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PubMed1995

Effect of object and movement cues on receptive communication by preschool children with mental retardation.

Preschool children with mental retardation typically have delays in language comprehension that may result in difficulty understanding spoken messages. The effect of the systematic application of object and movement cues was investigated to determine whether either or both cues would facilitate children's comprehension of a partner's intended referent during play and snack activities. Children were presented with stimulus items that the communication partner referred to under three conditions: object cue and speech, movement cue and speech, or speech alone. All children identified the intended referents with fewer trials to criterion when object or movement cues were used with speech than when speech alone was employed.

Attention↗
PubMed2005

Communication patterns of individuals with moderate or severe cognitive disabilities: interactions with unfamiliar partners.

Interactions between youth with cognitive disabilities and unfamiliar adult partners were observed during a "standard partner" condition to discern the effects of the use of an augmentative and alternative communication system on communication patterns. Thirteen individuals who used the System for Augmenting Language (SAL) were compared to individuals who do not speak and who do not have SAL experience and individuals who speak. In general, the SAL users fell in the middle of the range, communicating better than the symbol-naive nonspeakers, yet not quite as well as the natural speakers with cognitive disabilities. These findings highlight the distinct contributions symbol experience makes to communication interactions with unfamiliar partners.

Activities of Daily Living↗
PubMed2000

Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment.

Most studies of outcomes of genetic counseling have focused on client knowledge, reproductive plans and behavior, or satisfaction. Other measures of the "value" of genetic counseling are needed to guide research assessing the impact of genetic counseling on individuals and populations, as well as to improve the process of providing care. To obtain input from providers, we conducted telephone interviews with six experienced genetic counselors, and then we held a focus group with 10 additional genetic counselors from a variety of practice settings. To obtain input from consumers, telephone interviews were also conducted with 19 past clients of these participating counselors. We found that counselor goals focus on meeting clients' needs, usually educating and providing psychosocial support. Clients often had few goals going into a session because they were unaware of what would be discussed or how the session would be structured. They usually did not expect to receive "counseling," and when they did, it was a welcome surprise. Both clients and counselors commented that a positive interpersonal interaction and "connecting" are primary measures of success. All clients appreciated the large amount of time spent with the counselor, and the manner (clear, comprehensive, and unhurried) of providing information. Many clients said that genetic counseling resulted in improved communication with their partners and other family members. Clients view the counselor as an "expert" and value the counselor as an on-going resource for both information and support. These "outcomes"f genetic counseling need to be assessed, and new measures must be developed.

Adult↗
PubMedDate not supplied

Life after cancer: adaptation issues faced by Chinese gynaecological cancer survivors in Hong Kong.

An explorative study using qualitative data collection methods was used to look at the adaptation issues faced by Chinese survivors of gynaecological cancers. Eighteen women who were free from illness and between 2 and 16 years post-diagnosis participated. Content analysis of the data revealed that cancer and its treatment led to a positive revival of these women as they re-evaluated their life, started treasuring family relationships, improved their mood and became more sensitive to other people's needs. However, they also described problems with marital relationships, concerns about the future of their children, sexuality and femininity, loss of fertility and discomfort due to pain and weakness. A third of the sample reported that their husbands had extramarital affairs. Despite this, women, especially those who had good communication with their partners, commented that they maintained a loving relationship. Cultural beliefs and misconceptions about sexual functioning were also depicted as affecting adaptation to illness. Long-term psychosocial care may help these women to adapt better to the demands of the illness, especially sexual and psychosexual rehabilitation, as sexual problems were reported by all women in the study.

Adaptation, Psychological↗
PubMed1997

Structure-function correlations in the XerD site-specific recombinase revealed by pentapeptide scanning mutagenesis.

Xer-mediated site-specific recombination contributes to the stability of circular chromosomes in bacteria by resolving plasmid multimers and chromosome dimers to monomers prior to cell division. Two related site-specific recombinases, XerC and XerD, each catalyse one pair of strand exchange during Xer recombination. In order to relate the recently determined structure of XerD to its function, the XerD protein was subjected to pentapeptide scanning mutagenesis, which leads to a variable five amino acid cassette being introduced randomly into the target protein. This has allowed identification of regions of XerD involved in specific DNA binding, in communicating with the partner recombinase, XerC, and in catalysis and its control. The C-terminal domain of XerD, comprising two-thirds of the protein, contains the catalytic active site and comprises ten alpha helices (alphaE to alphaN) and a beta hairpin. A flexible linker connects this domain to the N-terminal domain that comprises four alpha helices (alphaA to alphaD). Pentapeptide insertions into alphaB, alphaD, alphaG, or alphaJ interfered with DNA binding. Helices alphaG and alphaJ comprise a pseudo helix-turn-helix DNA binding motif that may provide specificity of recombinase binding. An insertion in alphaL, adjacent to an active site arginine residue, led to loss of cooperative interactions between XerC and XerD and abolished recombination activity. Other insertions close to active site residues also abolished recombination activity. Proteins with an insertion in the beta hairpin turn bound DNA, interacted cooperatively with XerC and had a phenotype that is consistent with the protein being defective in XerD catalysis. This beta hairpin appears to be highly conserved in related proteins. Insertions at a number of dispersed locations did not impair XerD catalytic activity or DNA binding, but failed to allow XerC catalysis in vivo, indicating that several sites of interaction between XerD and XerC may be important for activation of XerC catalysis by XerD.

