1
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Johnson AM, Charre-Perales J, Todd A, Arguelles-Ramos M, Ali AAB. The impact of dietary oregano essential oil supplementation on fatty acid composition and lipid stability in eggs stored at room temperature. Br Poult Sci 2024:1-8. [PMID: 38507293 DOI: 10.1080/00071668.2024.2326886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/17/2024] [Indexed: 03/22/2024]
Abstract
1. In many countries, eggs are not refrigerated and must be stored at room temperature. The objective of this study was to explore the effects of dietary oregano oil (275 mg/ kg; ORE) versus an unsupplemented control diet (CON) on laying hens on the shelf life and fatty acid profile of eggs.2. Treatments were randomly distributed into 10 pens containing 27 birds each. A total of 200 eggs were collected from both groups on the same day and were stored for either 0, 10, 21 and 35 d. At each storage time, egg yolks were analysed for fatty acid profile and lipid peroxidation.3. The main indicator of lipid peroxidation, malondialdehyde (MDA), was significantly lower in ORE eggs compared to CON eggs (p = 0.001). Storage time had a significant impact on MDA concentrations (p = 0.023), with the highest found after 35 d. Significant differences were found for individual fatty acids, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA). Palmitic acid, stearic acid, oleic acid, linoleic acid and arachidonic acid were significantly lower in ORE eggs compared to CON eggs (p < 0.05). Palmitoleic acid (p = 0.002), linolenic acid (p = 0.001) and docosahexaenoic acid (DHA, p = 0.001) were significantly higher in ORE eggs.4. Storage only affected oleic, linolenic, linoleic, arachidonic and docosahexaenoic acids (p < 0.05). Total SFA, MUFA, n-6 and ratio of n-3 to n-6 (n-3:n-6) PUFA were significantly higher in CON eggs (p < 0.05). The ratio of SFA to PUFA (SFA:PUFA, p = 0.005) and total n-3 PUFA (p = 0.001) were significantly higher in ORE eggs.5. The n-3:n-6 ratio was significantly impacted by treatment (p = 0.021) and storage (p = 0.031) with no significant interaction. This ratio is important for human health indication and could lead to the development of designer eggs.
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Affiliation(s)
- A M Johnson
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - J Charre-Perales
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - A Todd
- College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - M Arguelles-Ramos
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
| | - A A B Ali
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, SC, USA
- Animal Behavior and Management, Veterinary Medicine, Cairo University, Cairo, Egypt
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2
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Cato ML, D'Agostino EH, Spurlin RM, Flynn AR, Cornelison JL, Johnson AM, Fujita RA, Abraham SM, Jui NT, Ortlund EA. Comparison of activity, structure, and dynamics of SF-1 and LRH-1 complexed with small molecule modulators. J Biol Chem 2023; 299:104921. [PMID: 37328104 PMCID: PMC10407255 DOI: 10.1016/j.jbc.2023.104921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/18/2023] Open
Abstract
Steroidogenic factor-1 (SF-1) is a phospholipid-sensing nuclear receptor expressed in the adrenal glands, gonads, and hypothalamus which controls steroidogenesis and metabolism. There is significant therapeutic interest in SF-1 because of its oncogenic properties in adrenocortical cancer. Synthetic modulators are attractive for targeting SF-1 for clinical and laboratory purposes due to the poor pharmaceutical properties of its native phospholipid ligands. While small molecule agonists targeting SF-1 have been synthesized, no crystal structures have been reported of SF-1 in complexes with synthetic compounds. This has prevented the establishment of structure-activity relationships that would enable better characterization of ligand-mediated activation and improvement in current chemical scaffolds. Here, we compare the effects of small molecules in SF-1 and its close homolog, liver receptor homolog-1 (LRH-1), and identify several molecules that specifically activate LRH-1. We also report the first crystal structure of SF-1 in complex with a synthetic agonist that displays low nanomolar affinity and potency for SF-1. We use this structure to explore the mechanistic basis for small molecule agonism of SF-1, especially compared to LRH-1, and uncover unique signaling pathways that drive LRH-1 specificity. Molecular dynamics simulations reveal differences in protein dynamics at the pocket mouth as well as ligand-mediated allosteric communication from this region to the coactivator binding interface. Our studies, therefore, shed important insight into the allostery driving SF-1 activity and show potential for modulation of LRH-1 over SF-1.
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Affiliation(s)
- Michael L Cato
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emma H D'Agostino
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Autumn R Flynn
- Department of Chemistry, Emory University, Atlanta, Georgia, USA
| | | | - Alyssa M Johnson
- Department of Chemistry, Emory University, Atlanta, Georgia, USA
| | - Rei A Fujita
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sarah M Abraham
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nathan T Jui
- Department of Chemistry, Emory University, Atlanta, Georgia, USA
| | - Eric A Ortlund
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia, USA.
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3
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Cato ML, Cornelison JL, Spurlin RM, Courouble VV, Patel AB, Flynn AR, Johnson AM, Okafor CD, Frank F, D’Agostino EH, Griffin PR, Jui NT, Ortlund EA. Differential Modulation of Nuclear Receptor LRH-1 through Targeting Buried and Surface Regions of the Binding Pocket. J Med Chem 2022; 65:6888-6902. [PMID: 35503419 PMCID: PMC10026694 DOI: 10.1021/acs.jmedchem.2c00235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Liver receptor homologue-1 (LRH-1) is a phospholipid-sensing nuclear receptor that has shown promise as a target for alleviating intestinal inflammation and metabolic dysregulation in the liver. LRH-1 contains a large ligand-binding pocket, but generating synthetic modulators has been challenging. We have had recent success generating potent and efficacious agonists through two distinct strategies. We targeted residues deep within the pocket to enhance compound binding and residues at the mouth of the pocket to mimic interactions made by phospholipids. Here, we unite these two designs into one molecule to synthesize the most potent LRH-1 agonist to date. Through a combination of global transcriptomic, biochemical, and structural studies, we show that selective modulation can be driven through contacting deep versus surface polar regions in the pocket. While deep pocket contacts convey high affinity, contacts with the pocket mouth dominate allostery and provide a phospholipid-like transcriptional response in cultured cells.
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Affiliation(s)
- Michael L. Cato
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
| | | | | | | | - Anamika B. Patel
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Autumn R. Flynn
- Department of Chemistry, Emory University, Atlanta, Georgia 30322
| | | | - C. Denise Okafor
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Filipp Frank
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Emma H. D’Agostino
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
| | | | - Nathan T. Jui
- Department of Chemistry, Emory University, Atlanta, Georgia 30322
| | - Eric A. Ortlund
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia 30322
- Corresponding Author:
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4
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Macdowall WG, Clifton S, Palmer MJ, Tanton C, Copas AJ, Lee DM, Mitchell KR, Mercer CH, Sonnenberg P, Johnson AM, Wellings K. Salivary Testosterone and Sexual Function and Behavior in Men and Women: Findings from the Third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3). J Sex Res 2022; 59:135-149. [PMID: 34634954 PMCID: PMC7613951 DOI: 10.1080/00224499.2021.1968327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Using data from the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) we examined associations between salivary testosterone (Sal-T) and sexual function and behavior. Single morning saliva samples were self-collected from a subsample of participants aged 18-74 years and analyzed using mass spectrometry. 1,599 men and 2,123 women were included in the analysis (40.6% of those invited to provide a sample). We adjusted for confounders in a stepwise manner: in model 1 we adjusted for age only; model 2 for age, season and relationship status, and model 3 we added BMI and self-reported health. In the fully adjusted models, among men, Sal-T was positively associated with both partnered sex (vaginal sex and concurrent partners) and masturbation. Among women, Sal-T was positively associated with masturbation, the only association with partnered sex was with ever experience of same-sex sex. We found no clear association between Sal-T and sexual function. Our study contributes toward addressing the sparsity of data outside the laboratory on the differences between men and women in the relationship between T and sexual function and behavior. To our knowledge, this is the first population study, among men and women, using a mass spectrometry Sal-T assay to do so.
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Affiliation(s)
- W G Macdowall
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine
| | - S Clifton
- Institute for Global Health, University College London, Mortimer Market Centre
- NatCen Social Research
| | - M J Palmer
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine
| | - C Tanton
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine
| | - A J Copas
- Institute for Global Health, University College London, Mortimer Market Centre
| | - D M Lee
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University
| | - K R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - C H Mercer
- Institute for Global Health, University College London, Mortimer Market Centre
| | - P Sonnenberg
- Institute for Global Health, University College London, Mortimer Market Centre
| | - A M Johnson
- Institute for Global Health, University College London, Mortimer Market Centre
| | - K Wellings
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine
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5
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Johnson AM, Kuperstein J, Graham RH, Talari P, Kelly A, Dupont-Versteegden EE. BOOSTing patient mobility and function on a general medical unit by enhancing interprofessional care. Sci Rep 2021; 11:4307. [PMID: 33619329 PMCID: PMC7900133 DOI: 10.1038/s41598-021-83444-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 02/02/2021] [Indexed: 11/09/2022] Open
Abstract
Low mobility during hospitalization remains prevalent despite associated negative consequences. The goal of this quality improvement (QI) project was to increase patient mobility and function by adding a physical therapist (PT) to an existing interprofessional care team. A mobility technician assisted treatment group patients with mobility during hospitalization based on physical therapist recommendations. Change in functional status and highest level of mobility achieved by treatment group patients was measured from admission to discharge. Observed hospital length of stay (LOS), LOS index, and 30-day all cause hospital readmission comparisons between treatment group and a comparison group on the same unit, and between cross-sectional comparison groups one year prior were used for Difference in Difference analysis. Bivariate comparisons between the treatment and a cross-sectional comparison group from one year prior showed a statistically significant change in LOS Index. No other bivariate comparisons were statistically significant. Difference in Difference methods showed no statistically significant change in observed LOS, LOS Index, or 30-day readmission. Patients in the treatment group had statistically significant improvements in functional status and highest level of mobility achieved. Physical function and mobility improved for patients who participated in mobility sessions. Mobility technicians may contribute to improved care quality and patient safety in the hospital.
