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Biomedical subjects

Luis Moreno

Publications and source records attributed to Luis Moreno.

10 recordsLinked to original sources
PubMed2006

The role of relationship intimacy in consistent condom use among female sex workers and their regular paying partners in the Dominican Republic.

Prior research has demonstrated an important link between relationship intimacy and condom use. Limited research has been conducted on this connection within the realm of female sex work. We examined the association between perceived relationship intimacy and consistent condom use among 258 female sex workers and 278 male regular paying partners who participated in a cross-sectional survey in the Dominican Republic. In multivariate analysis, higher intimacy among sex workers and regular paying partners was negatively associated with consistent condom use. Among those reporting higher perceived intimacy, male participants were more than twice as likely to report consistent condom use as female participants. Female sex workers in relationships of higher perceived intimacy are at greater risk of HIV/AIDS than their male regular paying partners. Gender-sensitive HIV prevention programs are needed to address the differential influence of relationship intimacy on condom use in the context of sex work.

Adolescent↗
PubMed2006

Modelling radionuclide transport for time varying flow in a channel network.

Water flowrates and flow directions may change over time in the subsurface for a number of reasons. In fractured rocks flow takes place in channels within fractures. Solutes are carried by the advective flow. In addition, solutes may diffuse in and out of stagnant waters in the rock matrix and other stagnant water regions. Sorbing species may sorb on fracture surfaces and on the micropore surfaces in the rock matrix. We present a method by which solute particles can be traced in flowing water undergoing changes in flowrate and direction in a complex channel network where the solutes can also interact with the rock by diffusion in the rock matrix. The novelty of this paper is handling of diffusion in the rock matrix under transient flow conditions. The diffusive processes are stochastic and it is not possible to follow a particle deterministically. The method therefore utilises the properties of a probability distribution function for a tracer moving in a fracture where matrix diffusion is active. The method is incorporated in a three dimensional channel network model. Particle tracking is used to trace out a multitude of flowpaths, each of which consists of a large number of channels within fractures. Along each channel the aperture and velocity as well as the matrix sorption properties can vary. An efficient method is presented whereby a particle can be followed along the variable property flowpath. For stationary flow conditions and a network of channels with advective flow and matrix diffusion, a simple analytical solution for the residence time distribution along each pathway can be used. Only two parameter groups need to be integrated along each path. For transient flow conditions, a time stepping procedure that incorporates a stochastic Monte-Carlo like method to follow the particles along the paths when flow conditions change is used. The method is fast and an example is used for illustrative purposes. It is exemplified by a case where land rises due to glacial rebound. It is shown that the effects of changing flowrates and directions can be considerable and that the diffusive migration in the matrix can have a dominating effect on the results.

Computer Simulation↗
PubMed2006

Cost-effectiveness of environmental-structural communication interventions for HIV prevention in the female sex industry in the Dominican Republic.

Behavior change communication often focuses on individual-level variables such as knowledge, perceived risk, self-efficacy, and behavior. A growing body of evidence suggests, however, that structural interventions to change the policy environment and environmental interventions designed to modify the physical and social environment further bolster impact. Little is known about the cost-effectiveness of such comprehensive intervention programs. In this study we use standard cost analysis methods to examine the incremental cost-effectiveness of two such interventions conducted in the Dominican Republic in sex establishments. In Santo Domingo the intervention was environmental; in Puerto Plata it was both environmental and structural (levying financial sanctions on sex establishment owners who failed to follow the intervention). The interventions in both sites included elements found in more conventional behavior change communication (BCC) programs (e.g., community mobilization, peer education, educational materials, promotional stickers). One key aim was to examine whether the addition of policy regulation was cost-effective. Data for the analysis were gleaned from structured behavioral questionnaires administered to female sex workers and their male regular paying partners in 41 sex establishments conducted pre- and post-intervention (1 year follow-up); data from HIV sentinel surveillance, STI screening results conducted for the intervention; and detailed cost data we collected. We estimated the number of HIV infections averted from each of the two intervention models and converted these estimates to the number of disability life years saved as compared with no intervention. One-way, two-way, three-way, and multivariate sensitivity analysis were conducted on model parameters. We examine a discount rate of 0%, 3% (base case), and 6% for future costs and benefits. The intervention conducted in Santo Domingo (community mobilization, promotional media, and interpersonal communication) was estimated to avert 64 HIV infections per 10,000 clients reached, and resulted in a cost per disability-adjusted life year (DALY) saved of $1,186. In Puerto Plata a policy/regulatory intervention was added, which resulted in 162 HIV infections averted per 10,000 clients reached, and yielded a cost per DALY saved of $457. Cost-effectiveness estimates were most correlated to the discount rate used and base rates of sexually transmitted infection (which affects the HIV transmission rate). Both intervention models resulted in cost-effective outcomes; however, the intervention that included policy regulation resulted in a substantially more cost-effective outcome.

