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PubMed1997

KAMEDIN: a telemedicine system for computer supported cooperative work and remote image analysis in radiology.

The software system KAMEDIN (Kooperatives Arbeiten und MEdizinische Diagnostik auf Innovativen Netzen) is a multimedia telemedicine system for exchange, cooperative diagnostics, and remote analysis of digital medical image data. It provides components for visualisation, processing, and synchronised audio-visual discussion of medical images. Techniques of computer supported cooperative work (CSCW) synchronise user interactions during a teleconference. Visibility of both local and remote cursor on the conference workstations facilitates telepointing and reinforces the conference partner's telepresence. Audio communication during teleconferences is supported by an integrated audio component. Furthermore, brain tissue segmentation with artificial neural networks can be performed on an external supercomputer as a remote image analysis procedure. KAMEDIN is designed as a low cost CSCW tool for ISDN based telecommunication. However it can be used on any TCP/IP supporting network. In a field test, KAMEDIN was installed in 15 clinics and medical departments to validate the systems' usability. The telemedicine system KAMEDIN has been developed, tested, and evaluated within a research project sponsored by German Telekom.

Humans↗
PubMed2001

Sexual initiation and childbearing among adolescent girls in KwaZulu Natal, South Africa.

A girl's first sexual intercourse is often unplanned and may put her at risk of STDs and HIV infection as well as unwanted pregnancy. The high prevalence of HIV among 15-24 year olds in KwaZulu Natal suggests that sex is initiated at an early age. This paper is based on a 1999 survey in South Africa which identified age of sexual debut and childbearing among adolescent girls in KwaZulu Natal. Of a sample of 796 girls, almost half had already had first sexual intercourse at a mean age of 16. Of these, 44 per cent reported having communicated with their first partner about preventing pregnancy, of whom 36 per cent were able to use a contraceptive method. The majority used a male condom, the pill or injectable. Similarly, 30 per cent had used a method, almost all of them a male condom, to prevent a sexually transmitted disease at first sex. About half of the girls had ever been pregnant and a large percentage of these indicated that the pregnancy had been unwanted. If sexuality education were to begin before puberty, at age 9-10 and in primary school, then many more girls would be in a better position to make informed choices about their sexual activities by the time they begin to engage in sex or reach menarche.

Adolescent↗
PubMedDate not supplied

Reasoning about diabetes and its relationship to the use of telecommunication technology by patients and physicians.

UNLABELLED: Health care is moving toward a team effort, with patients as partners. This requires effective communication between physicians and patients, who have different understandings of health and illness. These understandings in turn guide their decisions about management of health and illness. With the introduction of home-based technology, which provides an efficient way for doctors and patients to communicate, the question of the effectiveness of the decisions being made must be addressed. In this study, we assess the conceptualizations of health and illness related to diabetes and the relationship to the use of communication technology by patients and physicians. METHODS: The subjects were interviewed using a semi-structured questionnaire and were then asked to enter information into a telephone-based telecommunications system. Data were audiotaped, transcribed, and analyzed to characterize models of health and illness and for the factors that influence the decision making about diabetes management. Interactions with the system were then examined relative to these findings. RESULTS: Patients used lay concepts in providing explanations of their illness, whereas physicians used biomedical concepts. Use of these differing concepts influenced the use of telecommunication technology, with more errors in the communication of information being made by patients than by physicians. Examination of the organization of information required by the system showed it to be incongruent with the way patients normally reason, but in agreement with the way physicians reason. The paper discusses the implications of these findings for: (a) the nature of evidence used by patients and physicians; and (b) the design of technology to maximize effective doctor patient communication.

Attitude to Computers↗
PubMed2004

Ligand binding to symmetrical FeZn hybrids of variants of human HbA with modifications in the alpha1-beta2 interface.