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Affiliation(s)
- A M Johnson
- Department of Rehabilitation Science, College of Health Sciences, University of Kentucky, 900 S. Limestone Street, Lexington, KY 40536, USA.
| | - J Kuperstein
- Department of Rehabilitation Science, College of Health Sciences, University of Kentucky, 900 S. Limestone Street, Lexington, KY 40536, USA
| | - R Hogg Graham
- Department of Health and Clinical Sciences, College of Health Sciences, University of Kentucky, Lexington, USA
| | - P Talari
- Division of Hospital Medicine, University of Kentucky HealthCare, Lexington, USA
| | - A Kelly
- Department of Medicine, Center for Health Services Research, University of Kentucky, Lexington, USA
| | - E E Dupont-Versteegden
- Department of Rehabilitation Science, College of Health Sciences, University of Kentucky, 900 S. Limestone Street, Lexington, KY 40536, USA
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6
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Cornelison JL, Cato ML, Johnson AM, D'Agostino EH, Melchers D, Patel AB, Mays SG, Houtman R, Ortlund EA, Jui NT. Development of a new class of liver receptor homolog-1 (LRH-1) agonists by photoredox conjugate addition. Bioorg Med Chem Lett 2020; 30:127293. [PMID: 32631515 PMCID: PMC7701997 DOI: 10.1016/j.bmcl.2020.127293] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022]
Abstract
LRH-1 is a nuclear receptor that regulates lipid metabolism and homeostasis, making it an attractive target for the treatment of diabetes and non-alcoholic fatty liver disease. Building on recent structural information about ligand binding from our labs, we have designed a series of new LRH-1 agonists that further engage LRH-1 through added polar interactions. While the current synthetic approach to this scaffold has, in large part, allowed for decoration of the agonist core, significant variation of the bridgehead substituent is mechanistically precluded. We have developed a new synthetic approach to overcome this limitation, identified that bridgehead substitution is necessary for LRH-1 activation, and described an alternative class of bridgehead substituents for effective LRH-1 agonist development. We determined the crystal structure of LRH-1 bound to a bridgehead-modified compound, revealing a promising opportunity to target novel regions of the ligand binding pocket to alter LRH-1 target gene expression.
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Affiliation(s)
| | - Michael L Cato
- Department of Biochemistry, Emory University, Atlanta, GA 30322, United States
| | - Alyssa M Johnson
- Department of Chemistry, Emory University, Atlanta, GA 30322, United States
| | - Emma H D'Agostino
- Department of Biochemistry, Emory University, Atlanta, GA 30322, United States
| | - Diana Melchers
- Precision Medicine Lab, Pivot Park, Antoni van Leeuwenhoek Building, Office1131/lab1333, Kloosterstraat 9, 5349 AB Oss, the Netherlands
| | - Anamika B Patel
- Department of Biochemistry, Emory University, Atlanta, GA 30322, United States
| | - Suzanne G Mays
- Department of Biochemistry, Emory University, Atlanta, GA 30322, United States
| | - René Houtman
- Precision Medicine Lab, Pivot Park, Antoni van Leeuwenhoek Building, Office1131/lab1333, Kloosterstraat 9, 5349 AB Oss, the Netherlands
| | - Eric A Ortlund
- Department of Biochemistry, Emory University, Atlanta, GA 30322, United States.
| | - Nathan T Jui
- Department of Chemistry, Emory University, Atlanta, GA 30322, United States.
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7
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Jobe SL, Albrecht JS, Scharf SM, Johnson AM, Wickwire EM. 0538 What Happens After Prescription of Insomnia Medication Among Older Adults? Sleep 2020. [DOI: 10.1093/sleep/zsaa056.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Despite consensus recommendations regarding need for caution and careful management, sedative hypnotic insomnia therapies remain commonly prescribed among older adults. Further, sleep medications are often prescribed in the absence of a thorough sleep history or evaluation. However, little is known about delivery of sleep-related care following prescription of insomnia medications. Thus, the purpose of this study was to characterize the course of sleep-related care following a prescription fill for insomnia medication among older adults.
Methods
Our data source was a random 5% sample of Medicare administrative claims data from 2006-2013. Insomnia medications were identified by searching the Part D prescription drug claims and included FDA-approved insomnia-related medication classes and drugs. Sleep disorders were operationalized using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Descriptive analyses were performed to estimate the number of insomnia medication users who received sleep disorder diagnoses.
Results
A total of 33,252 Medicare beneficiaries without prior history of sleep disorders received at least one FDA-approved insomnia medication fill between 2006-2013. Of these, 43.2% (n=14,354) eventually received a sleep disorder diagnosis. Among those receiving a sleep diagnosis after being prescribed insomnia medication, insomnia was the most common disorder (71.0%; n=10,198). Further, 15.0% (n=2,149) of individuals who were prescribed insomnia medication received an obstructive sleep apnea diagnosis, 6.6% (n=947) were diagnosed with sleep disturbances, and 5.9% (n=845) were diagnosed with restless legs syndrome. Of those who received a sleep disorder diagnosis, 95.1% (n=13,649) were diagnosed with one sleep disorder, 4.5% (n=639) were diagnosed with two sleep disorders, and 0.4% (n=66) were diagnosed with three or more sleep disorders.
Conclusion
Fewer than half of Medicare beneficiaries prescribed FDA-approved sedative hypnotic insomnia medications ever received a formal sleep-related diagnosis. These results suggest that clinicians prescribe sedative hypnotics without thoroughly evaluating sleep complaints.
Support
This research was supported by an AASM Strategic Research Award from the AASM Foundation to the University of Maryland, Baltimore (PI: EMW).
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Affiliation(s)
- S L Jobe
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - J S Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - S M Scharf
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - A M Johnson
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - E M Wickwire
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
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8
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Jobe SL, Albrecht JS, Scharf SM, Johnson AM, Parthasarathy S, Wickwire EM. 1183 Board-certified Sleep Medicine Physicians See A Greater Proportion Of Complex Sleep Patients Than Non-specialist Providers. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Despite a growing literature regarding the impact of board-certification in sleep medicine, little is known about the complexity of patients seen by board-certified sleep medicine physicians (BCSMPs) relative to non-specialists. To address this gap, the purpose of the current study was to evaluate the differences in sleep complaints among Medicare beneficiaries seen by BCSMPs relative to individuals seen by non-specialists.
Methods
Our data source was a random 5% sample of Medicare administrative claims data from 2006-2013. Sleep disorders were operationalized using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Descriptive analyses were performed to estimate the number of sleep disorder diagnoses patients received by provider status. BCSMPs were identified using a cross-matching procedure based on National Provider Identifier (NPI).
Results
A total of 57,209 Medicare beneficiaries received a sleep disorder diagnosis between 2006-2013. Of these, only 2.2% were seen by BCSMPs. Relative to beneficiaries seen by non-specialists, those seen by BCSMPs were more likely to be diagnosed with more than one sleep disorder (p<0.001). Specifically, 91.0% of individuals seen by non-specialists received only one sleep disorder diagnosis, whereas 75.9% of individuals seen by BCSMPs received only one sleep disorder diagnosis. Among beneficiaries seen by non-specialists, the most common sleep disorders were insomnia (48.2%; n=26,967), obstructive sleep apnea (OSA; 31.4%; n=17,554), and restless legs syndrome (8.7%; n=4,871). Among those seen by BCSMPs, the most common sleep disorders were OSA, (70.4%; n=901), sleep apnea with hypersomnia (16.5%; n=211), and insomnia (11.7%; n=150).
Conclusion
BCSMPs see more complex sleep patients than do non-specialists. These results suggest the possibility that more complex patients are referred for sleep specialty care. Further, these results demonstrate the value of board certification in sleep medicine in caring for complex sleep patients.
Support
This research was supported by an AASM Strategic Research Award from the AASM Foundation to the University of Maryland, Baltimore (PI: EMW).