Cost-Benefit Analysis↗
PubMed2005

Environmental-structural interventions to reduce HIV/STI risk among female sex workers in the Dominican Republic.

OBJECTIVES: We assessed the effectiveness of 2 environmental-structural interventions in reducing risks of HIV and sexually transmitted infections (STIs) among female sex workers in the Dominican Republic. METHODS: Two intervention models were implemented over a 1-year period: community solidarity in Santo Domingo and solidarity combined with government policy in Puerto Plata. Both were evaluated via preintervention-postintervention cross-sectional behavioral surveys, STI testing and participant observations, and serial cross-sectional STI screenings. RESULTS: Significant increases in condom use with new clients (75.3%-93.8%; odds ratio [OR]=4.21; 95% confidence interval [CI]=1.55, 11.43) were documented in Santo Domingo. In Puerto Plata, significant increases in condom use with regular partners (13.0%-28.8%; OR=2.97; 95% CI=1.33, 6.66) and reductions in STI prevalence (28.8%-16.3%; OR = 0.50; 95% CI = 0.32, 0.78) were documented, as were significant increases in sex workers' verbal rejections of unsafe sex (50.0%-79.4%; OR=3.86; 95% CI=1.96, 7.58) and participating sex establishments' ability to achieve the goal of no STIs in routine monthly screenings of sex workers (OR=1.17; 95% CI=1.12, 1.22). CONCLUSIONS: Interventions that combine community solidarity and government policy show positive initial effects on HIV and STI risk reduction among female sex workers.

Adolescent↗
PubMed2005

The aromatase inhibitor letrozole increases the concentration of intraovarian androgens and improves in vitro fertilization outcome in low responder patients: a pilot study.

OBJECTIVE: To evaluate the impact of aromatase inhibitors as adjuvant treatment in IVF cycles on intraovarian androgens and cycle outcome. DESIGN: Observational, pilot study. SETTING: University-affiliated IVF unit. PATIENT(S): One hundred forty-seven low responder patients with a previous canceled IVF cycle; 71 patients were treated with letrozole 2.5 mg plus a high-dose FSH/hMG-antagonist regimen, and 76 patients were similarly treated but letrozole was not employed. INTERVENTION(S): In vitro fertilization treatment with an antagonist FSH/hMG protocol with or without letrozole was administered during the first 5 days of stimulation; hormones were evaluated in both serum and follicular fluid. MAIN OUTCOME MEASURE(S): Number of oocytes retrieved, fertilization rate, implantation rate, and pregnancy rate; androstenedione, T, E2, and P values in serum and follicular fluid. RESULT(S): Letrozole-treated patients showed significantly higher levels of follicular fluid T and androstenedione (80.3 vs. 43.8 pg/mL and 57.9 vs. 37.4 mg/mL, respectively). Similarly, these patients had a higher number of oocytes retrieved (6.1 vs. 4.3) and a higher implantation rate (25% vs. 9.4%) despite similar doses of FSH/hMG (3,627 vs. 3,804 IU). CONCLUSION(S): Adding 2.5 mg of letrozole to a high-dose FSH/hMG antagonist protocol increases intraovarian androstenedione and T concentration and improves IVF cycle outcome in poor responder patients.

Adult↗
PubMed2004

Tattoo remover.

Explore the source record for details and available documents.

Dermatologic Surgical Procedures↗
PubMed2003

Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic.

