Addressing male sexual behavior and condom use is a high priority for adolescent health programs. Using the 1997 Ghana Psychographic Survey, the aim of this study is to explore the factors related to current, partner-specific condom use, by Ghanaian males aged 15-24 years. A multivariate regression analysis reveals an independent association between psychographic attitudes, peer network characteristics, sexual partner characteristics, and some level of condom use with a nominated sexual partner. The most important predictor for both condom use consistently as well as condom use at least sometimes was respondents' knowing someone who died as a result of AIDS. This finding suggests that future interventions should aim to personalize the risk of HIV/STIs, promote condom use with a range of partner types, and educate youth about the importance of consistent use.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Xenogeneic transplantation of porcine hepatocytes into the CCl4 cirrhotic rat model.

Liver support using extracorporeal devices and hepatocyte transplantation has received renewed interest for the management of acute and chronic liver failure. The aim of this study was to determine whether xenogeneic porcine hepatocytes could integrate into the liver parenchyma of cirrhotic Lewis rats when administered by an intrasplenic route. Cirrhosis was induced by carbon tetrachloride (CCl4) inhalation and confirmed histologically. Freshly isolated porcine hepatocytes were infused directly into the splenic pulp at laparotomy over a 5-15-min interval. Using (111)In-labeled hepatocytes, the degree of localization of porcine hepatocytes to the spleen and liver was found to be greater than 60% in both control and cirrhotic rats. Integration of porcine hepatocytes into the rat liver parenchyma was determined by immunohistochemical staining for porcine albumin in rat liver sections. Further confirmation was provided by in situ hybridization using a porcine-specific probe that binds to a distinct repetitive element (PRE) in porcine DNA. Evidence of integrated porcine hepatocytes was seen for over 50 days in animals under cyclosporine immunosuppression. These data demonstrate the integration of xenogeneic porcine hepatocytes into the liver of the cirrhotic rat and their ability to produce porcine albumin for up to 50 days.

Albumins↗

PubMedDate not supplied

Flexible roles: a new model in nursing practice.

The problem of how to retain experienced nurses within a given specialist field impacts on both nurses and managers. This article explores the development of a new clinical role which gives experienced E and F grade nurses the opportunity for personal and professional growth. Within the new role, 50% of the nurse's time is devoted to ward-based clinical work and the other 50% to developing an area of clinical practice or research, as is the case with some clinical nurse specialists. There is flexibility over the area of specialist interest to reflect the needs of the service and the expertise and interests of the individual, and there is also flexibility in relation to the clinical commitment which increases opportunities for job shares. This development has arisen from an organizational culture which recognizes the need for more flexible job classifications and work rules. This new model for practice also represents a new model for management. In fostering self-reliance within the workforce it enables all parties to work towards a shared vision which is mutually beneficial for nurses, managers, the organization and, most importantly, the patient.

Career Mobility↗

PubMedDate not supplied

A broader vision for managed care, Part 1: Measuring the benefit to communities.

For the past quarter-century managed care plans have been judged almost exclusively in terms of their influence on the health and health care of individual enrollees. However, policymakers are now paying attention to the ways in which health care organizations affect the broader well-being of their communities. These forms of "community benefit" emerged originally from legal criteria for tax exemption but are increasingly applied to all health care organizations, whatever their form of ownership. In this paper we identify different paradigms for defining community benefit and trace the factors that have encouraged or discouraged their application to health care. We suggest several strategies encouraging managed care plans to broaden their goals to include community benefit.

Community Health Planning↗

PubMedDate not supplied

A broader vision for managed care, Part 2: A typology of community benefits.

Applying a "community benefit" standard to managed care is difficult because prevailing definitions of community benefit have been drawn largely from the hospital industry, which has different operating practices and capabilities than managed care plans do. To formulate a more comprehensive and appropriate typology for managed care, we describe four different conceptual perspectives on community benefit and identify actual plan practices that match each perspective. We propose a "balanced model" for encouraging community benefit through public and private policies.

Charities↗

PubMedDate not supplied

Market incentives, plan choice, and price increases.

The Federal Employees Health Benefits Program (FEHBP) has attracted considerable interest for its ability to control health care costs. We examine the impact of the FEHBP's maximum dollar contribution on incentives to select low-cost plans and the growth in insurance premiums over time. Unless the maximum dollar contribution is pegged to a low-price plan, few enrollees select such plans. Moreover, premiums rise at least five percentage points per year faster among plans below this fixed subsidy level than they do in plans above it. Our results have important implications for the design of similar market-based approaches.

Choice Behavior↗