A structural equation model of patient-healthcare provider relationships and HIV-infected patient outcomes in Chinese populations

Obtaining maximum antiretroviral therapy (ART) adherence is critical for maintaining a high CD4 count and strong immune function in PLWHA. Key factors for achieving optimum adherence include good medication self-efficacy, decreased medication-taking difficulties, and positive patient-healthcare provider (HCP) relationships. Limited studies have analyzed the correlation of these factors and ART adherence in Chinese population. In this paper, structural equation modeling was performed to assess the proposed model of relations between patient-HCP relationships and adherence. Audio Computer-Assisted Self-Interview (ACASI) software was used to collect data on ART adherence and patient variables among 227 PLWHA in Shanghai and Taipei. Participants completed a one-time 60-minute ACASI survey that consisted of standardized measures to assess demographics, recent CD4 counts, self-efficacy, patient-HCP relationship, adherence, and medication-taking difficulties. The data shown the relationship between patient-HCP relationships and adherence was significantly consistent with mediation by medication self-efficacy. However, patient-HCP interaction did not directly influence medication-taking difficulties, and medication-taking difficulties did not significantly affect CD4 counts. Furthermore, patient-HCP interactions did not directly impact CD4 counts; rather, the relation was consistent with mediation (by either better medication self-efficacy or better adherence) or by improved adherence alone. Future interventions should be designed to enhance self-management and provide better patient-HCP communication. This improved communication will enhance medication self-efficacy and decrease medication-taking difficulties. This in turn will improve medication adherence and immune function among PLWHA.

A first look at the effects of long inter-pregnancy interval and advanced maternal age on perinatal outcomes: A retrospective cohort study

BACKGROUND

After China's One-child Policy was replaced with the Two-child Policy in 2013, the rate of second pregnancies with a longer inter-pregnancy interval (IPI) has suddenly increased in that country; however, the effect of long IPIs (≥49 months) on perinatal outcomes remains unreported.

METHODS

This was a retrospective cohort study in China from July 2015 through June 2016. We used univariate and multivariate logistic regression models to test the associations among IPI, maternal age, and perinatal outcome (preterm delivery, term low birthweight, and small-for-gestational age). We included baseline factors and variables with biological plausibility as confounders.

RESULTS

Our analytic sample included 3309 second pregnancies. The mean IPI was 75.36 months. Compared with second pregnancies with a short IPI of 7-24 months, those with long IPIs had higher adjusted odds ratios (ORs) of preterm delivery (1.70-2.00 [95% CI 1.20-3.33]) and term low birthweight (2.16-2.68 [1.10-6.17]), but not small-for-gestational age. The mean maternal age at current delivery was 32.0 years. Compared with the reference group (25-29 years), second pregnancies for the oldest maternal age group (≥35 years) showed no statistically significant increased ORs for adverse perinatal outcomes.

CONCLUSION

Long IPI is a significant contributor to preterm delivery and term low birthweight. Health care providers need to pay close attention to preterm delivery prevention and fetal growth during prenatal care for second pregnancies where the mothers have long IPIs.

Exploring Chinese Women's Perception of Cervical Cancer Risk as It Impacts Screening Behavior: A Qualitative Study

BACKGROUND

Chinese women rarely undergo regular cervical screening. Women's decisions about cervical screening may be influenced by their perception of the risk of cervical cancer. Therefore, understanding how women perceive the risk of cervical cancer, how personal risk factors are interpreted, and the influence of cultural issues on cervical screening behavior is important.

OBJECTIVE

The aim of this study is to understand cervical cancer risk perception and the role of personal risk factors as they influence screening behavior among Chinese women.

METHOD

An exploratory qualitative research design was used. We conducted semistructured, in-depth interviews of 27 women in Changsha, a medium-size city in Hunan province, China.

RESULTS

Participants identified that cervical cancer had serious consequences, but they distanced themselves psychologically from the disease because they felt that "cervical cancer is a shameful and deadly disease." Although women identified some of the risk factors for the disease, they had little specific knowledge of human papillomavirus infection, its association with cervical cancer, and the importance of cervical screening.