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Affiliation(s)
- S L Jobe
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - J S Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - S M Scharf
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - A M Johnson
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - S Parthasarathy
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, Tucson, AZ
| | - E M Wickwire
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
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9
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Johnson AM, Fulton JR, Abdoulaye T, Ayedun B, Widmar NJO, Akande A, Bandyopadhyay R, Manyong V. Aflatoxin awareness and Aflasafe adoption potential of Nigerian smallholder maize farmers: OPEN ACCESS. WORLD MYCOTOXIN J 2018; 11:437-446. [PMID: 33552313 PMCID: PMC7797632 DOI: 10.3920/wmj2018.2345] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 07/10/2018] [Indexed: 11/19/2022]
Abstract
Aflatoxin is a potent mycotoxin that can cause cancer and death and is associated
with stunted growth. Prevalence of aflatoxin is widespread in Africa negatively
impacting health and trade. Aflasafe is a biological control product that can be
applied to maize or groundnut fields to reduce aflatoxin contamination. This
study examines the levels of aflatoxin and Aflasafe awareness and understanding
among smallholder maize farmers in Nigeria. In addition, the factors affecting
Aflasafe purchase patterns and sustained usage over multiple growing seasons by
farmers were evaluated. In-person surveys of 902 Nigerian smallholder farmers
were conducted during October and November of 2016. This work contributes to the
existing literature by documenting awareness levels of aflatoxin and use of
Aflasafe as a control in Nigeria. Results suggest that the level of awareness of
aflatoxin was very high in states where Aflasafe was promoted as an intervention
for aflatoxin management. In Kaduna state, the region with the longest
intervention, there was a consistent increase in the usage of Aflasafe since its
introduction in 2010. Furthermore, farmers who purchase Aflasafe bundled
(combined) with other inputs were more likely to persist in using the product.
Education was found to significantly and positively impact continued usage of
Aflasafe. Continued interventions, promotion and general education of the public
are recommended for increased awareness, trial, and adoption of Aflasafe in
Nigeria.
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Affiliation(s)
- A M Johnson
- Department of Agricultural Economics, Purdue University, 403 West State Street, West Lafayette, IN 47907, USA
| | - J R Fulton
- Department of Agricultural Economics, Purdue University, 403 West State Street, West Lafayette, IN 47907, USA
| | - T Abdoulaye
- International Institute of Tropical Agriculture (IITA), PMB 5320, Oyo Road, Idi-Oshe, Ibadan, Nigeria
| | - B Ayedun
- International Institute of Tropical Agriculture (IITA), PMB 5320, Oyo Road, Idi-Oshe, Ibadan, Nigeria
| | - N J O Widmar
- Department of Agricultural Economics, Purdue University, 403 West State Street, West Lafayette, IN 47907, USA
| | - A Akande
- IITA, PMB 82, Garki GPO, Kubwa, Abuja, Nigeria
| | - R Bandyopadhyay
- International Institute of Tropical Agriculture (IITA), PMB 5320, Oyo Road, Idi-Oshe, Ibadan, Nigeria
| | - V Manyong
- IITA, Plot No. 25, Mikocheni Light Industrial Area, Mwenge - Coca-cola Road, Mikocheni B, P.O. Box 34441, Dar es Salaam
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10
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Ilyushin VV, Johnson AM, Hohl J, Cloessner EA, Lovas FJ, Lavrich RJ. Isotopic Dependence of the Hydrogen-Transfer-Triggered Methyl-Group Rotation in Deuterated 5-Methyltropolone. J Mol Spectrosc 2018; 343:10.1016/j.jms.2017.09.004. [PMID: 31097843 PMCID: PMC6512845 DOI: 10.1016/j.jms.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We present here the first experimental study of the microwave spectrum of deuterated 5-methyltropolone, a molecule which exhibits two large-amplitude motions: an intramolecular hydrogen transfer (deuterium transfer in the current case of deuterated 5-methyltropolone) and a methyl torsion. The main goal of this study was to get information on the isotopic dependence of the main tunneling parameters of 5-methyltropolone in the framework of the two dimensional tunneling formalism, which previously has shown some counterintuitive results for isotopic dependence of tunneling parameters in 2-methylmalonaldehyde. Measurements were carried out by Fourier-transform microwave spectroscopy in the 9 GHz to 26 GHz frequency range. Theoretical analysis was carried out using a tunneling-rotational Hamiltonian based on a G12 m extended-group-theory formalism. Our global fit of 384 transitions to 17 molecular parameters gave a weighted root-mean-square deviation of 0.8. The current study on the isotopic dependence of the main tunneling parameters in 5-methyltropolone supports the assumption of possible "leakage" between tunneling parameters in the two-dimensional tunneling formalism in use.
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Affiliation(s)
- Vadim V Ilyushin
- Institute of Radio Astronomy of NASU, Mystetstv 4, 61002 Kharkov, Ukraine
- Quantum Radiophysics Department of V.N. Karazin Kharkiv National University, Svobody Square 4, 61022, Kharkov, Ukraine
| | - Alyssa M Johnson
- Department of Chemistry and Biochemistry, College of Charleston, Charleston, SC 29424, USA
| | - Jenna Hohl
- Department of Chemistry and Biochemistry, College of Charleston, Charleston, SC 29424, USA
| | - Emily A Cloessner
- Department of Chemistry and Biochemistry, College of Charleston, Charleston, SC 29424, USA
| | - Frank J Lovas
- Sensor Science Division, National Institute of Standards and Technology, Gaithersburg, MD 20899-8441, USA
| | - Richard J Lavrich
- Department of Chemistry and Biochemistry, College of Charleston, Charleston, SC 29424, USA
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Mitchell KR, Geary R, Graham CA, Datta J, Wellings K, Sonnenberg P, Field N, Nunns D, Bancroft J, Jones KG, Johnson AM, Mercer CH. Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey. BJOG 2017; 124:1689-1697. [PMID: 28120373 PMCID: PMC5638059 DOI: 10.1111/1471-0528.14518] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 12/19/2022]
Abstract
Objective To estimate the prevalence of painful sex among women in Britain, and to explore associated sexual, relationship and health factors that should be considered in assessment. Design Multi‐stage, clustered and stratified population probability sample survey, using computer‐assisted self‐interview. Sample frame was the British Postcode Address File. Setting Participants interviewed at home between 2010 and 2012. Sample A total of 15 162 adults aged 16–74 years (8869 women). Data reported from 6669 sexually active women. Methods Age‐adjusted logistic regressions to examine associations between painful sex and indicators of sexual, relational, mental and physical health. Main outcome measure Physical pain as a result of sex for ≥3 months in the past year, plus measures of symptom severity. Results Painful sex was reported by 7.5% (95% CI 6.7–8.3) of sexually active women, of whom one‐quarter experienced symptoms very often or always, for ≥6 months, and causing distress. Reporting painful sex was strongly associated with other sexual function problems, notably vaginal dryness (age adjusted odds ratio 7.9; 6.17–10.12), anxiety about sex (6.34; 4.76–8.46) and lacking enjoyment in sex (6.12; 4.81–7.79). It was associated with sexual relationship factors [such as not sharing same level of interest in sex (2.56; 1.97–3.33)], as well as with adverse experiences such as non‐volitional sex (2.17; 1.68–2.80). Associations were also found with measures of psychological and physical health, including depressive symptoms (1.68; 1.28–2.21). Conclusion Painful sex is reported by a sizeable minority of women in Britain. Health professionals should be supported to undertake holistic assessment and treatment which takes account of the sexual, relationship and health context of symptoms. Tweetable abstract Painful sex—reported by 7.5% of women in Britain—is linked to poorer sexual, physical, relational and mental health. Painful sex–reported by 7.5% of women in Britain–is linked to poorer sexual, physical, relational and mental health. This article includes Author Insights, a video abstract available at https://vimeo.com/rcog/authorinsights14518.
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Affiliation(s)
- K R Mitchell
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - R Geary
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
| | - C A Graham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK
| | - J Datta
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - K Wellings
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - P Sonnenberg
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
| | - N Field
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
| | - D Nunns
- Department of Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J Bancroft
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - K G Jones
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
| | - A M Johnson
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
| | - C H Mercer
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
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Johnson AM, Waring MS, DeCarlo PF. Real-time transformation of outdoor aerosol components upon transport indoors measured with aerosol mass spectrometry. Indoor Air 2017; 27:230-240. [PMID: 27008502 DOI: 10.1111/ina.12299] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/18/2016] [Indexed: 05/18/2023]
Abstract
Outdoor aerosols are transported indoors, where their component concentrations depend on aerosol size, physiochemical properties, indoor sources and losses, and cross-environment gradients of temperature and relative humidity. We explored these dependencies by measuring real-time outdoor and indoor non-refractory, submicron (PM1 ) aerosol component mass concentrations in a mixed-use laboratory space with an Aerodyne mini-aerosol mass spectrometer (AMS) and black carbon (BC) with an aethalometer. The median indoor/outdoor (I/O) ratios were 0.60 for sulfate, 0.25 for nitrate, 0.52 for ammonium, 0.73 for organics, and 0.61 for BC. Positive matrix factorization (PMF) on organic aerosol data identified hydrocarbon-like (HOA), cooking (COA), and oxygenated (OOA) factors. By assuming sulfate was nonvolatile, lost only by mechanical processes, and without indoor sources, the transformations of other components i due to partitioning changes or indoor sources were parameterized by normalizing their I/O ratios by sulfate's I/O ratio, that is, (I/O)i/SO4 . Component-specific behavior was quantified by regressions of (I/O)i/SO4 to outdoor-to-indoor temperature differences. Nitrate and HOA strongly and OOA weakly showed losses with increasing temperatures indoors vs. outdoors, and HOA likely had an indoor source. To our knowledge, this is the first reported deployment of an AMS to analyze real-time indoor aerosol composition and outdoor-to-indoor transformation.
