"He enjoys giving her pleasure": diversity and complexity in young men's sexual scripts

Research on heterosexual men's sexual expectations has focused on self-described personal traits and culturally dominant models of masculinity. In a pair of studies, we used a sexual scripts perspective to explore the range and diversity of young men's thoughts about sex and relationships with women and to develop measures for assessing these scripts. In the first study, we conducted semi-structured interviews to elicit young men's accounts of their sexual relationships. We used these narratives to produce brief sexual script scenarios describing typical sexual situations, as well as conventional survey items assessing sexual behavior themes. In the second study, we administered the scenarios and theme items to an ethnically diverse, national sample of 648 heterosexually active young men in an online survey. Using exploratory factor analysis, we delineated sets of sexual scripts and sexual behavior themes. In the scenarios, we found both a traditional masculine "player" script and a script that emphasized mutual sexual pleasure. Analysis of theme items produced scales of Drinking and Courtship, Monogamy and Emotion, and Sexual Focus and Variety. We discuss the implications of these findings for understanding heterosexual men's thinking about sexuality and how cultural change in sexual thinking may arise. We also discuss the need for measures of sexual thinking that better integrate perceptions and expectations about the partner as well as the self in relation to the partner, rather than solely self-assessed traits.

Condoms and Contexts: Profiles of Sexual Risk and Safety Among Young Heterosexually Active Men

Heterosexual men's sexual safety behavior is important to controlling the U.S. epidemic of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). While sexual safety is often treated as a single behavior, such as condom use, it can also be conceptualized as resulting from multiple factors. Doing so can help us achieve more nuanced understandings of sexual risk and safety within partner-related contexts. We used latent class analysis with data collected online from 18- to 25-year-old heterosexually active U.S. men (n = 432) to empirically derive a typology of the patterns of sexual safety strategies they employed. Indicators were sexual risk-reduction strategies used in the past year with the most recent female sex partner: condom use, discussing sexual histories, STI testing, agreeing to be monogamous, and discussing birth control. We identified four subgroups: Risk Takers (12%), Condom Reliers (25%), Multistrategists (28%), and Relationship Reliers (35%). Partner-related context factors--number of past-year sex partners, relationship commitment, and sexual concurrency--predicted subgroup membership. Findings support tailoring STI prevention to men's sexual risk-safety subgroups. Interventions should certainly continue to encourage condom use but should also include information on how partner-related context factors and alternate sexual safety strategies can help men reduce risk for themselves and their partners.

A physical impact of organic fouling layers on bacterial adhesion during nanofiltration

Organic conditioning films have been shown to alter properties of surfaces, such as hydrophobicity and surface free energy. Furthermore, initial bacterial adhesion has been shown to depend on the conditioning film surface properties as opposed to the properties of the virgin surface. For the particular case of nanofiltration membranes under permeate flux conditions, however, the conditioning film thickens to form a thin fouling layer. This study hence sought to determine if a thin fouling layer deposited on a nanofiltration membrane under permeate flux conditions governed bacterial adhesion in the same manner as a conditioning film on a surface. Thin fouling layers (less than 50 μm thick) of humic acid or alginic acid were formed on Dow Filmtec NF90 membranes and analysed using Atomic Force Microscopy (AFM), confocal microscopy and surface energy techniques. Fluorescent microscopy was then used to quantify adhesion of Pseudomonas fluorescens bacterial cells onto virgin or fouled membranes under filtration conditions. It was found that instead of adhering on or into the organic fouling layer, the bacterial cells penetrated the thin fouling layer and adhered directly to the membrane surface underneath. Contrary to what surface energy measurements of the fouling layer would indicate, bacteria adhered to a greater extent onto clean membranes (24 ± 3% surface coverage) than onto those fouled with humic acid (9.8 ± 4%) or alginic acid (7.5 ± 4%). These results were confirmed by AFM measurements which indicated that a considerable amount of energy (10(-7) J/μm) was dissipated when attempting to penetrate the fouling layers compared to adhering onto clean NF90 membranes (10(-15) J/μm). The added resistance of this fouling layer was thusly seen to reduce the number of bacterial cells which could reach the membrane surface under permeate conditions. This research has highlighted an important difference between fouling layers for the particular case of nanofiltration membranes under permeate flux conditions and surface conditioning films which should be considered when conducting adhesion experiments under filtration conditions. It has also shown AFM to be an integral tool for such experiments.

