Low-frequency Users Research Articles

Nonoxynol-9 fails to prevents STDs, but microbicide research continues

A WHO/CONRAD meeting was held in Geneva in October 2001 to consider the importance of these and other data (CONRAD stands for Contraceptive Research and Development Programme). The meeting concluded that nonoxynol-9 should not be used or promoted for the prevention of HIV or sexually acquired infections: condoms are the method of choice. The meeting also concluded that for women at low risk of HIV infection nonoxynol-9 remains a contraceptive option although its effectiveness as a contraceptive when used alone is modest. The rationale for this conclusion is that low-risk women are also likely to be low-frequency users of nonoxynol-9 and hence at low risk of genital lesions which are the putative mechanism for placing women who use nonoxynol-9 frequently at increased HIV risk. However women at high risk of HIV infection and those unaware or unsure of their risk should not use nonoxynol-9 as such use may increase their risk of infection. (excerpt)

Psychophysical responses to single and multiple presentations of the oral irritant zingerone: Relationship to frequency of chili consumption

There are few data on the psychophysical properties of zingerone, one of the pungent components in ginger, particularly in contrast to capsaicin. The time-intensity characteristics of zingerone irritation were examined using high-frequency, intermediate-frequency, and low-frequency users of chili, who rated the intensity of whole-mouth rinses of 1% zingerone at 6-s intervals for 3 min. Maximum intensity was reached within the first 20 s, while the zingerone was in the mouth. At this stage, there were no differences between groups. Following expectoration at 30 s, frequent users showed a more rapid decline in rated intensity than did intermediate users, who showed a more rapid decline than infrequent users. Capsaicin sensitization and desensitization are dependent upon the interstimulus intervals (ISIs) used. A second experiment, also using groups of high-, intermediate-, and low-frequency chili users, examined whether sensitization to zingerone could be demonstrated using ISIs based on the point of maximum intensity observed in the first study. In contrast to sensitization effects found with capsaicin, slight desensitization was observed over 10 successive zingerone stimuli. Following a 5-min hiatus in stimulation, further desensitization was apparent. These results point to the ability of zingerone to self-desensitize, although the effect is of a smaller magnitude than that of capsaicin. None of these effects varied as a function of chili use. Analysis of the qualities that constituted zingerone irritation found that the sensations produced are predominantly burning and warmth, making it qualitatively similar to capsaicin.

Health Insurance Status and the Use of Emergency and Other Outpatient Services by Adults With Sickle Cell Disease

Study objective: To evaluate insurance status and frequency of use of emergency services in adults with sickle cell disease. Design: Retrospective analysis of visits. Setting: Emergency department and outpatient clinics of an urban university hospital. Participants: One hundred seventy-two subjects, who made 771 visits to the ED during 1990. Results: Of the 172 subjects, 31 were covered by commercial insurance, 32 were covered by Medicare, and 109 were covered by Medicaid or were uninsured. Insurance status and frequency of use of emergency services were independent ( P >.05). On discriminant analysis, Medicaid-covered and uninsured subjects were correctly classified, but commercially insured and Medicare subjects were not. Medicaid and uninsured subjects were more likely to be younger and to live closer to the hospital ( P<.00005). High-frequency users of emergency services were discriminated from low-frequency users. High-frequency users were more likely to be younger, to be users of primary-care services,and to live closer to the hospital ( P =.0004). Conclusion: Provision of primary-care services or stable insurance in the form of commercial insurance or Medicare did not decrease use of emergency services in subjects with sickle cell disease in a group of patients selected from one urban academic ED. [Hand R, Koshy M, Dorn L, Patel M: Health insurance status and the use of emergency and other outpatient services by adults with sickle cell disease. Ann Emerg Med February 1995;25:224-229.]

Recreational Drug Use and the Risk of Primary Infertility

Recreational drug (marijuana, lysergic acid diethylamide or LSD, speed, cocaine, and "other") exposures of women with primary infertility were compared with those of a matched control group of women with proven fertility. Women who reported smoking marijuana had a slightly elevated risk for infertility due to an ovulatory abnormality (RR = 1.7, 95% CI = 1.0 to 3.0). The risk was greatest among women who had used marijuana within one year of trying to become pregnant (RR = 2.1, 95% CI = 1.1 to 4.0). No consistent frequency or duration of use effects could be demonstrated, and the risk was confined to low-frequency users. Risks associated with the use of other drugs were not elevated. The risk of infertility from a tubal abnormality associated with cocaine use was greatly increased (RR = 11.1, 95% CI = 1.7 to 70.8). Our results are consistent with animal studies suggesting that smoking marijuana may cause a transient disruption of ovulatory function. The possibility that cocaine exposure influences the development of tubal infertility needs further investigation.

Prevention, Declining Mortality Rates, and the Cost of Medicare

It is commonly assumed that with declining adult mortality rates, the elderly population will continue to increase and become a major fiscal problem for the Medicare program. However, this population, like other age groups, consists of a small number of frequent medical-care users and a large number of low-frequency users. If the decline in mortality rates occurs as a result of primary and secondary prevention efforts rather than tertiary interventions, a 26.4 percent increase in the population 65 years of age and older could result in only a 19.4 percent increase in gross Medicare expenditures and a slight decline in net Medicare expenditures.

Utilization, Attrition, and the Senior Center

Evaluative studies of senior center utilization traditionally rely on numerical increase of participation as a principle criterion for determining success. This study compares the participation patterns of 54 high- and low-frequency users of an urban senior center for the purpose of identifying actors which influence usage. The chi-square and point biserial correlation coefficient were statistics utilized for the purpose of identifying relationships between 16 variables. The subjects were similar with regard to health, mobility, access to the center, and disengagement potential. Significant relationships were identified between usage and: life space, club affiliation, alternative activities, friends outside the center, living arrangements, and duration of membership. The data suggest that usage appears to be influenced by social losses and gains, which provides a novel perspective of participation and attrition. Therefore, evaluative studies of senior center utilization might consider not only numerical c...