articles met the inclusion criteria. Pooled, adjusted results from seven trials that examined the effects of peer‐led interventions on condom use at last sex found no overall benefit (odds ratio, 1.0). None of the three trials that assessed consistent condom use found a benefit. One study reported a reduced risk of chlamydia (0.2), but another found no impact on STD incidence. One study found that young women (but not young men) who received peer‐led education were more likely than nonrecipients to have never had sex. Most interventions produced improvements in knowledge, attitudes and intentions. Only three studies fulfilled all 10 of the assessed quality criteria; two others met nine criteria.

CONCLUSIONS:  Despite promising results in some trials, overall findings do not provide convincing evidence that peer‐led education improves sexual outcomes among adolescents. Future trials should build on the successful trials conducted to date and should strive to fulfill existing quality criteria.
Associations Between Low‐Income Women’s Relationship Characteristics and Their Contraceptive Use
Authors: Wilson Ellen K. , Koo Helen P.
Published: June 2009

CONTEXT:  Women’s relationship context likely influences both their ability and their motivation to use contraceptives. No recent studies, however, have examined associations between women’s relationship characteristics and use of different methods.

METHODS:  Data were collected in a longitudinal study of 839 low‐income women at risk of unintended pregnancy who visited public family planning and postpartum clinics and maternity wards in two Southeastern cities. Simulated probabilities calculated from multivariate analyses assessed associations between a wide range of relationship characteristics and the use of no method, condoms, withdrawal, female methods or dual methods.

RESULTS:  Women who had had a child with their partner had an increased likelihood of contraceptive nonuse and use of withdrawal, and a decreased likelihood of using any female method. Respondents who were in a relationship for a relatively long time had an elevated likelihood of nonuse and use of female methods, but a lowered likelihood of condom use. Furthermore, married or cohabiting women were less likely than others to use dual methods. Respondents who had good communication with their partner had an elevated likelihood of using condoms. In addition, women who expected to receive a lot of emotional support from their partner if they became pregnant were more likely than others to report any condom use or dual method use, and less likely to report contraceptive nonuse.

CONCLUSIONS:  When counseling family planning clients, providers should consider women in the context of their relationships. Future research exploring factors associated with contraceptive method use should examine variables related to the establishment, quality and expectations of their relationships.
The Link Between Couples’ Pregnancy Intentions And Behavior: Does It Matter Who Is Asked?
Authors: Waller Maureen R. , Bitler Marianne P.
Published: June 2009

CONTEXT:  Previous studies have linked pregnancy intentions with some pregnancy‐related behaviors and infant health outcomes. However, most have used only women’s reports of intentions and examined only maternal behaviors.

METHODS:  Baseline data from the Fragile Families and Child Wellbeing Study (1998–2000) are used to examine whether parents of newborns considered abortion upon learning of the pregnancy and whether this measure of pregnancy intention is associated with their behaviors during pregnancy or with infant birth weight. Associations between outcomes and each parent’s pregnancy intention are explored with multivariate probit regressions or least squares regressions for 737 married and 2,366 unmarried couples.

RESULTS:  If at least one parent considered abortion, unmarried mothers had a significantly reduced probability of initiating early prenatal care, and unmarried fathers had a significantly reduced probability of providing cash or in‐kind support during the pregnancy. The proportion of mothers receiving care in the first trimester was 12 percentage points lower when the mother only or both parents considered abortion than when neither parent did; depending on which parent reported on fathers’ support during pregnancy, the proportion of fathers who provided cash or in‐kind assistance was 6–10 percentage points lower when the father only considered abortion and 6–14 points lower when both parents considered abortion than when neither did.

CONCLUSIONS:  Future research on pregnancy intentions should incorporate both men and women. Understanding men’s pregnancy intentions and their associations with early support of mothers may inform discussions of how to encourage men’s involvement in family planning, prenatal health care and parenting.
Reproductive Health Service Preferences And Perceptions of Quality Among Low‐Income Women: Racial, Ethnic and Language Group Differences
Authors: Becker Davida , Tsui Amy O.
Published: June 2009

CONTEXT:  Eliminating racial and ethnic disparities in health care is an important national priority. Despite substantial research documenting such disparities, this topic has received limited attention in the reproductive health field.