Peak plasma anti-Xa levels after first and third doses of enoxaparin in women receiving weight-based thromboprophylaxis following caesarean section: a prospective cohort study

BACKGROUND

Women undergoing caesarean section are at higher risk for thromboembolic complications following delivery than other parturients. The aim of this study was to determine whether higher doses of enoxaparin based on body weight are safe and more likely to achieve plasma anti-Xa levels within the accepted thromboprophylactic range.

METHODS

We undertook a prospective cohort study of 80 women undergoing caesarean section in a tertiary obstetric hospital with >6000 deliveries per year. Enoxaparin was administered after caesarean section using the Royal College of Obstetricians and Gynaecologists weight-adjusted dosing guidelines. Plasma anti-Xa levels were measured at baseline and 3-4 h after enoxaparin administration on days one and three postoperatively. The main outcomes of interest were plasma anti-Xa levels and the proportion of patients with plasma anti-Xa levels in the range of 0.2-0.4 IU/mL.

RESULTS

The proportion of women with anti-Xa levels between 0.2 and 0.4 IU/mL was 72% (95% CI 60-81%). Unadjusted mean anti-Xa levels were 0.26 ± 0.09 IU/mL and 0.28 ± 0.08 IU/mL on day one and day three respectively. No woman had levels >0.48 IU/mL.

CONCLUSION

The majority of women receiving weight-based enoxaparin thromboprophylaxis following caesarean section achieved plasma anti-Xa levels within the putative thromboprophylactic range. No woman achieved levels associated with an increased risk of bleeding (>0.8 IU/mL). These findings provide a safety basis for a large prospective study using this regimen.

The importance of laboratory water quality for studying initial bacterial adhesion during NF filtration processes

Biofouling of nanofiltration (NF) and reverse osmosis (RO) membranes for water treatment has been the subject of increased research effort in recent years. A prerequisite for undertaking fundamental experimental investigation on NF and RO processes is a procedure called compaction. This involves an initial phase of clean water permeation at high pressures until a stable permeate flux is reached. However water quality used during the compaction process may vary from one laboratory to another. The aim of this study was to investigate the impact of laboratory water quality during compaction of NF membranes. A second objective was to investigate if the water quality used during compaction influences initial bacterial adhesion. Experiments were undertaken with NF 270 membranes at 15 bar for permeate volumes of 0.5 L, 2 L, and 5 L using MilliQ, deionized or tap water. Membrane autopsies were performed at each permeation point for membrane surface characterisation by contact angle measurements, profilometry, and scanning electron microscopy. The biological content of compacted membranes was assessed by direct epi-fluorescence observation following nucleic acid staining. The compacted membranes were also employed as substrata for monitoring the initial adhesion of Ps. fluorescens under dynamic flow conditions for 30 min at 5 min intervals. Compared to MilliQ water, membrane compaction using deionized and tap water led to decreases in permeate flux, increase in surface hydrophobicity and led to significant build-up of a homogeneous fouling layer composed of both living and dead organisms (>10(6) cells cm(-2)). Subsequent measurements of bacterial adhesion resulted in cell loadings of 0.2 × 10(5), 1.0 × 10(5) cells cm(-2) and 2.6 × 10(5) cells cm(-2) for deionized, tap water and MilliQ water, respectively. These differences in initial cell adhesion rates demonstrate that choice of laboratory water can significantly impact the results of bacterial adhesion on NF membranes. Standardized protocols are therefore needed for the fundamental studies of bacterial adhesion and biofouling formation on NF and RO membrane. This can be implemented by first employing pure water during all membrane compaction procedures and for the modelled feed solutions used in the experiment.

Sexual scripts among young heterosexually active men and women: continuity and change

Whereas gendered sexual scripts are hegemonic at the cultural level, research suggests they may be less so at dyadic and individual levels. Understanding "disjunctures" between sexual scripts at different levels holds promise for illuminating mechanisms through which sexual scripts can change. Through interviews with 44 heterosexually active men and women aged 18 to 25, the ways young people grappled with culture-level scripts for sexuality and relationships were delineated. Findings suggest that, although most participants' culture-level gender scripts for behavior in sexual relationships were congruent with descriptions of traditional masculine and feminine sexuality, there was heterogeneity in how or whether these scripts were incorporated into individual relationships. Specifically, three styles of working with sexual scripts were found: conforming, in which personal gender scripts for sexual behavior overlapped with traditional scripts; exception-finding, in which interviewees accepted culture-level gender scripts as a reality, but created exceptions to gender rules for themselves; and transforming, in which participants either attempted to remake culture-level gender scripts or interpreted their own nontraditional styles as equally normative. Changing sexual scripts can potentially contribute to decreased gender inequity in the sexual realm and to increased opportunities for sexual satisfaction, safety, and well-being, particularly for women, but for men as well.