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Affiliation(s)
- A M Johnson
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, USA
| | - M S Waring
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, USA
| | - P F DeCarlo
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, USA
- Department of Chemistry, Drexel University, Philadelphia, PA, USA
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Clifton S, Macdowall W, Copas AJ, Tanton C, Keevil BG, Lee DM, Mitchell KR, Field N, Sonnenberg P, Bancroft J, Mercer CH, Wallace AM, Johnson AM, Wellings K, Wu FCW. Salivary Testosterone Levels and Health Status in Men and Women in the British General Population: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). J Clin Endocrinol Metab 2016; 101:3939-3951. [PMID: 27552539 PMCID: PMC5095233 DOI: 10.1210/jc.2016-1669] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Salivary T (Sal-T) measurement by liquid chromatography-tandem mass spectroscopy resents the opportunity to examine health correlates of Sal-T in a large-scale population survey. OBJECTIVE This study sought to examine associations between Sal-T and health-related factors in men and women age 18-74 years. DESIGN AND SETTING Morning saliva samples were obtained from participants in a cross-sectional probability-sample survey of the general British population (Natsal-3). Self-reported health and lifestyle questions were administered as part of a wider sexual health interview. PARTICIPANTS Study participants included 1599 men and 2123 women. METHODS Sal-T was measured using liquid chromatography-tandem mass spectroscopy. Linear regression was used to examine associations between health factors and mean Sal-T. RESULTS In men, mean Sal-T was associated with a range of health factors after age adjustment, and showed a strong independent negative association with body mass index (BMI) in multivariable analysis. Men reporting cardiovascular disease or currently taking medication for depression had lower age-adjusted Sal-T, although there was no association with cardiovascular disease after adjustment for BMI. The decline in Sal-T with increasing age remained after adjustment for health-related factors. In women, Sal-T declined with increasing age; however, there were no age-independent associations with health-related factors or specific heath conditions with the exception of higher Sal-T in smokers. CONCLUSIONS Sal-T levels were associated, independently of age, with a range of self-reported health markers, particularly BMI, in men but not women. The findings support the view that there is an age-related decline in Sal-T in men and women, which cannot be explained by an increase in ill health. Our results demonstrate the potential of Sal-T as a convenient measure of tissue androgen exposure for population research.
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Affiliation(s)
- S Clifton
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Macdowall
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A J Copas
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - C Tanton
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - B G Keevil
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D M Lee
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - K R Mitchell
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Field
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Sonnenberg
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Bancroft
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - C H Mercer
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A M Wallace
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A M Johnson
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - K Wellings
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - F C W Wu
- Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom
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Aicken CRH, Fuller SS, Sutcliffe LJ, Gibbs J, Tickle L, Estcourt CS, Sonnenberg P, Mercer CH, Johnson AM, Sadiq ST, Shahmanesh M. OP34 Online care for sexually transmitted infections: using qualitative research in intervention development and evaluation. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mercer CH, Jones KG, Johnson AM, Lewis R, Mitchell KR, Gravningen K, Clifton S, Tanton C, Sonnenberg P, Wellings K, Cassell JA, Estcourt CS. How can we objectively categorise partnership type? A novel classification of population survey data to inform epidemiological research and clinical practice. Sex Transm Infect 2016; 93:129-136. [PMID: 27535765 PMCID: PMC5339562 DOI: 10.1136/sextrans-2016-052646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/27/2016] [Accepted: 07/17/2016] [Indexed: 11/16/2022] Open
Abstract
Background Partnership type is a determinant of STI risk; yet, it is poorly and inconsistently recorded in clinical practice and research. We identify a novel, empirical-based categorisation of partnership type, and examine whether reporting STI diagnoses varies by the resulting typologies. Methods Analyses of probability survey data collected from 15 162 people aged 16–74 who participated in Britain's third National Survey of Sexual Attitudes and Lifestyles were undertaken during 2010–2012. Computer-assisted self-interviews asked about participants' ≤3 most recent partners (N=14 322 partners/past year). Analysis of variance and regression tested for differences in partnership duration and perceived likelihood of sex again across 21 ‘partnership progression types’ (PPTs) derived from relationship status at first and most recent sex. Multivariable regression examined the association between reporting STI diagnoses and partnership type(s) net of age and reported partner numbers (all past year). Results The 21 PPTs were grouped into four summary types: ‘cohabiting’, ‘now steady’, ‘casual’ and ‘ex-steady’ according to the average duration and likelihood of sex again. 11 combinations of these summary types accounted for 94.5% of all men; 13 combinations accounted for 96.9% of all women. Reporting STI diagnoses varied by partnership-type combination, including after adjusting for age and partner numbers, for example, adjusted OR: 6.03 (95% CI 2.01 to 18.1) for men with two ‘casual’ and one ‘now steady’ partners versus men with one ‘cohabiting’ partner. Conclusions This typology provides an objective method for measuring partnership type and demonstrates its importance in understanding STI risk, net of partner numbers. Epidemiological research and clinical practice should use these methods and results to maximise individual and public health benefit.
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Affiliation(s)
- C H Mercer
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - K G Jones
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - A M Johnson
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - R Lewis
- Department of Social and Environmental Health Research, Centre for Sexual and Reproductive Health Research, London School of Hygiene and Tropical Medicine, London, UK.,Department of Sociology, University of the Pacific, Stockton, USA
| | - K R Mitchell
- Department of Social and Environmental Health Research, Centre for Sexual and Reproductive Health Research, London School of Hygiene and Tropical Medicine, London, UK.,MRC/CSO Social and Public Health Sciences Unit, Institute of Wellbeing, University of Glasgow, Glasgow, UK
| | - K Gravningen
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - S Clifton
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - C Tanton
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - P Sonnenberg
- Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK
| | - K Wellings
- Department of Social and Environmental Health Research, Centre for Sexual and Reproductive Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - J A Cassell
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, UK
| | - C S Estcourt
- Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK.,Barts Sexual Health Centre, St Bartholomew's Hospital, London, UK
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Khadr SN, Jones KG, Mann S, Hale DR, Johnson AM, Viner RM, Mercer CH, Wellings K. Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey. BMJ Open 2016; 6:e011961. [PMID: 27363820 PMCID: PMC4932314 DOI: 10.1136/bmjopen-2016-011961] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Health risk behaviours are prominent in late adolescence and young adulthood, yet UK population-level research examining the relationship between drug or alcohol use and sexual health and behaviour among young people is scarce, despite public health calls for an integrated approach to health improvement. Our objective was to further our understanding of the scale of and nature of any such relationship, using contemporary data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). METHODS Analyses of data from Natsal-3, a stratified probability survey of 15 162 men and women (3869 aged 16-24 years), undertaken in 2010-2012, using computer-assisted personal interviewing, were carried out. Logistic regression was used to explore associations between reporting (1) frequent binge drinking (≥weekly), (2) recent drug use (within past 4 weeks) or (3) multiple (both types of) substance use, and key sexual risk behaviours and adverse sexual health outcomes. We then examined the sociodemographic profile, health behaviours and attitudes reported by 'risky' young people, defined as those reporting ≥1 type of substance use plus non-condom use at first sex with ≥1 new partner(s), last year. RESULTS Men and women reporting frequent binge drinking or recent drug use were more likely to report: unprotected first sex with ≥1 new partner(s), last year; first sex with their last partner after only recently meeting; emergency contraception use (last year) and sexually transmitted infection diagnosis/es (past 5 years). Associations with sexual risk were frequently stronger for those reporting multiple substance use, particularly among men. The profile of 'risky' young people differed from that of other 16-24 years old. CONCLUSIONS In this nationally representative study, substance use was strongly associated with sexual risk and adverse sexual health outcomes among young people. Qualitative or event-level research is needed to examine the context and motivations behind these associations to inform joined-up interventions to address these inter-related behaviours.
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Affiliation(s)
- S N Khadr
- Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK
| | - K G Jones
- Research Department of Infection and Population Health, University College London, London, UK
| | - S Mann
- Research Department of Reproductive Health, University College London Institute of Women's Health, London, UK
| | - D R Hale
- Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK
| | - A M Johnson
- Research Department of Infection and Population Health, University College London, London, UK
| | - R M Viner
- Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK
| | - C H Mercer
- Research Department of Infection and Population Health, University College London, London, UK
| | - K Wellings
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
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Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Field N, Mercer CH, Johnson AM, Wellings K. Prevalence of infertility and help seeking among 15 000 women and men. Hum Reprod 2016; 31:2108-18. [PMID: 27365525 PMCID: PMC4991655 DOI: 10.1093/humrep/dew123] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/29/2016] [Indexed: 12/03/2022] Open
Abstract
STUDY QUESTION What is the prevalence of infertility and of help seeking among women and men in Britain? SUMMARY ANSWER One in eight women and one in ten men aged 16–74 years had experienced infertility, defined by unsuccessfully attempting pregnancy for a year or longer, and little more than half of these people sought medical or professional help. WHAT IS KNOWN ALREADY Estimates of infertility and help seeking in Britain vary widely and are not easily comparable because of different definitions and study populations. STUDY DESIGN, SIZE, DURATION A cross-sectional population survey was conducted between 2010 and 2012 with a sample of 15 162 women and men aged 16–74 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants completed the Natsal-3 questionnaire, using computer-assisted personal interviewing (CAPI) and computer-assisted self-interview (CASI). MAIN RESULTS AND THE ROLE OF CHANCE The reported prevalence of infertility was 12.5% (CI 95% 11.7–13.3) among women and 10.1% (CI 95% 9.2–11.1) among men. Increased prevalence was associated with later cohabitation with a partner, higher socio-economic status and, for those who had a child, becoming parents at older ages. The reported prevalence of help seeking was 57.3% (CI 95% 53.6–61.0) among women and 53.2% (CI 95% 48.1–58.1) among men. Help seekers were more likely to be better educated and in higher status occupations and, among those who had a child, to have become parents later in life. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional so it is not possible to establish temporality or infer causality. Self-reported data may be subject to recall bias. WIDER IMPLICATIONS OF THE FINDINGS The study provides estimates of infertility and help seeking in Britain and the results indicate that the prevalence of infertility is higher among those delaying parenthood. Those with higher educational qualifications and occupational status are more likely to consult with medical professionals for fertility problems than others and these inequalities in help seeking should be considered by clinical practice and public health. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by grants from the Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health. AMJ is a Governor of the Wellcome Trust. Other authors have no competing interests.