The equilibria of oxygen binding to and kinetics of CO combination with the symmetrical iron-zinc hybrids of a series of variants of human adult hemoglobin A have been measured at pH 7 in the presence of inositol hexaphosphate (IHP). In addition, the kinetics of CO combination have also been measured in the absence of IHP. The hybrids have the heme groups of either the alpha or the beta subunits replaced by zinc protoporphyrin IX, which is unable to bind a ligand and is a good model for permanently deoxygenated heme. The variants examined involve residues located in the alpha1beta2 interface of the hemoglobin tetramer. Alterations of residues located in the hinge region of the interface are found to affect the properties of both the alpha and the beta subunits of the protein. In contrast, alterations of residues in the switch region of the interface have substantial effects only on the mutant subunit and are poorly communicated to the normal partner subunit. When the logarithms of the rate constants for the combination of the first CO molecule with a single subunit in the presence of IHP are analyzed as functions of the logarithms of the dissociation equilibrium constants for the binding of the first oxygen under the same conditions, a linear relationship is found. The relationship is somewhat different for the alpha and beta subunits, consistent with the well-known differences in the geometries of their ligand binding sites.

Carbon Monoxide↗
PubMed1997

Enhancing motivation to reduce the risk of HIV infection for economically disadvantaged urban women.

This research evaluated a motivation-based HIV risk reduction intervention for economically disadvantaged urban women. Participants completed a survey that assessed HIV-related knowledge, risk perceptions, behavioral intentions, sexual communication, substance use, and risk behavior. A total of 102 at-risk women (76% African American) were randomly assigned to either the risk reduction intervention or to a waiting list. Women were reassessed at 3 and 12 weeks. Results indicated that treated women increased their knowledge and risk awareness, strengthened their intentions to adopt safer sexual practices, communicated their intentions with partners, reduced substance use proximal to sexual activities, and engaged in fewer acts of unprotected vaginal intercourse. These effects were observed immediately, and most were maintained at follow-up.

Adolescent↗
PubMed2003

Community action against asthma: examining the partnership process of a community-based participatory research project.

BACKGROUND: Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. OBJECTIVE: To conduct a process evaluation of the CAAA community-academic partnership. DESIGN: In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. SETTING: Community setting in Detroit, Michigan. PARTICIPANTS: Twenty-three members of the CAAA SC. MEASUREMENTS: Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. MAIN RESULTS: Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to "a different way of doing things" in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CONCLUSIONS: CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved.

Asthma↗
PubMed2001

[Resource oriented interventions in pregnancy].

Premature labour and premature birth keep on being an unsolved problem in spite of diverse medical measures in the obstetrics. The system of risk catalogues did not meet the expectations and can lead even for the disconcertion from pregnant women. If one places the risks performed in the German mother passport as a basis, approximately 50% of all pregnant women would be risk cases. In current publications stress finds strong attention as a psychophysiological declaration model of premature birth. Own results refer to psychosomatic connections at premature birth. Social relief and here particularly the one through the babies father seems to be a preventive factor with regard to some premature birth. Under a resource-oriented visual angle the salutogenetic-model of Antonovsky is employed for care concepts of the primary and second prevention in the pregnancy as a basis. Specific target group offers for pregnant woman that focus also on the stabilization of their competence feeling, particularly next to knowledge transfer, relaxation training and learning of coping strategies, the activation of social nets and, where appropriate, early inclusion of the partner and offer of communication training for pregnant couples are described as a good complement to traditional prenatal care. A bearing away of the risk-model opens the resources-model for prenatal care new ways and is a challenge also for science.

Adult↗
PubMedDate not supplied

[Speech therapy assessment: field study on psychometric properties, practicability, acceptance and process quality].