METHODS:  Logistic regression was used to test for group differences in three service delivery preferences and five service quality perceptions among a nationally representative sample of 1,741 low‐income black, Latina and white women aged 18–34; the data were collected in 1995 and represent the most recent data available for looking at these issues.

RESULTS:  English‐speaking Latinas and Spanish‐speaking Latinas were more likely than whites to prefer a female clinician at their visits (odds ratios, 1.8 and 3.6, respectively) and to highly value clinician continuity (1.7 and 2.2). English‐speaking Latinas and blacks were more likely than whites to prefer receiving reproductive health care at a site delivering general health care (1.5 and 1.6). Both groups of Latinas were less likely than whites to give the facility environment or the patient‐centeredness at their most recent reproductive health visit the highest rating (0.3–0.5). Blacks were more likely than whites to report ever having been pressured by a clinician to use contraceptives (2.3).

CONCLUSIONS:  Efforts to reduce racial, ethnic and language group differences in clients’ perceptions of reproductive health service quality should focus on improving client‐clinician communication, the service environment and contraceptive counseling. Future research should continue to assess group differences and try to determine their underlying causes.
Changes in Sexual Risk Behavior as Young Men Transition to Adulthood
Authors: Dariotis Jacinda K. , Sonenstein Freya L. , Gates Gary J. , Capps Randy , Astone Nan M. , Pleck Joseph H. , Sifakis Frangiscos , Zeger Scott
Published: June 2009

CONTEXT:  Understanding how young men’s sexual risk behaviors change during the transition from adolescence to early adulthood is important for the design and evaluation of effective strategies to reduce the transmission of HIV and other STDs.

METHODS:  Data from three waves of the National Survey of Adolescent Males (1988, 1991 and 1995) were used to categorize 1,880 respondents into clusters according to sexual risk behaviors. Univariate and bivariate analyses were conducted to assess associations between clusters and rates of self‐reported STD diagnoses and positive chlamydia tests.

RESULTS:  Two dimensions of sexual risk‐taking defined the clusters: partner characteristics and condom use. More than 50% of men remained in low‐risk groups over time. In the first two waves, 24–32% of men reported engaging in high‐risk behaviors (risky partners, condom nonuse); these behaviors were associated with elevated levels of STD outcomes. Nearly 40% of men who entered a high‐risk group in the first two waves transitioned to a lower risk group by the third wave. Nine percent of men either engaged in increasingly risky behaviors or maintained membership in high‐risk groups; elevated STD rates characterized both trajectories. Low condom use combined with having multiple partners during adolescence was associated with elevated STD rates in the year preceding the third wave; high condom use coupled with having risky partners was not.

CONCLUSIONS:  The prominence of low‐risk behaviors over time suggests that most young men avoid sexual risk‐taking. Effective strategies to reduce HIV and STD risk in young men must simultaneously address multiple dimensions of sexual behavior.
Sexual Risk‐Taking Among Adult Dating Couples In the United States
Authors: Billy John O. G. , Grady William R. , Sill Morgan E.
Published: June 2009

CONTEXT: Knowledge of sexual and contraceptive behaviors as risk factors for STDs is largely based on women's or men's separate reports of their attitudes and behaviors. Little research has been based on couples.

METHODS: Data from the 2005–2006 National Couples Survey were used to examine the sexual risk‐taking behavior of 335 dating couples. Associations between each partner's characteristics and the couple's probability of recently having had anal sex and of having done something to protect themselves from STDs were assessed using logistic regression analyses. Models included measures of power dynamics and partners' perceptions of who controls sexual and contraceptive decisions.

RESULTS: Couples in which the female partner reported that her male partner made the decisions about sex and contraception had increased probability of having had anal sex during the four weeks prior to the interview. In addition, partners' relationship power and their perception of control over sex and contraception moderated associations between couples' behavior and partners' characteristics, experiences and beliefs. For example, although couples in which the male partners had known someone with AIDS were less likely than others to engage in anal sex, that association was much greater for males with high income—and thus greater power—than for those with low income.

