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PubMed2004

What makes women feel powerful? An exploratory study of relationship power and sexual decision-making with African Americans at risk for HIV/STDs.

Because of the importance of relationship power and cultural norms on women's ability to protect themselves from HIV/STDs, effective interventions must address power differentials among men and women. These programs need to be informed by and adapted to the cultural values of the target population. Accordingly, we conducted exploratory interviews with 22 young African American women at risk of HIV/ STDs and unintended pregnancy and their male partners regarding the meaning of power in heterosexual relationships, what makes a woman feel powerful in a relationship with a man, and who makes sexual and reproductive decisions in their relationships. Content analyses suggested that relationship power was linked to control and decision-making for most participants; yet, others appeared to associate power with positive relationship qualities such as respect and security. In addition, most participants reported that they shared decision-making about sexual and reproductive matters with their partners. Subsequently, interviews were conducted with another 40 women to explore and identify cultural beliefs regarding what makes women feel powerful in their relationships with their husbands or partners. Cultural consensus analysis was performed and results indicated that the participants comprise a cultural group with shared beliefs about what makes women feel powerful in their relationships. Participants believed that women's sense of power in their relationships came from (1) knowing what they want and having autonomy and control; (2) the quality of their relationships; (3) having resources to provide for their families; and (4) physical attractiveness and sexual factors.

Adult↗
PubMed2004

Influential characteristics of physician/pharmacist collaborative relationships.

BACKGROUND: A theoretical model of physician/pharmacist collaborative relationships, driven by 3 groups of relationship characteristics termed participant, context, and exchange, has been developed. There are no studies that have examined the types of characteristics which most influence development of collaborative relationships between physicians and pharmacists. OBJECTIVE: To test the model and determine which drivers most influence physician/pharmacist collaboration. METHODS: Data on the relationship drivers and collaborative practice were collected via a mailed survey of a random sample of 1000 primary care physicians in Iowa. Participant variables include demographics; context drivers refer to the practice environment and professional interactions between physicians and pharmacists. Exchange characteristics describe the nature of social exchange and were elicited using scores from 3 domains (relationship initiation, trustworthiness, role specification) of the Physician/Pharmacist Collaboration Instrument (PPCI). Five additional questions asked about the physician's collaborative practice with a pharmacist. Hierarchical linear regression analysis was performed with collaborative practice as the dependent variable and measures of participant, context, and exchange drivers as independent variables. RESULTS: Three hundred forty usable surveys (34%) were returned. Almost 70% of the respondents were male and aged 45.8 +/- 9.9 years (mean +/- SD). The majority were family practice physicians (72.1%) in private practice (67.3%). Regression analyses produced an R2 = 0.804 (p < 0.001). Significant predictors in the model were internal medicine physicians, professional interaction with a pharmacist, and the 3 domains of exchange drivers from the PPCI (p < 0.05). CONCLUSIONS: Although participant and context factors influenced physician/pharmacist collaborative relationships, exchange characteristics were the most influential relationship drivers. Role specification, trustworthiness, and relationship initiation were positively associated with physician/pharmacist collaborative practice. Recognition of these drivers may help pharmacists who are developing collaborative working relationships with physicians. But, studies are needed to delineate other factors that may influence physician/pharmacist relationships.

Adult↗
PubMed2004

Dating partners' responses to simulated dating conflict: violence chronicity, expectations, and emotional quality of relationship.

The focus of this study was couple emotions and expectations underlying chronic dating violence. The author categorized undergraduate partners in dating relationships into chronic violent versus nonchronic or nonviolent relationships based on Revised Conflict Tactics Scale (M. A. Straus, S. L. Hamby, S. Boney-McCoy, & D. B. Sugarman, 1996) scores. Results showed that men and women in chronic violent relationships, versus those who were not in chronic violent relationships, rated their current relationships as lower in positive affective tone and listening and understanding. Women in chronic violent relationships, versus other women, were more likely to expect their postviolent relationships to improve, to remain with their partners, and to experience lower anticipatory negative emotion about violence. Men in chronic violent relationships, versus other men, expected that their postviolent relationship would become increasingly violent and were in relationships of longer duration.