OBJECTIVE: to investigate the internal consistency, responsiveness, discriminative validity, practicability, acceptance and process quality of a recently developed Speech Therapy Assessment (STA) under routine work conditions of speech and language therapists in German speaking countries. Since standardised, generic and ICF-oriented assessment tools for documentation and evaluation of speech therapy interventions for adult clients are missing in German speaking countries and existing tests cover only sub-areas, the STA has been developed in the years 1995 to 2002. By means of different domains, speech and language therapists assess client (1) communication, (2) aphasia, (3) speech apraxia, (4) dysarthria and (5) dysphagia as well as (6) her or his dealing with corresponding disabilities. METHODS: 17 therapists from 14 institutions applied the STA to 260 adult clients with language, speaking or swallowing disorders. The clients were included in the study consecutively over a period of 7 month. After this period, the therapists completed a questionnaire regarding the benefit and practicability of the STA. Cronbach alpha was calculated as indicator for internal consistency, effect sizes (standardised response means) for responsiveness and ROC values for discriminative validity. The answers of the questionnaire about the benefit of the STA were evaluated both, quantitatively and qualitatively. RESULTS: The internal consistency and discriminative validity were high (Cronbach alpha: 0.79 to 0.95; ROC-values: 0.84 to 0.98). Effect sizes regarding responsiveness were moderate (standardised response means: 0.46 to 0.78). On a 5-step Likert scale (1 = very good, 5 = inadequate), the therapists rated the average (standard deviation) benefit of the STA with: practicability 2.6 (1.2), acceptance 2.8 (1.3), impact on diagnostics 2.8 (1.3), impact on finding therapeutic goals 3.5 (1.2), impact on communication with other rehabilitation partners 2.7 (1.5) and overall judgement 2.6 (0.9). CONCLUSION: The STA fulfils essential quality criteria of the classical test theory. The involved therapists assessed the benefit of the STA as satisfactory. In addition, they pointed out concrete improvement potential for the implementation in practice. It is planed to investigate a refined version of the STA in a multi centre validation study.

Aged↗
PubMed1994

Symbiotic host specificity between leguminous plants and rhizobia is determined by substituted and acylated glucosamine oligosaccharide signals.

Rhizobia are nitrogen-fixing bacteria which invade root hairs of leguminous plants and induce, in a specific manner, the formation of root nodules in which they fix nitrogen. The early steps of the symbiosis can be considered as a reciprocal molecular communication between the two partners. Initially, the plant excretes a gene inducer which stimulates the expression of bacterial nodulation genes. These nodulation genes are responsible for the synthesis of extracellular host-specific signals, called nodulation factors. The bacterial nodulation factors were isolated and structurally identified as substituted and N-acylated chitin oligosaccharides. These prokaryotic lipo-oligosaccharide signals play a key role in the symbiosis by controlling the host specificity of the bacteria. They constitute a new class of signalling molecules able to elicit nodule organogenesis in leguminous plants in the absence of bacteria.

Carbohydrate Conformation↗
PubMed1990

High HIV risk-taking among young gay men.

Previous research has shown younger age to be correlated with greater HIV sexual risk-taking among gay men. The purpose of this study was to identify variables associated with HIV risk-taking among younger gay men. Ninety-nine gay men aged 18-25 in three medium-sized West Coast communities completed self-report questionnaires regarding HIV-related behaviors and attitudes. Of the respondents, 43% reported having engaged in unprotected anal intercourse during the previous 6 months. Men who engaged in unprotected anal intercourse reported greater enjoyment of unprotected anal intercourse, perceived less risk of unprotected anal intercourse, labeled themselves as more at risk for AIDS, reported poorer communication skills with sexual partners, and were more likely to have a boyfriend/lover than men who had not engaged in high-risk sex. In addition, respondents perceived the likelihood of acquiring HIV from unprotected anal intercourse with young gay men to be significantly lower than with older gay men. These findings highlight the need for HIV risk-reduction interventions designed specifically for young gay men and identify critical areas to be targeted in such interventions.

Adolescent↗
PubMed2006

Rhizobia and plant-pathogenic bacteria: common infection weapons.