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Affiliation(s)
- J Datta
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - M J Palmer
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - C Tanton
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - L J Gibson
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - K G Jones
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - W Macdowall
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - A Glasier
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TY, UK Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - P Sonnenberg
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - N Field
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - C H Mercer
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - A M Johnson
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - K Wellings
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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18
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McDaid LM, Aghaizu A, Frankis J, Riddell J, Nardone A, Mercey D, Johnson AM, Hart GJ, Flowers P. Frequency of HIV testing among gay and bisexual men in the UK: implications for HIV prevention. HIV Med 2016; 17:683-93. [PMID: 26991460 PMCID: PMC5026165 DOI: 10.1111/hiv.12373] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 11/29/2022]
Abstract
Objectives The aim of the study was to explore HIV testing frequency among UK men who have sex with men (MSM) in order to direct intervention development. Methods Cross‐sectional surveys were completed by 2409 MSM in Edinburgh, Glasgow and London in 2011 and a Scotland‐wide online survey was carried out in 2012/13. The frequency of HIV testing in the last 2 years was measured. Results Overall, 21.2% of respondents reported at least four HIV tests and 33.7% reported two or three tests in the last 2 years, so we estimate that 54.9% test annually. Men reporting at least four HIV tests were younger and less likely to be surveyed in London. They were more likely to report higher numbers of sexual and anal intercourse partners, but not “higher risk” unprotected anal intercourse (UAI) with at least two partners, casual partners and/or unknown/discordant status partners in the previous 12 months. Only 26.7% (238 of 893) of men reporting higher risk UAI reported at least four tests. Among all testers (n = 2009), 56.7% tested as part of a regular sexual health check and 35.5% tested following a risk event. Differences were observed between surveys, and those testing in response to a risk event were more likely to report higher risk UAI. Conclusions Guidelines recommend that all MSM test annually and those at “higher risk” test more frequently, but our findings suggest neither recommendation is being met. Additional efforts are required to increase testing frequency and harness the opportunities provided by biomedical HIV prevention. Regional, demographic and behavioural differences and variations in the risk profiles of testers suggest that it is unlikely that a “one size fits all” approach to increasing the frequency of testing will be successful.
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Affiliation(s)
- L M McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - J Frankis
- Glasgow Caledonian University, Glasgow, UK
| | - J Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - D Mercey
- University College London, London, UK
| | | | - G J Hart
- University College London, London, UK
| | - P Flowers
- Glasgow Caledonian University, Glasgow, UK
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Woodhall SC, Murphy G, Craig R, Mindell JS, Soldan K, Johnson AM, Nardone A. P10.19 Can hsv-2 seropositivity be used as a biological marker of sexual behaviour? findings from a seroprevalence survey in england. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wayal S, Parsons V, Copas A, Danielle M, Nardone A, Aghaizu A, Hart G, Gilson R, Johnson AM. O20.5 Trends in undiagnosed hiv and hiv testing behaviour in community samples of men who have sex with men in london, uk: results from repeat cross-sectional surveys between 2000–2013. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mercer CH, Geary R, Jones KG, Clifton S, Tanton C, Sonnenberg P, Gravningen K, Johnson AM. P04.23 Mind the gap! biological and behavioural concurrency and their potential for sti transmission in the british population. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Woodhall SC, Wills G, Horner P, Craig R, Mindell JS, Murphy G, McClure M, Soldan K, Nardone A, Johnson AM. P08.12 Insights into chlamydia trachomatiscumulative incidence in the context of widespread opportunistic chlamydia screening in england: seroprevalence study using sera from a nationally-representative household survey. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Prah P, Hickson F, Bonell C, McDaid L, Erens B, Riddell J, Wayal S, Nardone A, Sonnenberg P, Johnson AM, Mercer CH. P11.02 Representing men who have sex with men (msm) in britain: evidence from comparative analyses of the latest convenience and probability surveys. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mercer CH, Jones KG, Johnson AM, Lewis R, Mitchell KR, Clifton S, Tanton C, Sonnenberg P, Wellings K, Cassell JA, Estcourt CS. O11.2 Overcoming the ambiguity of sexual partnership type: a novel categorisation using data from britain’s 3 rdnational survey of sexual attitudes and lifestyles (natsal-3). Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Woodhall SC, Soldan K, Sonnenberg P, Mercer CH, Clifton S, Saunders P, da Silva FC, Alexander S, Tanton C, Field N, Copas A, Ison CA, Johnson AM. P08.13 What can probability surveys tell us about changes in chlamydia prevalence in britain? evidence from the national surveys of sexual attitudes and lifestyles (natsal). Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Prah P, Mercer CH, Johnson AM. O20.5 Patterns of Sexual and Social Mixing Among Heterosexual Couples Living Together in England: Analyses of a Probability Sample Survey. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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27
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McDaid LM, Aghaizu A, Young I, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. P3.422 Opportunities For HIV Prevention Among Men Who Have Sex with Men in the UK: HIV Testing and Willingness to Use Pre-Exposure Prophylaxis. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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28
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Mercer CH, Robinson C, Craig R, Nardone A, Johnson AM. OP74 Measuring Sexual Behaviour Comes of Age: A Comparison of Outcomes in the 2010 Health Survey for England with the National Survey of Sexual Attitudes and Lifestyles. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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29
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Nardone A, Robinson C, Craig R, Woodhall S, Talebi A, Mercer C, Johnson AM. P67 Estimation of population coverage of chlamydia testing among young adults in England in 2010. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mercer CH, Robinson C, Craig R, Nardone A, Johnson AM. P195 Asking about sex in general health surveys: it can be done! Comparing data collected by the 2010 Health Survey for England with Natsal. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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31
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Davie KL, Oram Cardy JE, Holmes JD, Gagnon M, Hyde A, Jenkins ME, Johnson AM. The effects of word length, articulation, oral-motor movement, and lexicality on gait: a pilot study. Gait Posture 2012; 35:691-3. [PMID: 22225852 DOI: 10.1016/j.gaitpost.2011.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 09/21/2011] [Accepted: 12/05/2011] [Indexed: 02/02/2023]
Abstract
Previous research has suggested that articulatory demands are important predictors of the impact of dual-task interference on spatial-temporal parameters of gait. In this study, we evaluated the effects of word length, oral-motor movement, articulation, and lexicality, within a verbal task, on a continuous gait task. Fifteen healthy young women participated in a study in which two word lengths (monosyllabic and bisyllabic) were crossed with four levels of secondary task complexity (no dual-task, non-speech movement, spoken non-word, and spoken word). Spatial and temporal parameters of gait were measured using a 23' instrumented carpet. Results indicated a significant multivariate main effect for task type, F(15, 120)=3.07, that explained 71.1% of the demonstrated variability in gait. Univariate analyses of this main effect revealed statistically significant effects for velocity, step time, swing time, and stance time, but no statistically significant effect for step length. Post hoc analyses suggested that dual-task interference produced significant changes in the parameters of gait, but that this interference was not significantly greater with non-words as compared to the non-speech movement condition, nor was it significantly greater with words as compared to non-words. The results of this systematic deconstruction of a simple verbal task suggest that the motor component of a secondary speech task may produce the largest amount of interference within a dual-task interference paradigm.
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Affiliation(s)
- K L Davie
- Health and Rehabilitation Sciences, The University of Western Ontario, Canada
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Abstract
OBJECTIVE To determine the incidence of and risk factors for driving outcomes in drivers with Parkinson disease (PD). METHODS In a prospective cohort study, we ascertained the time until driving cessation, a crash, or a traffic citation using self-report and state Department of Transportation records in 106 licensed, active drivers with PD and 130 controls. RESULTS Drivers with PD stopped driving earlier than controls, hazard ratio (95% confidence interval) = 7.09 (3.66-13.75), p < 0.001. Cumulative incidence of driving cessation at 2 years after baseline was 17.6% (11.5%-26.5%) for PD and 3.1% (1.2%-8.1%) for controls. No significant differences between groups on times to first crash or citation were detected. However, the number of observed crashes was low. Cox proportional hazards models showed that significant baseline risk factors for driving cessation in PD were older age, preference to be driven by somebody else, positive crash history, use of compensatory strategies, low driving exposure, impairments in visual perception (especially visual processing speed and attention) and cognitive abilities, parkinsonism (especially activities of daily living score and total daily dose of antiparkinsonian medications), and higher error counts on a road test. Within PD, crashes were associated with poorer postural stability and history of driving citations, and citations were associated with younger age and road errors at baseline. CONCLUSIONS Drivers with PD are at a higher risk of driving cessation than elderly control drivers. A battery evaluating motor and nonmotor aspects of PD, driving record, and performance can be useful in assessing future driving outcomes in PD.