CONCLUSION

This study contributes new knowledge to the understanding of cervical screening behavior within a specific social and cultural context. Better efforts should be made to educate Chinese women on the risk of cervical cancer and emphasize that effective cancer treatments are available and that there is a good chance of survival.

IMPLICATIONS FOR PRACTICE

Nurses working with Chinese women should ensure that the information they provide is culturally sensitive, particularly by acknowledging the normative beliefs of this population group.

90-90-90-Plus: Maintaining Adherence to Antiretroviral Therapies

Medication adherence is the "Plus" in the global challenge to have 90% of HIV-infected individuals tested, 90% of those who are HIV positive treated, and 90% of those treated achieve an undetectable viral load. The latter indicates viral suppression, the goal for clinicians treating people living with HIV (PLWH). The comparative importance of different psychosocial scales in predicting the level of antiretroviral adherence, however, has been little studied. Using data from a cross-sectional study of medication adherence with an international convenience sample of 1811 PLWH, we categorized respondent medication adherence as None (0%), Low (1-60%), Moderate (61-94%), and High (95-100%) adherence based on self-report. The survey contained 13 psychosocial scales/indices, all of which were correlated with one another (p < 0.05 or less) and had differing degrees of association with the levels of adherence. Controlling for the influence of race, gender, education, and ability to pay for care, all scales/indices were associated with adherence, with the exception of Berger's perceived stigma scale. Using forward selection stepwise regression, we found that adherence self-efficacy, depression, stressful life events, and perceived stigma were significant predictors of medication adherence. Among the demographic variables entered into the model, nonwhite race was associated with double the odds of being in the None rather than in the High adherence category, suggesting these individuals may require additional support. In addition, asking about self-efficacy, depression, stigma, and stressful life events also will be beneficial in identifying patients requiring greater adherence support. This support is essential to medication adherence, the Plus to 90-90-90.

Achromatic Metalens over 60 nm Bandwidth in the Visible and Metalens with Reverse Chromatic Dispersion

In this Letter, we experimentally report an achromatic metalens (AML) operating over a continuous bandwidth in the visible. This is accomplished via dispersion engineering of dielectric phase shifters: titanium dioxide nanopillars tiled on a dielectric spacer layer above a metallic mirror. The AML works in reflection mode with a focal length independent of wavelength from λ = 490 to 550 nm. We also design a metalens with reverse chromatic dispersion, where the focal length increases as the wavelength increases, contrary to conventional diffractive lenses. The ability to engineer the chromatic dispersion of metalenses at will enables a wide variety of applications that were not previously possible. In particular, for the AML design, we envision applications such as imaging under LED illumination, fluorescence, and photoluminescence spectroscopy.

[Up-regulation of DLK1 in non-small cell lung cancer and the relevant molecular mechanism]

OBJECTIVE

To explore the expression of delta-like 1 homolog (DLK1) gene in non-small cell lung cancer (NSCLC) and its regulatory mechanism.

METHODS

The expression levels of DLK1 protein in 204 NSCLC tissues were examined by immunohistochemical (IHC) staining, and the correlation between DLK1expression and clinicopathological features was analyzed. Bisulfate sequencing PCR (BSP) of DNA samples from the tumor tissues of 18 NSCLC patients was performed to evaluate the DNA methylation status of CpG island in the DLK1 promoter region, and also compared with the corresponding IHC staining of DLK1 protein in the same samples.

RESULTS

Among the 102 squamous cell carcinoma (SCC) tissue specimens and their adjacent normal bronchial epithelia, DLK1 was up-regulated in 72 and 37 samples, respectively (P=0.001), and among 102 adenocarcinomas (ADC) tissues and their adjacent alveolar tissues, DLK1 was up-regulated in 77 and 7 samples, respectively (P<0.001). In addition, overexpression of DLK1 was significantly associated with histological type, clinical stage and tumor size of NSCLC (P<0.05 for all). The expression of DLK1protein was inversely correlated with its promoter methylation (P<0.05).