Plant-interacting micro-organisms can establish either mutualistic or pathogenic associations. Although the outcome is completely different, common molecular mechanisms that mediate communication between the interacting partners seem to be involved. Specifically, nitrogen-fixing bacterial symbionts of legume plants, collectively termed rhizobia, and phytopathogenic bacteria have adopted similar strategies and genetic traits to colonize, invade and establish a chronic infection in the plant host. Quorum-sensing signals and identical two-component regulatory systems are used by these bacteria to coordinate, in a cell density-dependent manner or in response to changing environmental conditions, the expression of important factors for host colonization and infection. The success of invasion and survival within the host also requires that rhizobia and pathogens suppress and/or overcome plant defence responses triggered after microbial recognition, a process in which surface polysaccharides, antioxidant systems, ethylene biosynthesis inhibitors and virulence genes are involved.

Fabaceae↗
PubMedDate not supplied

Clinicians' views on reproductive needs and services for teens with negative pregnancy tests.

ISSUES AND PURPOSE: To explore services available to adolescent girls at the time of the negative pregnancy test (NPT) in an urban community. DESIGN AND METHODS: Clinician focus groups were conducted to identify the needs of adolescents at the time of a NPT result. RESULTS: Teens access care in a variety of ways, services provided at the time of a NPT were agency and clinician dependent, and strategies for follow-up care often were unstructured. Few services were available for parents or partners. Barriers included difficulty communicating with agencies, lack of staff trained to work with adolescents, and time/financial constraints. CONCLUSION: Adolescents need comprehensive, teen-friendly reproductive care at the time of a NPT result.

Adolescent↗
PubMed2002

Identification of a hydrophobin gene that is developmentally regulated in the ectomycorrhizal fungus Tricholoma terreum.

The symbiosis between ectomycorrhizal fungi and trees is an essential part of forest ecology and depends entirely on the communication between the two partners for establishing and maintaining the relationship. The identification and characterization of differentially expressed genes is a step to identifying such signals and to understanding the regulation of this process. We determined the role of hydrophobins produced by Tricholoma terreum in mycorrhiza formation and hyphal development. A hydrophobin was purified from culture supernatant, and the corresponding gene was identified. The gene is expressed in aerial mycelium and in mycorrhiza. By using a heterologous antiserum directed against a hydrophobin found in the aerial mycelium of Schizophyllum commune, we detected a hydrophobin in the symbiosis between T. terreum and its native pine host Pinus sylvestris. The hydrophobin was found in aerial mycelium of the hyphal mantle and also in the Hartig net hyphae, which form the interface between both partners. Interestingly, this was not the case in the interaction of T. terreum with a host of low compatibility, the spruce Picea abies. The differential expression with respect to host was verified at the transcriptional level by competitive PCR. The differential protein accumulation pattern with respect to host compatibility seen by immunofluorescence staining can thus be attributed at least in part to transcriptional control of the hyd1 gene.

Basidiomycota↗
PubMed2005

The so locus is required for vegetative cell fusion and postfertilization events in Neurospora crassa.

The process of cell fusion is a basic developmental feature found in most eukaryotic organisms. In filamentous fungi, cell fusion events play an important role during both vegetative growth and sexual reproduction. We employ the model organism Neurospora crassa to dissect the mechanisms of cell fusion and cell-cell communication involved in fusion processes. In this study, we characterized a mutant with a mutation in the gene so, which exhibits defects in cell fusion. The so mutant has a pleiotropic phenotype, including shortened aerial hyphae, an altered conidiation pattern, and female sterility. Using light microscopy and heterokaryon tests, the so mutant was shown to possess defects in germling and hyphal fusion. Although so produces conidial anastomosis tubes, so germlings did not home toward wild-type germlings nor were wild-type germlings attracted to so germlings. We employed a trichogyne attraction and fusion assay to determine whether the female sterility of the so mutant is caused by impaired communication or fusion failure between mating partners. so showed no defects in attraction or fusion between mating partners, indicating that so is specific for vegetative hyphal fusion and/or associated communication events. The so gene encodes a protein of unknown function, but which contains a WW domain; WW domains are predicted to be involved in protein-protein interactions. Database searches showed that so was conserved in the genomes of filamentous ascomycete fungi but was absent in ascomycete yeast and basidiomycete species.