Amino Acid Sequence↗
PubMed1990

Attitudinal and experiential correlates of anorgasmia.

Twenty-four orgasmic and 10 anorgasmic women, ages 21-40, provided continuous self-report measures of sexual arousal while viewing explicit videotape segments depicting a variety of sexual activities. They also completed several questionnaires designed to assess sexual attitudes, knowledge, and guilt. As compared to the orgasmic women, the anorgasmic women reported (i) greater discomfort in communicating with a partner regarding only those sexual activities involving direct clitoral stimulation, (ii) more negative attitudes toward masturbation, (iii) greater endorsement of sex myths, and (iv) greater sex guilt. Contrary to expectations, the groups failed to differ significantly on either the frequency of use of any of the sexual activities depicted or on arousal to viewing these activities. The theoretical and clinical implications of these findings are explored.

Adult↗
PubMed2006

Eroticizing creates safer sex: a research synthesis.

This meta-analytic review examined the effectiveness of sexual risk reduction interventions in 21 studies (N=5,015) that integrated a safer sex eroticization component. Compared to controls, intervention participants exhibited lower sexual risk on 6 dimensions: HIV-related knowledge, attitudes toward condoms, condom use, overall behavioral risk, communication with sexual partners, and sexual frequency. Additional analyses examined pre- to post-test outcomes and showed significant improvement in condom use in the intervention compared to the control groups. Overall, findings suggest that eroticizing safer sex leads to more risk-preventive attitudes, which in turn facilitates less risky sexual behavior.

Female↗
PubMed2004

Managing Syphilis in the HIV-infected Patient.

Syphilis has re-emerged in the United States and elsewhere, and clinicians caring for HIV-infected patients are challenged with syphilis diagnosis and management decisions. HIV alters the natural history of syphilis to an extent that is poorly understood, and initial presentation may be more varied in coinfected patients. Although commonly available diagnostic assays for syphilis should be interpreted as usual, such tests rely on antibody measurement and may be an imperfect indicator of active infection. Assessment of all available clinical and risk behavior data remains critically important in the diagnosis of syphilis in coinfected patients. Treatment of syphilis in such patients requires stage-appropriate therapy, with careful serologic monitoring to assess response. Clinicians must have heightened appreciation of the role of frequent risk assessment, serologic screening, symptom recognition, and follow-up of treated patients, as well as an understanding of public health functions such as sex partner treatment and communicable disease reporting.

Journal Article↗
PubMed1994

Determinants of condom use by Australian secondary school students.

PURPOSE: To identify factors that are associated with condom use to aid in the understanding of how to change the behavior of those young people who have sex without using condoms. METHODS: The article reports data from 932 sexually active grade 10-12 students from a sample of 72 public secondary schools in seven Australian states and territories. The data were collected using a cross-sectional, self-report questionnaire. RESULTS: Boys were more likely than girls to report that a condom was used the last time they had sex. For boys and girls, communication with a partner about avoiding infection with HIV/STDs, the belief that more peers use condoms, and a higher perceived risk of becoming infected with HIV/STDs were associated with using a condom, as was lower knowledge of STDs. The use of oral contraception and the unavailability of condoms were reported by the students as prominent reasons for non-use of condoms. Number of sexual partners in the past year and type of relationship with partner on the most recent occasion were not associated with condom use. CONCLUSIONS: Adolescents are more concerned with unwanted pregnancy than with disease prevention. School students more at risk are not more likely to take the necessary precautions to protect themselves from HIV/STDs.

Adolescent↗
PubMed2005

Clinical applications of exhaled nitric oxide for the diagnosis and management of asthma: a consensus report.