CONCLUSION

DLK1 expression is up-regulated in NSCLCs, which may be due, at least in part, to the DNA hypomethylation in the promoter region of theDLK1 gene.

[Relationship between urinary polycyclic aromatic hydrocarbon metabolite and cell cycle of lymphocyte in coke oven workers]

Objective: To investigate the relationship between urinary polycyclic aromatic hydrocarbon metabolite and cell cycle of lymphocyte in coke oven workers. Methods: 437 coke oven workers and 163 work-ers in water treatment department were recruited in this study. Flow cytometry was used to detect the cell cycle of lymphocyte. For the measurement of urinary metabolites, urine samples were treated with β-glucuronidase and analyzed using HPLC with a fluorescence detector. Results: The concentrations of urinary 2-naphthol, 2-hydroxyfluorene, 9-phenanthrol and 1-hydroxypyrene l in coke oven workers were significantly higher than those in control group (P<0.01) . The distributions of cell cycle were analyzed in high exposure group (the content of urinary metabolites high than P75) and low exposure group (the content of urinary metabolites low than P25) . According to the content of 1-hydroxypyrene, the proportions of S phase in high exposure group were significant-ly higher than those of low exposure group (Z=-2.496, P=0.013) , but the proportions of G0/G1 phase were sig-nificantly lower than low exposure group (Z=-2.074, P=0.038) . The similar results were not been found in other hydroxylated metabolites as internal exposure group. Conclusion: Increasing levels of urinary 1-hydroxypyrene might resulting in cell cycle of lymphocyte disorders, mainly for G0/G1 phase shorten and S phase arrest.

Polarization-Insensitive Metalenses at Visible Wavelengths

In this Letter, we demonstrate highly efficient, polarization-insensitive planar lenses (metalenses) at red, green, and blue wavelengths (λ = 660, 532, and 405 nm). Metalenses with numerical apertures (NA) of 0.85 and 0.6 and corresponding efficiencies as high as 60% and 90% are achieved. These metalenses are less than 600 nm-thick and can focus incident light down to diffraction-limited spots as small as ∼0.64λ and provide high-resolution imaging. In addition, the focal spots are very symmetric with high Strehl ratios. The single step lithography and compatibility with large-scale fabrication processes make metalenses highly promising for widespread applications in imaging and spectroscopy.

Facilitators of and barriers to HIV self-management: Perspectives of HIV-positive women in China

AIMS

The aim is to explore perceived facilitators of and barriers to HIV self-management for HIV-positive Chinese women.

BACKGROUND

Little is known about self-management among HIV-positive Chinese women in China. Understanding the experiences of this population is needed to promote self-management.

METHODS

27 in-depth interviews were conducted in Beijing and Shanghai. Facilitators included families being supportive after disclosure, patients learning how to live with HIV, antiretroviral therapy (ART) adherence, and rediscovering the meaning of life. Several barriers were also identified, including lack of support, stigma, fatigue, and financial difficulty.

RESULTS

HIV disclosure is essential to obtaining necessary support. Ironically, disclosing to family members who stigmatize the disease may invite unwelcome responses. Helping HIV-positive women to decrease self-stigma and develop an effective way to disclose, if they choose to, is important.

CONCLUSION

Future interventions should focus on disclosure strategies development and self-management to prevent isolation, enhance social support, and decrease self-stigma.

Disclosing Parental HIV Status to Children in China: Lessons Learned Through an Intervention Study

For HIV-infected parents, deciding whether and how to disclose their illness to their children is a major stressor. In China, due to significant HIV stigma, disclosure distress is acute. Our objective was to understand HIV-infected parents' concerns regarding disclosure of their HIV status to their children. HIV-infected parents (N = 10) were recruited to attend a three-session nursing intervention. In our post hoc analysis, progress notes from each session were analyzed for themes to illuminate parental decision-making processes. By the end of the intervention, all parents had considered the importance of HIV disclosure and stated that they felt somewhat prepared to disclose. Primary themes included (a) severe stigma experienced by fathers who were sexually active with men, (b) need for both parents to agree on plans for disclosure, and (c) parents' fears about the consequences of disclosure. Parents living with HIV can benefit from nurse-delivered interventions during parental HIV disclosure decision-making.