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Affiliation(s)
- E Y Uc
- Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, USA.
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Griffiths C, Johnson AM, Fenton KA, Erens B, Hart GJ, Wellings K, Mercer CH. Attitudes and first heterosexual experiences among Indians and Pakistanis in Britain: evidence from a national probability survey. Int J STD AIDS 2011; 22:131-9. [PMID: 21464449 DOI: 10.1258/ijsa.2009.009496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We compare attitudes, experiences of learning about sex and first intercourse among Indians (n = 393) and Pakistanis (n = 365) using a probability survey of Britain's general population aged 16-44 years conducted during 1999-2001 (n = 12,110). Higher proportions of Pakistanis (64.6%) and Indians (28.1%) reported religion as 'very important' versus 6.2% of other ethnicities. Pakistanis were more conservative in their attitudes, e.g. reporting premarital sex as wrong (adjusted odds ratios [AORs] for sociodemographic differences, 4.71 [men] and 6.59 [women]). Pakistanis were more likely to be married at first sex (AORs 6.2 [men] and 9.53 [women]), yet men were more likely than women to be in non-marital relationships at this time (69.4% versus 25.2%). Pakistani men and women and Indian women were more likely to report not using reliable contraception at first sex relative to others (AORs 2.33, 3.16 and 1.90, respectively). Pakistani and Indian women were more likely than others to report school lessons as their main source of sex education (AORs 2.23 and 1.77) and not discussing sex with their parents during adolescence (AORs 2.04 and 2.62). These unique data have implications for ensuring that sex and relationship education and health promotion messages are appropriately planned, targeted and delivered to benefit Pakistanis and Indians.
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Affiliation(s)
- C Griffiths
- Research Department of Infection and Population Health, University College London, London, UK.
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34
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Shallcross LJ, Williams K, Hopkins S, Aldridge RW, Johnson AM, Hayward AC. Panton-Valentine leukocidin associated staphylococcal disease: a cross-sectional study at a London hospital, England. Clin Microbiol Infect 2011; 16:1644-8. [PMID: 20969671 DOI: 10.1111/j.1469-0691.2010.03153.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recently, there has been international concern at the rapid emergence of highly pathogenic strains of Staphylococcus aureus associated with a toxin called Panton-Valentine leukocidin (PVL). In the UK, these strains are considered to be rare and mainly severe. We estimate the proportion of staphylococcal infections that are caused by strains containing the PVL genes, and describe risk factors for these infections. Three hundred and ninety consecutive S. aureus clinical isolates, submitted for routine diagnostic purposes were screened for PVL genes. Risk factors for infection were identified from the patient medical record. 9.7% (95% CI 7.0-13.1%) of clinical isolates and 20.8% of skin and soft tissue specimens contained the genes for PVL. Methicillin-resistant S. aureus with PVL was rare (0.8% of all isolates) but PVL with methicillin-sensitive S. aureus was common (9.0% of all specimens). PVL infection was more frequent in males (OR 3.0, 95% CI 1.3-7.0), and in young adults aged 20-39 years (OR 3.7, 95% CI 1.3-10.4). Over half of PVL positive S. aureus infections originated in patients based in the community. Community-onset PVL-associated disease is common in the UK and mainly causes skin and soft tissue infections that do not require admission to hospital. Consideration should be given to current infection control strategy, which advocates household contact screening and decolonization on the assumption that PVL-associated disease is rare.
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Affiliation(s)
- L J Shallcross
- Research Department of Infection & Population Health, University College London, UK.
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35
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Thompson AM, Bray S, Johnson AM, Quinlan P, Nikloff DM, Evans DG, Clarke R, Lawrence HJ, Howell A, Latif A, Ferraldeschl R, Hillman G, Fontecha M, Newman WG. CYP2D6 genotype affects outcome in postmenopausal breast cancer patients treated with tamoxifen monotherapy. Breast Cancer Res 2010. [PMCID: PMC2875610 DOI: 10.1186/bcr2545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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36
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Holmes JD, Jenkins ME, Johnson AM, Adams SG, Spaulding SJ. Dual-task interference: the effects of verbal cognitive tasks on upright postural stability in Parkinson's disease. Parkinsons Dis 2010; 2010:696492. [PMID: 20976093 PMCID: PMC2957284 DOI: 10.4061/2010/696492] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 10/03/2009] [Accepted: 11/29/2009] [Indexed: 11/20/2022]
Abstract
Although dual-task interference has previously been demonstrated to have a significant effect on postural control among individuals with Parkinson's disease, the impact of speech complexity on postural control has not been demonstrated using quantitative biomechanical measures. The postural stability of twelve participants with idiopathic Parkinson's disease and twelve healthy age-matched controls was evaluated under three conditions: (1) without a secondary task, (2) performing a rote repetition task and (3) generating a monologue. Results suggested a significant effect of cognitive load on biomechanical parameters of postural stability. Although both groups increased their postural excursion, individuals with Parkinson's disease demonstrated significantly reduced excursion as compared with that of healthy age-matched controls. This suggests that participants with Parkinson's disease may be overconstraining their postural adjustments in order to focus attention on the cognitive tasks without losing their balance. Ironically, this overconstraint may place the participant at greater risk for a fall.
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Affiliation(s)
- J D Holmes
- School of Occupational Therapy, The University of Western Ontario, London, ON, Canada N6G 1H1
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Abstract
OBJECTIVE To assess road safety and its predictors in drivers with Parkinson disease (PD). METHODS Licensed, active drivers with PD (n = 84; age = 67.3 +/- 7.8, median Hoehn & Yahr stage II) and controls (n = 182; age = 67.6 +/- 7.5) underwent cognitive, visual, and motor tests, and drove a standardized route in urban and rural settings in an instrumented vehicle. Safety errors were judged and documented by a driving expert based on video data review. RESULTS Drivers with PD committed more total safety errors compared to controls (41.6 +/- 14.6 vs 32.9 +/- 12.3, p < 0.0001); 77.4% of drivers with PD committed more errors than the median total error count of the controls (medians: PD = 39.5, controls = 31.0). Lane violations were the most common error category in both groups. Group differences in some error categories became insignificant after results were adjusted for demographics and familiarity with the local driving environment. The PD group performed worse on tests of motor, cognitive, and visual abilities. Within the PD group, older age and worse performances on tests of visual acuity, contrast sensitivity, attention, visuospatial abilities, visual memory, and general cognition predicted error counts. Measures of visual processing speed and attention and far visual acuity were jointly predictive of error counts in a multivariate model. CONCLUSIONS Overall, drivers with Parkinson disease (PD) had poorer road safety compared to controls, but there was considerable variability among the drivers with PD, and some performed normally. Familiarity with the driving environment was a mitigating factor against unsafe driving in PD. Impairments in visual perception and cognition were associated with road safety errors in drivers with PD.
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Affiliation(s)
- E Y Uc
- Department of Neurology, University of Iowa, Carver College of Medicine, 200 Hawkins Drive-2RCP, Iowa City, IA 52242, USA.
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Evans HER, Tsourapas A, Mercer CH, Rait G, Bryan S, Hamill M, Delpech V, Hughes G, Brook G, Williams T, Johnson AM, Singh S, Petersen I, Chadborn T, Cassell JA. Primary care consultations and costs among HIV-positive individuals in UK primary care 1995-2005: a cohort study. Sex Transm Infect 2009; 85:543-9. [DOI: 10.1136/sti.2009.035865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Evans HER, Mercer CH, Rait G, Hamill M, Delpech V, Hughes G, Brook MG, Williams T, Johnson AM, Singh S, Petersen I, Chadborn T, Cassell JA. Trends in HIV testing and recording of HIV status in the UK primary care setting: a retrospective cohort study 1995-2005. Sex Transm Infect 2009; 85:520-6. [PMID: 19564649 DOI: 10.1136/sti.2008.034801] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To provide nationally representative data on trends in HIV testing in primary care and to estimate the proportion of diagnosed HIV positive individuals known to general practitioners (GPs). METHODS We undertook a retrospective cohort study between 1995 and 2005 of all general practices contributing data to the UK General Practice Research Database (GPRD), and data on persons accessing HIV care (Survey of Prevalent HIV Infections Diagnosed). We identified all practice-registered patients where an HIV test or HIV positive status is recorded in their general practice records. HIV testing in primary care and prevalence of recorded HIV positive status in primary care were estimated. RESULTS Despite 11-fold increases in male testing and 19-fold increases in non-pregnant female testing between 1995 and 2005, HIV testing rates remained low in 2005 at 71.3 and 61.2 tests per 100,000 person years for males and females, respectively, peaking at 162.5 and 173.8 per 100,000 person years at 25-34 years of age. Inclusion of antenatal tests yielded a 129-fold increase in women over the 10-year period. In 2005, 50.7% of HIV positive individuals had their diagnosis recorded with a lower proportion in London (41.8%) than outside the capital (60.1%). CONCLUSION HIV testing rates in primary care remain low. Normalisation of HIV testing and recording in primary care in antenatal testing has not been accompanied by a step change in wider HIV testing practice. Recording of HIV positive status by GPs remains low and GPs may be unaware of HIV-related morbidity or potential drug interactions.