Adult↗
PubMed2004

Rated importance of personal qualities across four relationships.

Are there stable personal qualities that people value in others across a range of personal and professional relationships? For 4 relationship types that varied across social and professional associations (those of "close friend," "romantic partner," "an employee of yours," and "your boss"), participants rated each of 34 personal qualities on the basis of how important it would be in selecting someone for the relationship. The author factor-analyzed the ratings of importance and created composite scores to represent the 4 factors identified (intimacy, dependability, achievement, and kindness). The author found no difference that was due to relationship type for the factor of kindness. The relationship of romantic partners received the highest ratings on the factor of intimacy. Participants rated the relationship of close friends lower than the other 3 relationships for both of the factors of dependability and achievement. The results indicated that people value some qualities the same regardless of the relationship involved, with other qualities varying in importance across these relationships. Of special interest was the tendency of participants to see stable qualities as generally less important for choosing close friends than for choosing the others in the other three relationships.

Adult↗
PubMed1991

Assessment of elderly people in general practice. 3. Confiding relationships.

Little is known about the importance of confiding relationships in elderly people. Associations between lack of confiding relationships and depression, lifestyle characteristics, medication use, and contacts with doctors were studied by interviewing a random sample of 235 elderly people aged 75 years and over registered with nine general practices in inner London. It was found that men were not significantly more likely than women to report lack of confiding relationships. Married people of both sexes were more likely to have confiding relationships than those who were single, separated, divorced or widowed. Depression was not associated with lack of a confiding relationship, but those lacking such relationships were significantly more likely to smoke, and were prescribed significantly more medicines than those with confiding relationships. Individuals without a confiding relationship were significantly less likely to admit to any alcohol consumption in the previous three months, suggesting that alcohol consumption in this age group is largely a social phenomenon. Confiding relationships do not appear to confer strong protection against depression and a question on confiding relationships should not therefore be routinely incorporated into surveillance programmes for elderly people in the community.

Aged↗
PubMed1990

Relationships between independent living centers and medical rehabilitation programs.

A survey of independent living centers (ILCs) and medical rehabilitation programs (MRPs) with cooperative relationships was conducted to (1) document the extent and kinds of relationships that exist and (2) identify factors that are reported to impede or facilitate those relationships. A questionnaire was mailed to 83 ILCs that are listed in the ILRU Registry of Independent Living Programs and that reported having a relationship with one or more MRPs. Subsequently, another questionnaire was sent to the MRPs with which each ILC reported having a relationship. Usable questionnaires were received from 46 ILCs. In descending order, the most frequently reported relationships were (1) making referrals to or supplying information about MRPs, (2) providing peer counseling services, and (3) conducting training in daily living skills for medical rehabilitation patients. Mean ratings of satisfaction with the various kinds of relationships were relatively high. The three most frequently endorsed barriers to stronger relationships were conflicting approaches or styles of service delivery, funding of services, and conflicting program philosophies. Using information from a database describing ILCs, it was found that ILCs with MRP relationships served significantly more consumers than centers not having such relationships. According to results provided by 25 MRPs, patients with spinal cord injury most frequently received services by staff members of ILCs, with peer counseling being the most frequently provided service.

Activities of Daily Living↗
PubMed2001

The capacity for romantic intimacy: exploring the contribution of best friend and marital and parental relationships.