Sexual transmission-risk behaviour among HIV-positive persons: a multisite study using social action theory

AIM

Sexual risk behaviour was explored and described using Social Action Theory.

BACKGROUND

The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence.

DESIGN

Cross-sectional survey.

METHODS

Self-report questionnaire administered to adults living with HIV/AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011.

FINDINGS

Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use.

CONCLUSION

Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk.

Life priorities in the HIV-positive Asians: a text-mining analysis in young vs. old generation

HIV/AIDS is one of the most urgent and challenging public health issues, especially since it is now considered a chronic disease. In this project, we used text mining techniques to extract meaningful words and word patterns from 45 transcribed in-depth interviews of people living with HIV/AIDS (PLWHA) conducted in Taipei, Beijing, Shanghai, and San Francisco from 2006 to 2013. Text mining analysis can predict whether an emerging field will become a long-lasting source of academic interest or whether it is simply a passing source of interest that will soon disappear. The data were analyzed by age group (45 and older vs. 44 and younger). The highest ranking fragments in the order of frequency were: "care", "daughter", "disease", "family", "HIV", "hospital", "husband", "medicines", "money", "people", "son", "tell/disclosure", "thought", "want", and "years". Participants in the 44-year-old and younger group were focused mainly on disease disclosure, their families, and their financial condition. In older PLWHA, social supports were one of the main concerns. In this study, we learned that different age groups perceive the disease differently. Therefore, when designing intervention, researchers should consider to tailor an intervention to a specific population and to help PLWHA achieve a better quality of life. Promoting self-management can be an effective strategy for every encounter with HIV-positive individuals.

Multispectral Chiral Imaging with a Metalens

The vast majority of biologically active compounds, ranging from amino acids to essential nutrients such as glucose, possess intrinsic handedness. This in turn gives rise to chiral optical properties that provide a basis for detecting and quantifying enantio-specific concentrations of these molecules. However, traditional chiroptical spectroscopy and imaging techniques require cascading of multiple optical components in sophisticated setups. Here, we present a planar lens with an engineered dispersive response, which simultaneously forms two images with opposite helicity of an object within the same field-of-view. In this way, chiroptical properties can be probed across the visible spectrum using only the lens and a camera without the addition of polarizers or dispersive optical devices. We map the circular dichroism of the exoskeleton of a chiral beetle, Chrysina gloriosa, which is known to exhibit high reflectivity of left-circularly polarized light, with high spatial resolution limited by the numerical aperture of the planar lens. Our results demonstrate the potential of metasurfaces in realizing a compact and multifunctional device with unprecedented imaging capabilities.

Super-Dispersive Off-Axis Meta-Lenses for Compact High Resolution Spectroscopy

Metasurfaces have opened a new frontier in the miniaturization of optical technology by allowing exceptional control over the wavefront. Here, we demonstrate off-axis meta-lenses that simultaneously focus and disperse light of different wavelengths with unprecedented spectral resolution. They are designed based on the geometric phase via rotated silicon nanofins and can focus light at angles as large as 80°. Due to the large angle focusing, these meta-lenses have superdispersive characteristics (0.27 nm/mrad) that make them capable of resolving wavelength differences as small as 200 pm in the telecom region. In addition, by stitching several meta-lenses together, we maintain a high spectral resolution for a wider wavelength range. The meta-lenses have measured efficiencies as high as 90% in the wavelength range of 1.1 to 1.6 μm. The planar and compact configuration together with high spectral resolution of these meta-lenses has significant potential for emerging portable/wearable optics technology.