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Affiliation(s)
- H E R Evans
- Centre for Sexual Health and HIV Research, Research Department of Infection & Population Health, University College London, London, UK
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Jenkins ME, Almeida QJ, Spaulding SJ, van Oostveen RB, Holmes JD, Johnson AM, Perry SD. Plantar cutaneous sensory stimulation improves single-limb support time, and EMG activation patterns among individuals with Parkinson's disease. Parkinsonism Relat Disord 2009; 15:697-702. [PMID: 19467910 DOI: 10.1016/j.parkreldis.2009.04.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 04/07/2009] [Accepted: 04/13/2009] [Indexed: 10/20/2022]
Abstract
Parkinson's disease is a chronic neurological disorder that results in gait and posture impairment. There is increasing evidence that these motor impairments may be partially due to deficits within the sensory system. In this study, the effects of a facilitatory insole that provides increased plantar sensory stimulation, was evaluated during gait, in a group of individuals with Parkinson's disease in comparison with healthy age-matched controls. Spatial-temporal parameters of gait were evaluated using an instrumented carpet, and muscle activation patterns were evaluated using surface EMG. All participants were tested with both a facilitatory (ribbed) insole and a conventional (flat) insole while walking 20 feet. Results indicated that the use of the facilitatory insole produced a significant increase in single-limb support time. Additionally, the muscle activation sequence of the tibialis anterior was normalized by the facilitatory insole, at the time of initial ground contact. These changes may lead to an overall improvement in gait pattern and stability, and suggest that the use of this type of facilitatory insole may be a useful treatment strategy for improving the gait of individuals with Parkinson's disease. This also provides support for the role of facilitation of the sensory system in improving motor output in individuals with Parkinson's disease.
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Affiliation(s)
- M E Jenkins
- Department of Clinical Neurological Sciences, Schulich School of Medicine, University of Western Ontario, Canada.
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Mercer CH, Hart GJ, Johnson AM, Cassell JA. Behaviourally bisexual men as a bridge population for HIV and sexually transmitted infections? Evidence from a national probability survey. Int J STD AIDS 2009; 20:87-94. [DOI: 10.1258/ijsa.2008.008215] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We consider the potential of behaviourally bisexual men (BBM) as a bridge population in sexually transmitted infection (STI)/HIV transmission by comparing sexual risk behaviours, attitudes and sexual health outcomes of BBM (defined as men who reported sex with men and women), with men who reported (i) exclusively male partners (MEMP) and (ii) exclusively female partners (MEFP), using a probability survey of the British general population aged 16–44 years, conducted between 1999 and 2001 ( n = 5168 men). About 1.3% of men who reported sex in the past five years were BBM (44.1% of all men reporting male partners); 29.0% of BBM were married/cohabiting with women. Median partner numbers in this timeframe were seven among BBM, two among MEFP and 10 among MEMP. Similar proportions of BBM and MEMP reported STI diagnosis/es in the past five years, yet BBM were less likely than MEMP to report HIV-testing (odds ratio adjusted for sociodemographics: 0.31). BBM are thus mid-way between MEFP and MEMP in their sexual risk behaviour, but are similar to MEMP in reporting STI diagnosis/es. These data have implications for health promotion and partner notification, as BBM are unlikely to be appropriately targeted by safe-sex messages aimed at men identifying as gay.
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Affiliation(s)
- C H Mercer
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London WC1E 6JB
| | - G J Hart
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London WC1E 6JB
| | - A M Johnson
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London WC1E 6JB
| | - J A Cassell
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton BN1 9PH, UK
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Dyer PE, Johnson AM, Walton CD. Inscription of fibre Bragg gratings in non-sensitised fibres using VUV F2 laser radiation. Opt Express 2008; 16:19297-19303. [PMID: 19582023 DOI: 10.1364/oe.16.019297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report the inscription of fibre Bragg gratings in non-sensitised SMF 28 and HI 980 fibre by exposure to VUV F2 laser radiation at 157 nm. The modulated effective refractive index change Deltan(eff) deduced from the shift in the grating reflection peaks was Deltan(eff) = 2.8x10(-4) and 1.7x10(-4) in SMF 28 and HI 980 fibre respectively. The possible influence of non-uniformity of core exposure and VUV cladding absorption loss on these results is discussed.
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Affiliation(s)
- P E Dyer
- Department of Physics, University of Hull, Hull, UK.
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Brown AE, Murphy G, Rinck G, Clewley JP, Hill C, Parry JV, Johnson AM, Pillay D, Gill ON. Implications for HIV testing policy derived from combining data on voluntary confidential testing with viral sequences and serological analyses. Sex Transm Infect 2008; 85:4-9. [PMID: 18955386 DOI: 10.1136/sti.2008.031831] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Laboratory, clinical and sequence-based data were combined to assess the differential uptake of voluntary confidential HIV testing (VCT) according to risk and explore the occurrence of HIV transmission from individuals with recently acquired HIV infection, before the diagnostic opportunity. METHODS Between 1999 and 2002, nearly 30,000 anonymous tests for previously undiagnosed HIV infection were conducted among men who have sex with men (MSM) attending 15 sentinel sexually transmitted infection (STI) clinics in England, Wales and Northern Ireland. Using a serological testing algorithm, undiagnosed HIV-infected men were categorised into those with recent and non-recent infection. VCT uptake was compared between HIV-negative, recently HIV-infected and non-recently HIV-infected men. A phylogenetic analysis of HIV pol sequences from 127 recently HIV-infected MSM was conducted to identify instances in which transmission may have occurred before the diagnostic opportunity. RESULTS HIV-negative MSM were more likely to receive VCT at clinic visits compared with undiagnosed HIV-infected MSM (56% (14,020/24,938) vs 31% (335/1072); p<0.001). Recently HIV-infected MSM were more likely to receive VCT compared with those with non-recent infections (42% (97/229) vs 28% (238/844); p<0.001). 22% (95/425) of undiagnosed HIV-infected MSM with STI received VCT. Phylogenetic analysis revealed at least seven transmissions may have been generated by recently HIV-infected MSM: a group that attended STI clinics soon after seroconversion. CONCLUSIONS The integration of clinical, laboratory and sequence-based data reveals the need for specific targeting of the recently HIV exposed, and those with STI, for VCT. VCT promotion alone may be limited in its ability to prevent HIV transmission.
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Affiliation(s)
- A E Brown
- HIV/STI Department, Health Protection Agency Centre for Infections, London, UK.
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Allen E, Bonell C, Strange V, Copas A, Stephenson J, Johnson AM, Oakley A. Does the UK government's teenage pregnancy strategy deal with the correct risk factors? Findings from a secondary analysis of data from a randomised trial of sex education and their implications for policy. J Epidemiol Community Health 2007; 61:20-7. [PMID: 17183010 PMCID: PMC2465587 DOI: 10.1136/jech.2005.040865] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Much of the UK government's 1999 report on teenage pregnancy was by necessity based on rather old or non-longitudinal research. AIM To examine the associations between risk factors identified in the report and pregnancy at or before age 16 years among young women and partners of young men using the more recent data. RESULTS Socioeconomic disadvantage, being born to a teenage mother, expectation of being a teenage parent, low educational expectations and various other behaviours are potential risk factors for teenage pregnancy, as suggested by unadjusted analyses. Those who cited school as providing information on sex had a reduced risk of pregnancy at or before age 16 years, as did girls reporting easy communication with parent or guardian at baseline. Various measures of low sexual health knowledge were not associated, in either adjusted or unadjusted analyses, with increased risk of pregnancy at or before age 16 years among boys or girls. CONCLUSIONS A focus on many of the risk factors identified in the 1999 report is supported herein. It is suggested that knowledge may not be an important determinant, but that relationships with parents and school, as well as expectations for the future, may have important influences on teenage pregnancy. The analysis also provides new insights into risk factors for pregnancies among the partners of young men.
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Affiliation(s)
- E Allen
- Department of Primary Care and Population Sciences, Centre for Sexual Health and HIV Research, University College London, Mortimer Market Centre, London, UK.
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Petersen I, Johnson AM, Islam A, Duckworth G, Livermore DM, Hayward AC. Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ 2007; 335:982. [PMID: 17947744 PMCID: PMC2072032 DOI: 10.1136/bmj.39345.405243.be] [Citation(s) in RCA: 198] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the extent to which antibiotics reduce the risk of serious complications after common respiratory tract infections. DESIGN Retrospective cohort study. SETTING UK primary care practices contributing to the general practice research database. DATA SOURCE 3.36 million episodes of respiratory tract infection. MAIN OUTCOME MEASURES Risk of serious complications in treated and untreated patients in the month after diagnosis: mastoiditis after otitis media, quinsy after sore throat, and pneumonia after upper respiratory tract infection and chest infection. Number of patients needed to treat to prevent one complication. RESULTS Serious complications were rare after upper respiratory tract infections, sore throat, and otitis media, and the number needed to treat was over 4000. The risk of pneumonia after chest infection was high, particularly in elderly people, and was substantially reduced by antibiotic use, with a number needed to treat of 39 for those aged > or =65 and 96-119 in younger age groups. CONCLUSION Antibiotics are not justified to reduce the risk of serious complications for upper respiratory tract infection, sore throat, or otitis media. Antibiotics substantially reduce the risk of pneumonia after chest infection, particularly in elderly people in whom the risk is highest.