The role of a movement disorders clinic

Ireland's ageing population will result in a substantial increase in neurodegenerative disease with a projected increase in prevalence of Idiopathic Parkinson's disease (IPD) to 9,000 by 2021. There are few published audits of neurology services to assist care planning. As a first step towards evaluating future service needs for this group of patients, we audited a single tertiary referral IPD and Other Movement Disorders clinic for 2006. A total of 497 patients from all counties in Ireland were seen; 225 (59%) of patients had IPD, 32 (8.2%) had atypical parkinsonism, and 22 (5.8%) dystonia. In a subset of 275 patients, 151 (55%) were referred by GPs, 74 (27%) by other consultants, and 49 (18%) by other consultant neurologists. Diagnosis was changed in 22 (38%) and medication was adjusted in 203 (74%). A telephone survey of 50 patients demonstrated 100% satisfaction with the improved access to the clinical nurse specialist, telephone support and improved continuity of care. The IPD and Other Movement Disorders clinic provides an important local, regional, and national diagnostic and therapeutic service for complex movement disorders. It is proposed that a national registry of IPD and audit of the delivery of care to patients with movement disorders is needed.

"How can I not?": men's pathways to involvement in anti-violence against women work

Despite growing male participation in ending violence against women, little is known about the factors that precipitate men's engagement as antiviolence "allies." This study presents findings from a qualitative analysis of interviews with 27 men who recently initiated involvement in an organization or event dedicated to ending sexual or domestic violence. Findings suggest that men's engagement is a process that occurs over time, that happens largely through existing social networks, and that is influenced by exposure to sensitizing experiences, tangible involvement opportunities and specific types of meaning making related to violence. Implications for models of ally development and for efforts to engage men in antiviolence work are discussed.

Frontline worker responses to domestic violence disclosure in public welfare offices

Although substantial numbers of women seeking Temporary Assistance for Needy Families (TANF) report domestic violence, few receive mandated services through the Family Violence Option (FVO). This study used transcripts ofinterviews between welfare caseworkers and their clients to identify and classify the responses made by workers to client disclosures of abuse and to assess the match or mismatch of these responses with FVO policy requirements. Only 22 of 782 client interviews involved the disclosure of abuse to the welfare caseworker. A typology of worker responses was created, from least to most engaged. This typology shows that only half of those who disclosed abuse received assistance from the welfare worker, despite policy mandates that clients receive information on TANF waivers and community resources. This study suggests that problems with implementation of the FVO reflect a systemic reluctance to address issues of violence with women rather than problems of individual workers.

Prospective longitudinal studies of salmonid alphavirus infections on two Atlantic salmon farms in Ireland; evidence for viral persistence

Prospective longitudinal studies of two outbreaks of pancreas disease in Atlantic salmon (AS), Salmo salar L., in Ireland were conducted. Both outbreaks occurred during the marine phase of production, with one caused by salmonid alphavirus subtype 1 (SAV1) and the other by SAV4. In addition to screening a range of tissues by real-time reverse transcriptase polymerase chain reaction (RRT-PCR), virological, serological and histopathological examinations were performed along with partial genome sequencing and results were related to environmental and production data and farm history. On Farm 1 (marine sampling only), infection was detected within 3 weeks of smolts being placed on the farm, while on Farm 2 (freshwater and marine sampling), infection was first detected 315 days after transfer to sea. In both outbreaks, RRT-PCR signals were detected in a range of tissues including gill, heart, kidney, pancreas/pyloric caeca, brain and serum. Persistence of signal was longest in gill and heart (> or =265 days on both farms) and shortest in serum. Mortalities on the two farms varied from 10.9% to 30%. In both cases, partial genome sequence of the causative viruses were identical to SAV strains detected in previous populations of AS on each of the study farms, including populations with which the study populations overlapped in time and space.