A new method for estimating the number of non-differentially expressed genes

Control of the false discovery rate is a statistical method that is widely used when identifying differentially expressed genes in high-throughput sequencing assays. It is often calculated using an adaptive linear step-up procedure in which the number of non-differentially expressed genes should be estimated accurately. In this paper, we discuss the estimation of this parameter and point out defects in the original estimation method. We also propose a new estimation method and provide the error estimation. We compared the estimation results from the two methods in a simulation study that produced a mean, standard deviation, range, and root mean square error. The results revealed that there was little difference in the mean between the two methods, but the standard deviation, range, and root mean square error obtained using the new method were much smaller than those produced by the original method, which indicates that the new method is more accurate and robust. Furthermore, we used real microarray data to verify the conclusion. Finally we provide a suggestion when analyzing differentially expressed genes using statistical methods.

Successive spin orderings of tungstate-bridged Li2Ni(WO4)2 of spin 1

Magnetic, thermodynamic, and dielectric properties of Li2Ni(WO4)2 of S  =  1 system have been studied using magnetic susceptibility, specific heat, and dielectric constant measurements. The magnetic orderings can be identified in three stages, including a short range magnetic ordering indicated by the rounded χ(T) peak with maximum at  ∼20 K, and signatures of two successful antiferromagnetic long range orderings near T(N1) ~ 18 K and T(N2) ~ 13 K revealed by the d(χ(T)) /d(T) peaks. The successive long range magnetic orderings are related to the quasi triangular symmetry breaking in the ac- and bc-planes and to the change of the dielectric constant, suggesting the presence of spin-phonon coupling. The specific heat and magnetic entropy analysis for Li2Ni(WO4)2 shows the existence of a significant low dimensional magnetic correlations at high temperature and confirms the long range three-dimensional (3D) behavior of magnetic orderings below T(N1) and T(N2).

A Cross-Sectional Relationship Between Social Capital, Self-Compassion, and Perceived HIV Symptoms

CONTEXT

Individual resources of social capital and self-compassion are associated with health behaviors and perceived symptoms, suggesting that both are positive resources that can be modified to improve a person's symptom experience.

OBJECTIVES

The aim was to examine the relationship between self-compassion and social capital and its impact on current HIV symptom experience in adult people living with HIV (PLWH). We further explored the impact of age on this relationship.

METHODS

We conducted a cross-sectional analysis of 2182 PLWH at 20 sites in five countries. Social capital, self-compassion, and HIV symptom experience were evaluated using valid and reliable scales. To account for inflated significance associated with a large sample size, we took a random sample of 28% of subjects (n = 615) and conducted correlation analyses and zero-inflated Poisson regression, controlling for known medical and demographic variables impacting HIV symptom experience.

RESULTS

Controlling for age, sex at birth, year of HIV diagnosis, comorbid health conditions, employment, and income, our model significantly predicted HIV symptom experience (overall model z = 5.77, P < 0.001). Employment status and social capital were consistent, negative, and significant predictors of HIV symptom experience. Self-compassion did not significantly predict HIV symptom experience. For those reporting symptoms, an increase in age was significantly associated with an increase in symptoms.

CONCLUSION

Employment and social capital modestly predicted current HIV symptom experience. Social capital can be incorporated into symptom management interventions, possibly as a way to reframe a person's symptom appraisal. This may be increasingly important as PLWH age. The relationship between employment status and HIV symptom experience was significant and should be explored further.

Psychometric testing of the Chinese version of the Medical Outcomes Study Social Support Survey among people living with HIV/AIDS in China

PURPOSE

The aim of this study was to assess the psychometric properties of the Chinese (Mandarin) version of the Medical Outcomes Study Social Support Survey (MOS-SSS-CM) among people living with HIV/AIDS (PLWHA) in Mainland China.

METHODS

A cross-sectional study was conducted with a convenience sample of 200 Chinese PLWHA. They completed the MOS-SSS-CM along with the Chinese version of the Beck Depression Inventory Revised (BDI-II) scale, the Zung Self-Rating Anxiety Scale (SAS), the Perceived Stress Scale (PSS-10), and the World Health Organization Quality of Life Brief (WHOQOL-BREF) scale.