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Affiliation(s)
- I Petersen
- UCL Centre for Infectious Disease Epidemiology, Department of Primary Care and Population Sciences, University College London, London NW3 2PQ
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Mercer CH, Fenton KA, Wellings K, Copas AJ, Erens B, Johnson AM. Sex partner acquisition while overseas: results from a British national probability survey. Sex Transm Infect 2007; 83:517-22. [PMID: 17991687 DOI: 10.1136/sti.2007.026377] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Over the past 20 years, there has been a huge increase in the number of overseas trips made by UK residents. Although a number of studies have examined the frequency of overseas partner acquisition, they have used convenience samples and thus are not generalisable to the British general population. METHODS A national probability sample survey was carried out in 1999-2001 of 12,110 men and women aged 16-44 years resident in Britain. Sociodemographic, health-related, travel, sexual behaviour and attitudinal data were collected by computer-assisted interviewing. The main outcomes were the proportion of British residents who reported new sexual partners overseas in the past 5 years, the country of origin of these new sex partners, and the association between reporting a new partner while overseas with a range of demographic, behavioural and attitudinal variables. RESULTS 13.9% of men and 7.1% of women reported having new sexual partner(s) while overseas in the past 5 years. Among respondents who were aged 16-24 and never married, the proportions were significantly higher (23.0% of men and 17.0% of women). Half of those with new sex partners overseas reported their partner's origin as the UK, and over a third as another European country. In addition to age and marital status, reporting new partners overseas was associated with a higher number of partners, paying for sex (among men), reporting a diagnosis of sexually transmitted infection, and HIV testing. Adjustment for sociodemographic factors attenuated the magnitude of, but did not remove, these associations. CONCLUSIONS A substantial minority of young, unmarried people form new sexual partnerships abroad, but these are typically with residents from the UK or other European countries. Those who have new partners abroad are likely to have higher-risk sexual lifestyles more generally, and to be at higher risk of sexually transmitted infections. Greater attention should be paid to sexual health promotion for travellers abroad, especially young travellers, emphasising the risks of new sexual relationships with compatriots as well as those from other countries in terms of STI/HIV acquisition and onwards transmission.
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Affiliation(s)
- C H Mercer
- Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK.
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Burns FM, Imrie JY, Nazroo J, Johnson AM, Fenton KA. Why the(y) wait? Key informant understandings of factors contributing to late presentation and poor utilization of HIV health and social care services by African migrants in Britain. AIDS Care 2007; 19:102-8. [PMID: 17129864 DOI: 10.1080/09540120600908440] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The majority of new HIV diagnoses in the UK occur in people with heterosexually acquired HIV infection, the majority of whom are migrant Africans. In the UK HIV positive Africans access HIV services at a later stage of disease than non-Africans (Burns et al., 2001; Sinka et al., 2003). Employing purposive sampling techniques, semi-structured interviews were conducted with key informants to identify the key issues affecting utilization of HIV services for Africans in Britain. Considerable agreement about the major issues influencing uptake of HIV services existed amongst the key informants. Respondents felt there was high HIV awareness but this did not translate into perception of individual risk. Home country experience and community mobilization was highly influential on HIV awareness, appreciation of risk, and attitudes to health services. Institutional barriers to care exist; these include lack of cultural understanding, lack of open access or community clinics, failure to integrate care with support organizations, and the inability of many General Practitioners to address HIV effectively. Community involvement should include input to ensure there is: better cultural understanding within the health care system; normalization of the HIV testing process; and a clear message on the effectiveness of therapy.
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Affiliation(s)
- F M Burns
- Centre for Sexual Health and HIV Research, University College London.
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Cassell JA, Mercer CH, Imrie J, Copas AJ, Johnson AM. Who uses condoms with whom? Evidence from national probability sample surveys. Sex Transm Infect 2006; 82:467-73. [PMID: 17151032 PMCID: PMC2563886 DOI: 10.1136/sti.2005.019117] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2006] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the changing pattern of condom use from 1990 to 2000; to identify sociodemographic and behavioural factors associated with condom use; and reasons for condom use in 2000. METHODS Large probability sample surveys administered among those resident in Britain aged 16-44 (n = 13 765 in 1990, n = 11 161 in 2000). Face to face interviews with self completion components collected sociodemographic, behavioural, and attitudinal data. RESULTS Condom use in the past year among sexually active 16-24 year old men increased from 61.0% in 1990 to 82.1% in 2000 (p<0.0001), and from 42.0% to 63.2% (p<0.0001) among women of the same age, with smaller increases among older age groups. Among individuals reporting at least two partners in the previous 4 week period, approximately two thirds reported inconsistent or no condom use (63.1% (95% CI 55.9% to 69.8%) of the men and 68.5% (95% CI 57.6% to 77.7%) of the women). CONCLUSIONS Rates of condom use increased substantially between 1990 and 2000, particularly among young people. However, inconsistent condom use by individuals with high rates of partner acquisition may contribute significantly to the recent resurgence in STIs. This group is an important target for intensive and specific sexual health interventions.
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Affiliation(s)
- J A Cassell
- Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, Mortimer Market Centre off Capper Street, London WC1E 6JB, UK.
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Cassell JA, Mercer CH, Fenton KA, Copas AJ, Erens B, Wellings K, Johnson AM. A comparison of the population diagnosed with chlamydia in primary care with that diagnosed in sexual health clinics: implications for a national screening programme. Public Health 2006; 120:984-8. [PMID: 16949114 DOI: 10.1016/j.puhe.2006.05.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2005] [Revised: 02/14/2006] [Accepted: 05/24/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare demographic, behavioural and HIV testing characteristics of individuals diagnosed with chlamydia infection in primary care with those in genitourinary medicine clinics, in the absence of a screening programme. The aim was to explore the current and potential contribution of primary care to the control of chlamydia. STUDY DESIGN AND METHODS We analysed data on individuals who reported one or more chlamydia diagnoses in the past 5 years in a large probability sample survey of the resident, UK general population aged 16-44 years. Estimates were weighted and odds ratios calculated. RESULTS Women diagnosed in primary care reported fewer sexual partners, and were less likely to have had an HIV test in the past 5 years than their counterparts diagnosed in genitourinary medicine clinics. Age, ethnicity, social class, educational attainment and urbanization of area of residence did not differ between the two groups. Too few men were diagnosed in primary care to allow for such a comparison. CONCLUSIONS Primary care already diagnoses a large number of women with chlamydia infection, who may perceive themselves as low risk through age or sexual behaviour, yet are likely to comprise a substantial proportion of all infections. Few men are diagnosed in primary care. These groups need to be strategically targeted in the context of a future chlamydia screening programme, which will focus on the screening of younger women at high risk, and in which the role of primary care is still in development.
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Affiliation(s)
- J A Cassell
- Centre for sexual Health and HIV Research, University College London, Mortimer Market Centre, Off Capper Street, London WCIE 6JB, UK.
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McGarrigle CA, Cliffe S, Copas AJ, Mercer CH, DeAngelis D, Fenton KA, Evans BG, Johnson AM, Gill ON. Estimating adult HIV prevalence in the UK in 2003: the direct method of estimation. Sex Transm Infect 2006; 82 Suppl 3:iii78-86. [PMID: 16735298 PMCID: PMC2657482 DOI: 10.1136/sti.2006.020339] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Estimates of the total number of prevalent HIV infections attributable to the major routes of infection make an important contribution to public health policy, as they are used for planning services. METHODS In the UK, estimates were derived through the "direct method" which estimated the total number of diagnosed and undiagnosed HIV infections in the population. The direct method has been improved over a number of years since first used in 1994, as further data became available such as the inclusion of newly available behavioural survey data both from the National Survey of Sexual Attitudes and Lifestyles (Natsal 2000) and community surveys of men who have sex with men (MSM). These data were used to re-estimate numbers of people unaware of their infection and provided ethnic breakdowns within behavioural categories. The total population was divided into 10 mutually exclusive behavioural categories relevant to HIV risk in the UK-for example, MSM and injecting drug users. Estimates of the population size within each group were derived from Natsal 2000 and National Statistics mid-year population estimates. The total number of undiagnosed HIV infections was calculated by multiplying the undiagnosed HIV prevalence for each group, derived from the Unlinked Anonymous HIV Prevalence Monitoring Programme surveys (UAPMP), by the population size. These estimates were then added to the prevalent diagnosed HIV infections within each group derived from the national census of diagnosed HIV infections, the Survey of Prevalent HIV Infections Diagnosed (SOPHID). The estimates were then adjusted to include all adults in the UK. Because undiagnosed HIV prevalence estimates were not available for each of the behavioural categories, the UAPMP prevalence estimates were adjusted using available data to provide the best estimates for each group. RESULTS It is estimated that 53,000 individuals are infected with HIV in the UK in 2003, of whom 27% were unaware of their infection. Of the total of 53,000, an estimated 26,000 were among heterosexually infected and 24,500 among MSM. CONCLUSION The direct method uses an explicit framework and data from different components of the HIV surveillance system to estimate HIV prevalence in the UK, allowing for a comprehensive picture of the epidemic.
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Affiliation(s)
- C A McGarrigle
- HIV and STI Department, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
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