Inhibitory effects of polyunsaturated fatty acids on Kv4/KChIP potassium channels

Kv4/K channel interacting protein (KChIP) potassium channels are a major class of rapidly inactivating K(+) channels in neurons and cardiac muscle. Modulation of Kv4/KChIP channels by polyunsaturated fatty acids (PUFAs) is important in the regulation of cellular excitability and the induction of activity-dependent synaptic plasticity. Using the Xenopus laevis oocyte expression system, we studied the inhibition by PUFAs of the peak outward K(+) current and the accompanying increase in the rate of current inactivation of rKv4.2/rKChIP1b. Inhibitory effects do not depend on KChIP coexpression since Kv4.2 channels lacking an NH(2)-terminal KChIP association region were substantially inhibited by PUFAs and showed strong kinetic modulation. PUFAs accelerated both the fast and slow time constants that describe the kinetics of Kv4/KChIP inactivation. The time course of entry into closed inactivated states was facilitated by PUFAs, but steady-state inactivation and recovery from inactivation were unaltered. PUFA inhibition of Kv4/KChIP current was not use dependent. The concentration-response relationship for arachidonic acid (AA) inhibition of Kv4/KChIP channels mimicked that for activation of TRAAK channels. Internal serum albumin largely prevents the inhibitory effects of externally applied AA, and the membrane-impermeant AA-CoA is inactive when applied externally. Overall, our data suggest that PUFAs inhibit Kv4/KChIP channels by facilitating inactivation from open and closed gating states and that access of the fatty acid to the internal leaflet of the membrane is important. These results improve our understanding of the mechanisms for the inhibitory effects of PUFAs on Kv4/KChIP channel function.

Patient portals: survey of nursing informaticists

As the US moves toward a more patient centered health care system, an integrated Electronic Health Record with a Patient Portal is one way that providers and patients can more actively collaborate in the health care process. A patient portal is an Internet-based interactive website for patients to communicate with their healthcare provider and with varied functions that gives them access to portions of their medical record and other services [1,2,3,4]. Many hospitals and health centers in the USA have developed patient portals while others are still in the planning stage. From a review of the literature it is evident that there is no standard of the scope of functions that are essential in the Patient Portals and to date most are only accessible in English. If we are truly moving towards a patient centered focus in health care in a diverse society, we need to design patient portals that tailor these resources to the needs of this diverse population. This paper reports on the results of an online survey that was distributed between August and October 2007 to nursing informaticists who subscribe to the CARING e-mail list and nursing informaticists working in the Greater New York City area. The goal of the survey was to see how many of the institutions where nursing informaticists work had patient portals, what functions were embedded in these portals, what research was being conduct., and what plans each institution had for future directions.

Screening for domestic violence in public welfare offices: an analysis of case manager and client interactions

Despite a high prevalence of domestic violence among welfare clients, most studies of the implementation of the Family Violence Option (FVO) under welfare reform find that women rarely receive domestic violence services in welfare offices. This study reviews findings from current research on the factors that improve the likelihood that women will reveal their domestic violence experiences to service personnel, and uses the guidelines drawn from this review to evaluate domestic violence screening practices in welfare offices using 782 transcribed interviews between welfare workers and clients from 11 sites in four states. The analysis found that only 9.3% of case encounters involved screening for domestic violence. Screening rates differed by state, interview type, and length of worker employment. Qualitative analysis of the interviews showed that the majority of screening by workers was routine or consisted of informing clients of the domestic violence policy without asking about abuse. Only 1.2% of the interviews incorporated at least two of the procedures that increase the likelihood of disclosure among domestic violence survivors, suggesting deeply inadequate approaches to screening for abuse within the context of welfare offices, and a need for improved training, protocol, and monitoring of FVO implementation.

Engineering aspects of a mixed methanotrophic culture in a membrane-aerated biofilm reactor

Methanotrophic biodegradation using the membrane-aerated biofilm reactor (MABR) is a technology offering several advantages over both conventional biofilm reactors and suspended-cell processes. In this study the oxidation efficiency of a methanotrophic biofilm in a 1.5 litre MABR was investigated. Measurements of oxygen and methane uptake rates together with biofilm thickness were taken for developing biofilms. It was found that the specific rate of metabolic activity of the biofilm was unusually high as determined by the methane and oxygen uptake rates. Microbial activity stratification was evident and the location of stratified layers of oxygen consuming components of the consortium could be manipulated via the intra-membrane oxygen pressure.