This study examined, in a longitudinal design, the contributions of three different relationships, namely marital, parent-child and best friend, to the capacity for intimacy in romantic relationships of Israeli male adolescents, as well as the mediating role of socio-emotional capacities. Eighty-four 17-year-old adolescents and their parents filled out questionnaires concerning the quality of these relational contexts. Four years later the Intimacy Status Interview was administered to the adolescents at the conclusion of their mandatory military service to examine closeness, separateness, and commitment within their romantic relationships. Results showed that all relational contexts were related to capacity for intimacy (directly or indirectly), with higher relational qualities associated with better capability for intimacy. The marital relationship was associated with intimacy through its effect on the parent-child relationships. The effects of the parent-child relationships on the capacity for intimacy were mediated through the adolescents' socio-emotional capabilities. The contribution of the parent-adolescent relationships to the capacity for closeness and commitment was further mediated through relationships with the best friend, whereas the contribution to the capacity for separateness was not. A substantial number of our participants showed high capability for intimacy although in the military service context the circumstances for the development of intimacy were quite limited and non-optimal. Exploration of the separateness and closeness facets of intimacy in romantic relationships in the two sexes and in other contexts is recommended.

Adolescent↗
PubMed1995

A time series analysis of the relationship between ambulatory EMG, pain, and stress in chronic low back pain.

Twenty-one subjects with chronic back pain (CBP) participated in an ambulatory electromyography (EMG) monitoring study to ascertain the relationships between muscle activity, physical activity, psychosocial stress, and pain. A time-series analysis approach was adopted to investigate both immediate and lagged associations between these variables in an attempt to determine potential causal relationships. Results for group relationships showed a significant relationship between physical activity and pain, self-report of stress and pain, but no relationship between EMG activity and pain. A lagged relationship between physical activity and pain was found, suggesting a causal relationship between physical activity and pain. However, no time lag was observed between stress and pain, hence no causal relationship can be elucidated. Analysis at the individual level indicated stronger relationships between several combinations of these variables, highlighting the need to consider the heterogeneity of the CBP population and etiology of CBP. The use of ambulatory monitoring of pain, stress, and EMG is suggested as one avenue to further explore the population's heterogeneity.

Adult↗
PubMed2006

Disc-condyle Relationships during Class II Treatment with the Functional Mandibular Advancer (FMA).

OBJECTIVE: The objective of this study was to verify the effects of treatment to correct Class II malocclusion with the Functional Mandibular Advancer (FMA) on the relative positions of the articular disc and mandibular condyle. In particular, we aimed to find out whether the disc-condyle relationship changed between baseline and post-treatment, in temporomandibular joints initially exhibiting a physiological relationship and alternatively, in temporomandibular joints initially presenting anterior displacement of the articular disc. PATIENTS AND METHODS: Treatment progress in 15 patients was monitored at defined points in time by manual structural analysis (MSA) and magnetic resonance (MR) imaging. The disc-condyle relationship was assessed by examining the parasagittal MR images made up of three slices each (lateral, central, medial) taken in habitual intercuspation and maximum-open mouth position. The MR images were metrically analyzed to determine the sagittal positional relationship of the articular disc and mandibular condyle using two methods on the central slices of the images taken in closed-mouth position. MSA was used in particular to determine the disc-condyle relationships and to metrically record the extent of active movement of the mandible during mouth opening, protrusion, laterotrusion, and retrusion. RESULTS: Comparison of baseline and post-treatment findings revealed that none of the joints exhibited a treatment-induced deterioration in the disc-condyle relationship, while the relationship improved in five joints. After categorization of the joints according to groups according to disc position, metric analysis of the MR images showed significantly-improved post-treatment disc positions in the joints that had initially exhibited anterior disc displacement. Post-treatment findings for maximum-open mouth position, protrusion, and laterotrusion corresponded to the baseline values recorded before bite-jumping, and the extent of maximum active retrusion increased significantly. CONCLUSIONS: Functional jaw orthopedics for correction of skeletal Class II with the rigid fixed FMA leads to side-effects reflected in the disc-condyle relationship in the temporomandibular joints: no adverse effects were observed in joints presenting an initial physiological disc-condyle relationship, whereas the disc position may improve in joints with initial partial or total anterior disc displacement. In comparison with the baseline findings, we observed no post-treatment restriction in the extent of maximum mouth opening, protrusion, and left and right laterotrusion. Maximum active retrusion increased due to the treatment. MR imaging and MSA only partly cover the same aspects of temporomandibular joint diagnostics.