BACKGROUND: Patients with asthma routinely exhibit elevated levels of fractionated exhaled nitric oxide (FE(NO)), and this observation has led to studies investigating FE(NO) as a potential marker of airway inflammation. FE(NO) has been shown to enhance the diagnosis of asthma, detect deterioration in control of patients with asthma, and monitor response to anti-inflammatory therapy. OBJECTIVES: The aim of this work was to determine if FE(NO) measurement provides a noninvasive, well-tolerated, and standardized technique to monitor airway inflammation, and if it has the potential to complement standard asthma monitoring tools (eg, symptom diaries, control questionnaires, and pulmonary function testing) and to improve asthma control and patient outcomes. METHODS: Thirteen experts in the diagnosis and treatment of asthma met to discuss the use of FE(NO) in the diagnosis and management of patients with asthma. Participants were selected by Aerocrine, a medical, technical company with headquarters in Stockholm, Sweden, in consultation with their medical education partner Cadent Medical Communications located in Irving, Texas, to represent a diversity of specialists, including both clinicians and investigators, in the fields of allergy, immunology, and pulmonology. All participants were nominally compensated for their time to attend this closed scientific roundtable discussion. The meeting was supported by an educational grant from Aerocrine. This report represents the overall consensus reached by the participants on the clinical applicability of this technique. RESULTS: Our understanding of asthma has expanded so that investigators are now focusing on inflammation in addition to airway obstruction and hyper-reactivity. Whereas patient history, symptoms, and pulmonary function testing can assist in diagnosing asthma, they are not direct measures of the extent of airway inflammation. Elevated FE(NO) levels have been shown to reflect airway inflammation and to occur together with other conventional markers used to detect inflammation. Studies have confirmed increased levels of FE(NO) in both adults and children with asthma. In most studies, FE(NO) was found to be elevated 2- to 3-fold compared with normal controls. There are many determinants of FE(NO) levels, however, and factors other than inflammation must be considered when FE(NO) measurement is used to diagnose and monitor asthma. FE(NO) measurement alone is not sufficient for diagnosing or monitoring asthma, but it can be a valuable addition to current clinical tools. CONCLUSIONS: FE(NO) measurement is a noninvasive and reproducible test that is a surrogate measure of airway inflammation in patients with asthma. The test has demonstrated utility in diagnosing and managing asthma and in predicting response to therapy and, therefore, may be an important tool to incorporate into clinical care.

Adult↗
PubMed2006

Protein arginine methylation in lymphocyte signaling.

Methylation of arginine is an additional option within the repertoire of post-translational modifications that proteins utilize for their communication with other partner proteins and nucleic acids, which ultimately contributes to cellular functions. Recent studies reveal that protein arginine methylation is more common and widespread than previously thought and that it is implicated in a number of key cellular processes including signal transduction. Two recent investigations have propelled this new world of protein modification into the immunological community by showing that TCR and CD28 signaling exploit this pathway. In contrast to other protein modifications utilized in intracellular signaling, arginine methylation seems to be long-lasting, raising interesting questions as to when, where and for what reason it can be utilized in the lymphocyte differentiation processes.

Animals↗
PubMed2006

Platelet transfusion therapy: from 1973 to 2005.

Platelet transfusions are indispensable for supportive care of patients with hematological diseases. We describe the developments in platelet products for transfusion since the 1970s, when, in particular, support for patients with allo-antibodies against human leukocyte antigens was a laborious exercise with a high failure rate. Currently, due to many stepwise innovations, platelet transfusions are of low immunogenicity and sufficiently available, they have a shelf life up to 7 days, and even matched platelets can often be routinely delivered, provided that there is good communication between all partners in the chain. Future improvements can be expected from uniform type and screen approaches for immunized patients and cross-matching by computer. For efficient use of health care resources, blood banks and stem cell donor banks could share their typed donor files.

Blood Banks↗
PubMed2006

Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study.

PURPOSE: To assess the independent effects of various behavioral and psychosocial antecedents on contraceptive use among a sample of low-income African-American adolescent females. METHODS: Stepwise logistic regression was used to calculate odds ratios for baseline predictors of inconsistent contraceptive use six months later. Study participants include 375 nonpregnant African-American girls aged 14-18 years who reported sexual activity in the previous six months. Data were collected using a self-administered survey, individual interview and urine pregnancy test. RESULTS: Adolescents who were inconsistent contraceptive users at follow-up were more likely to have reported a desire for pregnancy, previous inconsistent contraceptive use, less frequent communication with their partners about prevention issues, and an increased number of lifetime sexual partners at the baseline assessment. Of equal importance was the finding that a previous pregnancy or sexually transmitted infection did not influence future contraceptive behaviors. CONCLUSIONS: Clinicians can play an important role in counseling adolescents about sexual health and dispelling misperceptions that hinder consistent contraceptive use. Findings from this research could have significant implications for the development of effective sexually transmitted infection (STI) and pregnancy prevention programs for adolescents and can help in guiding clinicians toward relevant treatment practices.