OBJECTIVE: To examine the influence of environmental-structural factors in promoting consistent condom use (CCU) among female sex workers (FSW) and their regular paying partners in the Dominican Republic. METHODS: A cross-sectional survey was conducted with 288 FSW recruited from 41 sex establishments in Santo Domingo from March to June 1998. Sex workers were asked about their sexual behavior, self-efficacy at negotiating safe sex, perceived intimacy with their most recent regular paying partner, and the physical, social and policy environment of the establishment where they worked. Factor and reliability analysis were utilized to develop aggregate measures for self-efficacy (Cronbach's Alpha 0.60), intimacy (Cronbach's Alpha 0.80), and environmental-structural support (Cronbach's Alpha 0.72). RESULTS: Controlling for sociodemographic characteristics of participants in multivariate analyses, environmental-structural support for condom use and HIV/sexually transmitted infection (STI) prevention was a significant predictor of CCU (OR 2.16; CI 1.18-3.97) among FSW and their regular paying partners. Safe sex self-efficacy (OR 2.80; CI 1.31-5.97) and low perceived intimacy with the most recent regular paying partner (OR 7.20; CI 3.49-14.83) were also significantly associated with CCU in multivariate analysis. CONCLUSION: Environmental-structural support for condom use and HIV/STI prevention is a significant predictor of CCU among FSW in the context of regular paying partnerships. Environmental-structural factors, in addition to relational and individual cognitive factors, should be assessed and addressed by behaviorally guided theory, research and interventions related to HIV/STI prevention and female sex work.

Adolescent↗
PubMed2003

Determination of the flow-wetted surface in fractured media.

Diffusion and sorption in the rock matrix are important retardation mechanisms for radionuclide transport in fractured media. For the conditions existing in a deep repository in crystalline rock, interaction with the rock matrix is controlled by the water flowrate in the fractures and the surface area in contact with the flowing water (the so-called "flow-wetted surface" (FWS)). The flow-wetted surface may be determined from the frequency of open fractures intersecting a borehole. The choice of packer distance used in these hydraulic measurements is crucial, however, since several open fractures may be found in one packer interval. The use of a packer distance that is too large may result in a considerable underestimation of the flow-wetted surface. This is especially important in zones with a high frequency of open fractures (fracture zones) where a small packer distance is a fundamental requirement. A large volume of hydraulic data has been compiled in Sweden from measurements using quite small packer distances. Over the last decade, the most common packer distance used for the hydraulic tests has been 3 m, although some new measurements using a shorter packer distance have also been performed. In several cases, the resolution of these measurements has been less than 0.5 m. All these data have been analysed in detail. From these data, the flow-wetted surface has been calculated and compared with the flow-wetted surface estimated in earlier studies. The results show the importance of using a small packer distance for carrying out borehole transmissivity measurements.

Adsorption↗
PubMed2003

Prediction of some in situ tracer tests with sorbing tracers using independent data.

Some recent converging tracer tests with sorbing tracers at the Aspö Hard Rock Laboratory in Sweden, the TRUE tests, have been predicted using only laboratory data and hydraulic data from borehole measurements. No model parameters were adjusted to obtain a better fit with the experiments. The independent data were fracture frequency and transmissivity data obtained in the field and laboratory data on sorption and matrix diffusion. Transmissivity measurements in five boreholes in the rock volume containing the region surrounding the injection and collection points show that there is a high frequency of water conducting fractures. Of 162 packed off sections with 0.5 m packer distances, 112 were found to have a transmissivity above the detection limit. The specific flow-wetted surface (FWS) of the rock mass could be estimated from these data. The transmissivities were found to be reasonably well described by a lognormal distribution. Laboratory data on diffusion and sorption properties together with the hydraulic data were used to "predict" the residence time distribution (RTD) of the sorbing tracers. The results were compared with the experimental breakthrough curves. In these experiments, the water residence time is very small compared to the residence time of the sorbing tracers due to their diffusion and sorption within the rock matrix. We thus could neglect the influence of the water residence time in our predictions. Therefore, no information on water residence times or on "dispersion" was needed. The dispersion of the sorbing tracers is caused by the different sorbing tracer residence times in different pathways. The sorbing tracer residence time is determined by the ratio of flowrate to the flow-wetted surface in the different pathways and not by the water residence time. Assuming a three-dimensional flow pattern and using the observed fracture frequency and flowrate distribution, breakthrough curves for three strongly sorbing tracers were predicted. Only the laboratory data, the transmissivity measurements and the pumping flowrate were used in the predictions. No information on the water residence time as obtained by the nonsorbing tracers was used. The predictions were surprisingly accurate.

Diffusion↗