Adolescent↗
PubMed2005

Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study.

Numerous studies indicate that bone mineral density (BMD) is closely related to body mass and its components. Most studies have examined these relationships in women with little attention given to how these relationships differ by gender. The aims of the present study were to use the opposite sex twin model to determine if there were gender differences in the relationship between body composition and its relation to BMD and how any such differences were influenced by age. We measured body composition and bone mass by dual energy X-ray absorptiometry in 93 pairs of opposite sex twins. To examine the effect of age, they were divided into two age groups: under 50 years old (45 pairs) and over 50 years old (48 pairs). Lean mass (LM) had stronger positive relationships with the most bone variables than fat mass in both genders at all ages. Fat mass (FM) had positive relationships with total body and hip BMD in women under age 50, but not over 50. There was no significant relationship between FM and total or regional BMD in men under age 50, but men over 50 showed positive relationships between FM measures and total and some regional BMD measures. Central adiposity showed a positive relationship with BMD in men over 50 and women under 50. Fat mass (FM) and lean mass (LM) and their distribution in the body have different relationships with regional BMD in men and women that differ by age.

Absorptiometry, Photon↗
PubMed2005

An exploration of nurse-patient relationships in accident and emergency.

This paper explores the nature of nurse-patient relationships in accident and emergency (A&E) drawing from nursing theory and research, and with reflection on three episodes of practice from the author's experience. First the case for nurse-patient relationships is presented with reference to nursing theory, statutory and professional literature. The benefits of positive nurse-patient relationships in A&E are then explored, followed by a discussion of the barriers to nurse-patient relationships forming in A&E. How relationships are formed is then considered, highlighting the short space of time available, and the importance of first impressions. The first practice episode analysed is a situation where the author felt she had not formed a relationship with the patient at all. In the second, the author questions whether the relationship had been over-involved and this is discussed in relation to the nature of involvement and what constitutes over-involvement. In the final practice episode the author felt that a positive relationship was formed with benefits to the patient concerned. The paper concludes by highlighting the importance of nurse-patient relationships in A&E, and how they can be formed in light of the barriers discussed previously.

Emergency Nursing↗
PubMed2006

Ethics, a neglected dimension of power relationships of physician leaders.

OBJECTIVE: Physician leaders in obstetrics and gynecology find themselves in complex power relationships with administrative subordinates, administrative peers, and administrative superiors. The ethical dimensions of these power relationships have not been examined previously. STUDY DESIGN: The authors draw on the work of 3 major historic figures (John Gregory, Thomas Hobbes, and Friedrich Hoffmann) to identify for the first time 3 major types of power relationships and organizational cultures. Gregorian power relationships and organizational cultures are characterized by shared fiduciary responsibility that advances the core mission of a health care organization. Hobbesian power relationships and organizational cultures are characterized by relentless self-interest in a zero-sum game. Hoffmannian power relationships and organizational cultures are characterized by enlightened self-interest in a win-win game. RESULTS: The authors analyze the ethical dimensions of power relationships of physician leaders with subordinates, peers, and superiors and of organizational cultures. CONCLUSION: The authors support transformational leadership toward Gregorian power relationships and organizational cultures, using, when necessary, Hoffmannian power relationships and organizational cultures as a way station.

Administrative Personnel↗
PubMed2006

Gender power and marital relationship as predictors of sexual dysfunction and sexual satisfaction among young married couples in rural China: a population-based study.

OBJECTIVES: To investigate associations between gender relationships and sexual dysfunction (SD) of younger married couples living in rural China. METHODS: An anonymous cross-sectional population-based survey study was conducted in a rural area in Hunan, China. A random sample of 298 couples were recruited. Self-reported SD, sexual satisfaction, and variables related to gender power and marital relationship were measured. RESULTS: Of the respondents, 28.2% and 45.6% of the husbands and wives were having at least one of the studied SDs, respectively. The results of the multivariate analyses showed that husbands not reporting a quality marital relationship (odds ratio [OR] 4.27, 95% confidence interval [CI] 2.13 to 8.57), who mistrusted their wives (OR 9.14, 95% CI 4.22 to 19.78), who claimed themselves as the decision-maker regarding condom use (OR 2.41, 95% CI 1.20 to 4.85), and whose wife scored lower in the relationship control subscale of the sexual relationship power scale (OR 2.83, 95% CI 1.15 to 6.95) were more likely than other husbands to have at least one SD. Wives who were not trusted by their husbands (OR 2.94, 95% CI 1.39 to 6.25), whose husbands were more powerful than they were in general decision-making (OR 1.98, 95% CI 1.14 to 3.43), and who scored lower in the relationship control subscale (OR 3.77, 95% CI 1.65 to 8.62) were more likely than other wives to have at least one SD. CONCLUSIONS: Gender relationships, including the quality of the marital relationship, mutual trust, decision-making, and relationship control, were significantly associated with SD. Gender inequality has been observed and needs to be taken into account in promoting sexual health among married couples living in rural China.

Adult↗
PubMed2002

Analysis of protein sequence/structure similarity relationships.

Current analyses of protein sequence/structure relationships have focused on expected similarity relationships for structurally similar proteins. To survey and explore the basis of these relationships, we present a general sequence/structure map that covers all combinations of similarity/dissimilarity relationships and provide novel energetic analyses of these relationships. To aid our analysis, we divide protein relationships into four categories: expected/unexpected similarity (S and S(?)) and expected/unexpected dissimilarity (D and D(?)) relationships. In the expected similarity region S, we show that trends in the sequence/structure relation can be derived based on the requirement of protein stability and the energetics of sequence and structural changes. Specifically, we derive a formula relating sequence and structural deviations to a parameter characterizing protein stiffness; the formula fits the data reasonably well. We suggest that the absence of data in region S(?) (high structural but low sequence similarity) is due to unfavorable energetics. In contrast to region S, region D(?) (high sequence but low structural similarity) is well-represented by proteins that can accommodate large structural changes. Our analyses indicate that there are several categories of similarity relationships and that protein energetics provide a basis for understanding these relationships.

Amino Acid Sequence↗
PubMed2000

A governing relationship for repetitive muscular contraction.

During repetitive contractions, muscular work has been shown to exhibit complex relationships with muscle strain length, cycle frequency, and muscle shortening velocity. Those complex relationships make it difficult to predict muscular performance for any specific set of movement parameters. We hypothesized that the relationship of impulse with cyclic velocity (the product of shortening velocity and cycle frequency) would be independent of strain length and that impulse-cyclic velocity relationships for maximal cycling would be similar to those of in situ muscle performing repetitive contraction. Impulse and power were measured during maximal cycle ergometry with five cycle-crank lengths (120-220mm). Kinematic data were recorded to determine the relationship of pedal speed with joint angular velocity. Previously reported in situ data for rat plantaris were used to calculate values for impulse and cyclic velocity. Kinematic data indicated that pedal speed was highly correlated with joint angular velocity at the hip, knee, and ankle and was, therefore, considered a valid indicator of muscle shortening velocity. Cycling impulse-cyclic velocity relationships for each crank length were closely approximated by a rectangular hyperbola. Data for all crank lengths were also closely approximated by a single hyperbola, however, impulse produced on the 120mm cranks differed significantly from that on all other cranks. In situ impulse-cyclic velocity relationships exhibited similar characteristics to those of cycling. The convergence of the impulse-cyclic velocity relationships from most crank and strain lengths suggests that impulse-cyclic velocity represents a governing relationship for repetitive muscular contraction and thus a single equation can predict muscle performance for a wide range of functional activities. The similarity of characteristics exhibited by cycling and in situ muscle suggests that cycling can serve as a window though which to observe basic muscle function and that investigators can examine similar questions with in vivo and in situ models.

Adult↗
PubMed2003

Peer and adult relationships of adolescents with disabilities.

The purpose of this study was to enhance our knowledge of what it is like to grow up with a disability, specifically, with focus on how adolescents with restricted mobility perceive social roles and relationships to peers and adults. The group investigated consisted of 12 adolescents with restricted mobility from northern Sweden, aged from 15 to 19 years. The adolescents were individually interviewed. The analysis resulted in a core category (Who am I), which describes how the adolescents perceive themselves. The core category was related to three subcategories: Relationships to friends--describes the adolescents' experiences of peer relationships, Relationships to adults--describes adolescents' relationships to adults, Thoughts about relationships in the future--comprises wishes for future relationships. The results indicated that the 12 disabled adolescents saw themselves as regular members of the adolescent peer group but that the members of the adolescent group saw them as being different. The relationships to friends of the same age were either markedly defective or did not exist at all, while relationships to adults were often characterized as ambivalent or asymmetric, i.e. the adults were simultaneously helpful and supportive while over protective and dominant. The study revealed that despite the many hindrances, the adolescents had a comparatively positive view of their future.

Adaptation, Psychological↗
PubMed1995

Uniqueness within the nurse-client relationship.

The uniqueness of individual nurse-client relationships was explored by comparing therapeutic relationships of two different clients with the same nurse, and two different nurses with the same client. This secondary analysis included 38 nurses who had two different clients in the original study, and 13 clients who had two different nurses. Instruments included the Working Alliance Inventory, semantic differential scales related to the nurse's view of the client and the client's view of the nurse, and the Relationship Form. The same nurse working with two different clients had different preconceptions, and a different relationship with respect to bond, task, and goals with each client. There was a relationship between the time required to establish a therapeutic relationship with the two different clients. Clients working with two different nurses had no significant relationship on any of the relationship measures. Findings suggest that the same individual, whether a nurse or a client, experiences very different therapeutic relationships with different people.

Adult↗
PubMed2002

The preload recruitable stroke work relationship as a measure of left ventricular contractile dysfunction in porcine cardiac allografts.

OBJECTIVE: Paradoxically, it has been reported that after 1.5-4 h of hypothermic ischaemic preservation there is complete recovery of contractile function in canine cardiac allografts, as assessed by the preload recruitable stroke work (PRSW) relationship. This raises questions about the suitability of the canine heart as a model for preservation research and the PRSW relationship as an end-point. The aim of the present study was to evaluate the PRSW relationship as an index of left ventricular contractility in porcine cardiac allografts. METHODS: Eighteen orthotopic heart transplants were performed in inbred Westran pigs. Brain death was induced in the donor pigs 1 h prior to explantation. The donor hearts were arrested with extracellular cardioplegia, which was stored in ice prior to administration. On explantation, the donor hearts were immersed in cardioplegia and stored in ice. The donor hearts were subjected to either 4 (IT4, n = 6), 6 (IT6, n = 9) or 14 (IT14, n = 3) h of ischaemia. Post-transplant, all hearts were supported with dobutamine (10 mcg/kg per min). The PRSW relationship was derived from pressure-volume loops obtained by epicardial sonomicrometry and transmyocardial micromanometry. Multiple linear regression was used to describe and compare the PRSW relationship before brain death in the donor and after weaning from bypass in the recipient. RESULTS: Eleven hearts were weaned successfully from cardiopulmonary bypass: IT4 100% (6/6), IT6 56% (5/9) and IT14 0% (0/3) (IT4 versus IT14: P = 0.012). Analysis of the PRSW relationship revealed a reduction in contractility in both the IT4 and IT6 groups (both P < 0.0001), but a greater reduction in the IT6 group (P < 0.0001). Notably, the volume-axis intercept of the PRSW relationship was found to be a better discriminator of post-preservation contractile dysfunction than the slope of the PRSW relationship. CONCLUSIONS: The porcine heart's susceptibility to ischaemic injury makes it ideal for evaluating the effect of different preservation strategies on contractile recovery. The PRSW relationship can be used to evaluate the differences in contractile recovery, though the nature of the effect of ischaemic preservation necessitates analysis by multiple linear regression.

Animals↗