Adolescent↗
PubMed2000

New opportunities for nurses as patient advocates.

OBJECTIVES: To define the role of nurses as patient advocates and to explore new strategies for the future. DATA SOURCES: Review articles, research studies, education and communications materials, and personal experience with oncology professionals, patients, and family members. CONCLUSIONS: Cancer nurses' roles in patient advocacy have progressed and grown as the profession of oncology nursing has itself matured. As resources continue to diminish, nurses need to consider the power of their roles as change agents, coordinators, and directors as well as interventionists. IMPLICATIONS FOR NURSING PRACTICE: There are many needs for research in this area as well as new roles for nurses who care for patients. Nurses need to be aware of ongoing research in areas such as health communications and consider partnering with persons in these other disciplines to enhance productivity and to use their time most efficiently.

Humans↗
PubMed2002

Reproductive health risk and protective factors among youth in Lusaka, Zambia.

PURPOSE: To: (a) identify risk and protective factors for behaviors that expose Zambian youth to risk of HIV infection and, (b) assess whether research findings from the United States concerning protective factors in "high-risk" environments might apply to other settings. METHODS: A community-based sample of 2328 youth ages 10-24 years residing in Lusaka, Zambia was interviewed. Multivariate statistical methods were used to isolate risk and protective factors for selected sexual and contraceptive behaviors. Seven categories of factors were considered: sociodemographic factors, sexual-reproductive health knowledge and perceptions, nonsexual risk behaviors, peer influence, connections with parents and social institutions, and communication with sexual partners. RESULTS: A sizeable number of factors were associated with each outcome. Only two factors, school attendance and knowledge of AIDS, were associated with both lower levels of sexual activity and consistent use of condoms, and only engaging in higher-risk social activities with close friends was a risk factor for both. The effects of the other factors considered varied by outcome and gender. As in prior research, strong influences of peers were observed, but connections with parents and social institutions unexpectedly did not emerge as protective. CONCLUSION: Because of the number and diverse nature of factors influencing adolescent behaviors, it is unlikely that a single intervention will be found to immediately change sexual risk-taking behaviors in Zambia.

Adolescent↗
PubMed2001

Promoting adherence to inhaled therapy: building partnerships through patient education.

Optimal treatment outcomes are dependent upon patient adherence to therapy. Problems in adherence can be overcome by developing a professional-patient partnership that has the goal of developing communication between the partners, mutual accountability, respect for personal values and viewpoints, and shared decision making. The process of patient education is shaped by the needs of this developing partnership rather than a-priori goals established by the professional.

Administration, Inhalation↗
PubMed2004

Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war.

This study examined the association of posttraumatic stress disorder (PTSD) with the quality of intimate relationships among present-day male World War II ex-prisoners of war (POWs). Ex-POWs had considerable marital stability; those with PTSD were no less likely to be in an intimate relationship. Ex-POWs in an intimate relationship who had PTSD (N=125 ) were compared with ex-POWs in a relationship who did not have PTSD (N=206). Marital functioning was within a range expected for persons without traumatic exposure. Yet, over 30% of those with PTSD reported relationship problems compared with only 11% of those without PTSD. Ex-POWs with PTSD reported poorer adjustment and communication with their partners and more difficulties with intimacy. Emotional numbing was significantly associated with relationship difficulties independent of other symptom complexes and severity of PTSD. Implications for clinical practice are discussed.

Aged↗
PubMed2004

[Attitudes towards eroticism and sexuality in the elderly over 60 years of age].

BACKGROUND: Sexual activities in the elderly were considered as a taboo for a long time. Therefore only few empirical results exist regarding sexuality in higher age. This paper presents results of interviews with persons at the age of 60 years or older regarding their sexual activities and aspects of eroticism. PARTICIPANTS AND METHODS: N = 728 persons at the age of 60 years or older were interviewed by means of structured interviews and questionnaires. RESULTS: Relationship-oriented aspects like confidence, love, faith and communication with the partner were more important than aspects like passion, change or physical attraction. Compared with people younger than 60 years, sexual activity is regarded as less important. This is mainly explained by the elderly with body complaints. Men wish more sexual activity than women, but experience more body complaints than women. Women more often than men have no partner for sexual activity. CONCLUSIONS: Sexuality in the elderly is not only influenced by body functions. Important factors are also relationship-oriented aspects, subjective attitudes regarding one's own body, subjects health and attitudes regarding sexuality.

Age Factors↗