CONCLUSIONS: Sexual behaviors are not controlled by any one individual in a relationship; characteristics of each partner are important. Couples‐based interventions that take into consideration relationship—especially power—dynamics may enable individuals to initiate and sustain safer‐sex practices.
It's Better on TV: Does Television Set Teenagers Up for Regret Following Sexual Initiation?
Authors: Martino Steven C. , Collins Rebecca L. , Elliott Marc N. , Kanouse David E. , Berry Sandra H.
Published: June 2009

CONTEXT: Two‐thirds of sexually experienced teenagers in the United States say they wish they had waited longer to have intercourse for the first time. Little is known about why such a large proportion of teenagers express disappointment about the timing of their initial experience with sex.

METHODS: Data on television viewing, on regret about the timing of first intercourse and on potentially relevant covariates were obtained from a national, three‐year (2001–2004) longitudinal survey of adolescents aged 12–17 at baseline. Logistic regression and path analysis were used to examine the association between exposure to sex on television and the likelihood of regret following sexual initiation, the extent to which shifts in expectations about the positive consequences of sex mediate this association and whether these relationships differ by gender.

RESULTS: Sixty‐one percent of females and 39% of males who had sex for the first time during the study period reported that they wished they had waited to have sex. Exposure to sexual content on television was positively associated with the likelihood of regret following sexual initiation among males (coefficient, 0.34) but not females. The association among males was partly explained by a downward shift in males' sex‐related outcome expectancies following sexual initiation.

CONCLUSIONS: Interventions that limit teenagers' exposure to televised sexual content, that provide a more accurate portrayal of sexuality than typically depicted on television or that help adolescents think critically about televised sexual content may help teenagers make more carefully considered decisions about sexual debut.
Complexity, Universities and the Arts
Authors: Elton Lewis
Published: June 2009

At a time when UK universities yield increasingly to top-down management systems, this article revisits Alexander von Humboldt's famous memorandum of 1810, which called for licensed seclusion and a spirit of open collaboration in the new University of Berlin. To today's administrators,
this would probably sound impossibly chaotic because, when learning communities become complex and independent, their flexibility is gained at the expense of managerial certainty. However, the article suggests that cybernetics, complexity theory and design might provide a theory for Humboldt's
practice. By emphasizing the more tacit aspects of knowledge sharing, emergent values can be sustained without the need for hierarchical control. This is exemplified in the co-design methods of artist, turned architect, Friedensreich Hundertwasser, whose residential buildings still sustain
thriving communities.
Beautiful place/beautiful view journey scrolls and writing structure in the hea(r)t of the southern hemisphere
Authors: Diggle Val
Published: June 2009

This article documents a re-iterated workshop which was presented firstly to groups of undergraduate students in New Zealand, from a variety of disciplines, not all of which were arts based, who had elected to take a paper in creative process as a minor component of their degree. For
these undergraduate students, the workshop was designed to introduce a system for entering a zone, a creative pre-space, which would be an effective preparation for writing creatively.

The same workshop was then presented to groups of postgraduate Master of Fine Art and Master of Design
students to improve the quality of their journal writing. For these students, the workshop was designed to introduce a performative series of actions which would help to disrupt preconceived notions, and introduce new ways of thinking, about the relationship between writing and creative practice.

In
the workshop, all the students were invited to consider, with the careful scrutiny of a forensic scientist, the secret life of places. They were introduced to a system used by Japanese scroll artists who record the journey from a beautiful place to a beautiful view by making observational
drawings of lateral views along the way, from regular vantage points, turning slowly through 180 degrees, until, having reached the destination, the beautiful view itself, their gaze is directed back to the starting point.

In the process of recording their own small journeys in this way,
with rolls of paper and charcoal, students described experiencing a slower, embodied form of knowing which not only enlivened them to the secret life of places, but also gave them a tacit understanding about writing structure. The students, at undergraduate and postgraduate stages in their
education, became aware of themselves simultaneously travelling, in a self-directed way, through space, whilst also being defined by that space. They expressed an awareness of this reciprocal relationship verbally, through drawings and in critical, self-reflective writing. The students absorbed
the exercise as part choreography, part script and as a metaphor for academic writing, in which the end (which can rarely be fully anticipated) must be signalled by the beginning, and in which the introduction is often finally drafted last.

This article also explores the value of irregularity
as a legitimate pedagogical strategy to inform journal writing, by empowering students to explore their own creativity through an autonomous process of critical self-reflection. The form of this article attempts to offer a model for a style of writing within this process which could be described
as belonging to the genre of creative non-fiction.