Alleles↗
PubMed2005

Who reports sexual function problems? Empirical evidence from Britain's 2000 National Survey of Sexual Attitudes and Lifestyles.

OBJECTIVE: To identify sociodemographic, sexual, and health behavioural and attitudinal factors associated with reporting sexual function problems. METHODS: A probability sample survey of 11 161 men and women aged 16-44 years resident in Britain in 2000. Data collected by a combination of computer assisted face to face and self interviewing. Outcomes were self report of a range of sexual function problems, considered as "any problems" (1+ lasting 1+ months in the past year) and "persistent problems" (1+ lasting 6+ months in the past year), and associations with sociodemographic, behavioural, and attitudinal variables. RESULTS: Both "any" and "persistent" sexual function problems were more commonly reported by women than men. A variety of sociodemographic factors were associated with both measures but differed by gender. For example, the adjusted odds ratio (AOR) for reporting any problems for married v single respondents was 0.70 (95% confidence interval (CI) 0.57 to 0.87) v 1.31 (95% CI 1.10 to 1.56) for men and women, respectively. Sexual behaviours significantly associated with reporting sexual function problems included competence at first sex, paying for sex in the past 5 years, number of occasions of sex and masturbation, both in the past 4 weeks. For men (only), reporting STI diagnosis(es) was significantly associated with reporting "any" problems (AOR 2.1, 95% CI 1.4 to 3.2) and "persistent" problems (AOR 2.1, 95% CI 1.1 to 3.9). Both measures were significantly more likely among men and women who reported communication difficulties with their partners, with AORs in excess of 1.9. CONCLUSIONS: Sexual fulfilment is an important part of sexual health. Understanding factors associated with reporting sexual problems, and recognising that such factors maybe partnership specific, is an important step towards improving our understanding of sexual function and thus improving the provision of care and support available.

Adolescent↗
PubMed2006

Patient preferences for partner notification.

OBJECTIVE: To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. METHODS: A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. RESULTS: The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. CONCLUSION: Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.

Adolescent↗
PubMed1979

Motion sickness susceptibility and solution choice in a pragmatic paradox.

This paper reports on an experiment which employed a classic paradox, known as the 'prisoner's dilemma', to explore possible differences in problem solving preference across a spectrum of motion sickness susceptibility. A mathematical form of the problem was used in which the subject was asked to imagine playing a game without communicating with his hypothetical partner. There were three possible solutions to the problem, a win-win, a lose-lose, and a win-lose solution. The results support the contention that a cognitive bias exists across a spectrum of motion sickness susceptibility, highly motion sick individuals having a greater tendency to pick the solution which allows both participants to win. This bias runs counter to that which might be expected on the basis of personality traits (non-motion sick individuals are more socially involved), and suggests that the cognitive tendency may reflect basic problem-solving strategies rooted in orientation process. The potential implications of these findings are discussed.

Dominance, Cerebral↗
PubMedDate not supplied

Politics and partnerships: challenges and rewards of partnerships in workplace health research in the healthcare sector of British Columbia, Canada.

In British Columbia (BC), Canada, a partnership of researchers, healthcare employers, and healthcare unions reduced high injury rates through examining determinants of healthy workplaces and designing, implementing, and evaluating interventions. Over 51 million dollars (Canadian) was saved from the BC healthcare budget over two years, largely attributable to the collaborative effort. Challenges and rewards of the process were determined from interviews and workshops with researchers and community stakeholders, and by obtaining direct input to this report. Challenges included maintaining communication and trust between partners, preserving partnerships during restructuring and labor disputes, and maintaining involvement and support of front-line workers and senior management. As all partners recognized the importance of the research agenda, the stakeholders remained committed to working through the challenges, and have consequently achieved considerable success.

British Columbia↗