RESULTS

Internal consistency (Cronbach's α) was 0.97 for the overall MOS-SSS-CM and 0.82-0.91 for the five subscales originally proposed. However, 11 of the 19 items demonstrated unsatisfactory item discriminant validity. An exploratory factor analysis yielded a two-factor solution with tangible and social-emotional dimensions, which demonstrated satisfactory reliability and better discrimination between different subscales than did the original five-factor model. The concurrent validity of the two-factor scale was further confirmed by its significant negative correlations with the BDI-II (r=-0.41, p<0.01); the SAS (r=-0.27, p<0.01); and the PSS-10 (r=-0.30, p<0.01), and significant positive correlation with the WHOQOL-BREF scale (r=0.61, p<0.01).

CONCLUSION

We found a two-factor solution for the MOS-SSS-CM, which demonstrated good reliability and validity when applied to Chinese PLWHA. This was consistent with results from a study of Taiwanese caregivers. Further validation in other populations and disease states is warranted.

Revising the American dream: how Asian immigrants adjust after an HIV diagnosis

AIM

We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population.

BACKGROUND

Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.

DESIGN

A mixed-methods study was conducted.

METHODS

Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013.

DISCUSSION

Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.'

CONCLUSION

Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.

Acculturation and perceived stress in HIV+ immigrants: depression symptomatology in Asian and Pacific Islanders

Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.

Chinese female immigrants english-speaking ability and breast and cervical cancer early detection practices in the New York metropolitan area

BACKGROUND

Breast and cervical cancers are significant causes of mortality and morbidity for Asian women, and poor English-speaking ability is a barrier to cancer prevention practices.

MATERIALS AND METHODS

This project tested relationships among English-speaking ability and early detection practices regarding to breast and cervical cancer among female Chinese immigrants. A descriptive cross-sectional survey was used.

RESULTS

175 female Chinese immigrants completed the survey in the breast cancer prevention section, and 35 of them also completed the cervical cancer prevention section. Some 63% of them had heard about the clinical breast exam (CBE), but only 54% had had a CBE. While 46% of the participants were aware of their need for a Pap smear, only 31% had heard about it and had undergone a pelvic exam.

CONCLUSIONS

English-speaking ability was strongly associated with immigrant women's knowledge of female cancer early detection. Culturally and linguistic issues should be considered as the first step to access immigrant population in designing future education intervention.

Cognitive control in opioid dependence and methadone maintenance treatment

BACKGROUND

Substance misuse is associated with cognitive dysfunction. We used a stop signal task to examine deficits in cognitive control in individuals with opioid dependence (OD). We examined how response inhibition and post-error slowing are compromised and whether methadone maintenance treatment (MMT), abstinence duration, and psychiatric comorbidity are related to these measures in individuals with OD.

METHODS

Two-hundred-and-sixty-four men with OD who were incarcerated at a detention center and abstinent for up to 2 months (n = 108) or at a correctional facility and abstinent for approximately 6 months (n = 156), 65 OD men under MMT at a psychiatric clinic, and 64 age and education matched healthy control (HC) participants were assessed. We computed the stop signal reaction time (SSRT) to index the capacity of response inhibition and post-error slowing (PES) to represent error-related behavioral adjustment, as in our previous work. We examined group effects with analyses of variance and covariance analyses, followed by planned comparisons. Specifically, we compared OD and HC participants to examine the effects of opioid dependence and MMT and compared OD sub-groups to examine the effects of abstinence duration and psychiatric comorbidity.

RESULTS

The SSRT was significantly prolonged in OD but not MMT individuals, as compared to HC. The extent of post-error slowing diminished in OD and MMT, as compared to HC (trend; p = 0.061), and there was no difference between the OD and MMT groups. Individuals in longer abstinence were no less impaired in these measures. Furthermore, these results remained when psychiatric comorbidities including misuse of other substances were accounted for.

CONCLUSIONS

Methadone treatment appears to be associated with relatively intact cognitive control in opioid dependent individuals. MMT may facilitate public health by augmenting cognitive control and thereby mitigating risky behaviors in heroin addicts.

Self-compassion and risk behavior among people living with HIV/AIDS

Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA.