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A survey of contraception in five west European countries.

In 1984 and 1985, a survey was conducted of 7696 women aged 15-44 living in Italy, France, Great Britain, Spain and the Federal Republic of Germany. The aim of the study was to examine the use of contraceptive methods, the differences in contraceptive use, knowledge of fertility, communication about contraception, motives for choice and the perceptions held by women regarding contraceptive methods, particularly oral contraception. The results show important differences between the countries studied.

Adolescent↗

EMG related anxiety and pain: a prospective study.

BACKGROUND: Electromyography (EMG) is a useful test, but unfortunately also painful. We frequently encounter patients who worry about its painful nature, but tolerate it very well. OBJECTIVES: We evaluated anxiety levels of patients referred for EMG to explore the possible correlating and contributing factors to high anxiety. METHODS: A structured questionnaire, including the State-Trait Anxiety Inventory was completed by patients immediately before EMG testing. Emergency, hospitalized, and seriously ill patients were excluded. RESULTS: Seventy-nine cases with ages ranging from 19-72 years (mean 43) were included. Thirty-five (44%) patients had a high pre-test anxiety level. The likelihood of high anxiety was increased if the patient was worried about the test (p < 0.001) or about other issues unrelated to the test or underlying diagnosis (p < 0.001), or was taking an anti-psychotic or anxiolytic drug (p = 0.008). The degree or source of knowledge regarding the test procedure, did not affect the pre-test anxiety level. CONCLUSIONS: The information about EMG testing received by patients in this group did not affect pre-test anxiety levels. The patient's expectations regarding the test did influence anxiety levels and this may reflect generalized anxiety regarding testing procedures or misinformation regarding the nature of the test, as patients in general reported a better than anticipated experience following the test.

Adult↗

Feminist approaches to social science: epistemological and methodological tenets.

This paper is a primer for community psychologists on feminist research. Much like the field of community psychology, feminist scholarship is defined by its values and process. Informed by the political ideologies of the 1970s women's movement (liberal, radical, socialist feminism, and womanism), feminist scholars reinterpreted classic concepts in philosophy of science to create feminist epistemologies and methodologies. Feminist epistemologies, such as feminist empiricism, standpoint theory, and postmodernism, recognize women's lived experiences as legitimate sources of knowledge. Feminist methodologies attempt to eradicate sexist bias in research and find ways to capture women's voices that are consistent with feminist ideals. Practically, the process of feminist research is characterized by four primary features: (1) expanding methodologies to include both quantitative and qualitative methods, (2) connecting women for group-level data collection, (3) reducing the hierarchical relationship between researchers and their participants to facilitate trust and disclosure, and (4) recognizing and reflecting upon the emotionality of women's lives. Recommendations for how community psychologists can integrate feminist scholarship into their practice are discussed.

Community Mental Health Services↗

Emergency contraception: the user profile.

UNLABELLED: Emergency contraception (EC) has recently become available, accepted and widely used in Sweden but little is known about the characteristics and background factors of women requesting EC. METHODS: During a four-month period, consecutive women (n = 762) visiting family planning clinics to request emergency contraception filled out a questionnaire about their current need for EC. RESULTS: The user of emergency contraception was typically a nulligravid young woman (83%) but 13% had a previous history of at least one induced abortion and 41% had given birth in the past. One out of four had used EC before, and of these 20% more than once. Condom breakage was the major reason for the current need for EC but as many as 37% had not discussed the need for contraception prior to intercourse. Friends were the most important source of knowledge about EC. CONCLUSION: Women requesting emergency contraception could be anyone and emergency contraception is used to compensate for contraceptive failure in order to prevent unwanted pregnancies.

Adolescent↗

Perceived long-term prognosis of teeth with orthodontically resorbed roots.

OBJECTIVES: To investigate the perceived significance of root resorption in the dental community. STUDY DESIGN AND SAMPLE: Mail out survey questionnaire accompanied by morphed images of 10-50% root resorption. General practitioners, periodontists, prosthodontists and orthodontists were the participants. OUTCOME MEASURES: Correlations between 'significant' and 'detrimental to the longevity of the tooth'. These assessments were conducted within specialty groups and among. Also measured was the source of knowledge upon which practitioner assessments were based. RESULTS AND CONCLUSIONS: General practitioners were the most concerned about root resorption. Although most practitioners feel 50% root resorption is significant and detrimental to the longevity of the tooth, extraction followed by prosthetic replacement was not an option. No agreement among practitioners when orthodontic treatment should be terminated; the general practitioners were conservative suggesting termination after 35% root loss. History of trauma, genetic disposition and root morphology are the most cited predisposing factors. Lengthy treatment time concerns general practitioners more than the orthodontists. With the exception of orthodontists, dentists believe excessive force is detrimental to the root, but no one is able to define what excessive force is. Overall, dental school curricula overstate the causes of root resorption. Generally, dental professionals seem to base their opinions on myths and are largely inconsistent in their assessments.

Attitude of Health Personnel↗

Major mental illness, housing, and supports. The promise of community integration.

Providing housing and supports for people with psychiatric disabilities, particularly those who are homeless, is a major public policy challenge. This article summarizes the ways in which the concept of these needs is rapidly shifting in the mental health field. The article is based on research on the effectiveness of non-facility-based community support and rehabilitation approaches, the findings of other disability fields, and the emergence of mental health consumers' own preferences for expanded choices, normal housing, and more responsive services, including consumer-operated services. These new sources of knowledge are facilitating a paradigm shift in which people with psychiatric disabilities are no longer seen as hopeless, or merely as service recipients, but rather as citizens with a capacity for full community participation and integration.

Community Mental Health Services↗

Condom use: a self-efficacy model.

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, acquired immunodeficiency syndrome (AIDS) knowledge, and perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about human immunodeficiency virus (HIV) transmission but reported not feeling at risk, even though many engaged in risky sexual behavior.

Acquired Immunodeficiency Syndrome↗

Attitudes of university students towards HIV/AIDS.

The purpose of this study was to assess, in one university in Finland, students' attitudes and feelings towards HIV/AIDS while they were studying for their first year at the University of Oulu. This study is part of a larger research project concerning HIV/AIDS in the Department of Nursing at the University of Oulu. The results can be used in planning and implementing health education for young people. The data were collected by using a questionnaire with both structured and open-ended questions. The study group consisted of 245 students who had started their studies in the autumn of 1993. The data were analysed by using cross tabulation (chi-square test) and inductively by content analysis. The most important source of knowledge concerning HIV/AIDS was television (84%) and 30% of the students had obtained their knowledge from a school nurse. Even when there was a lot of knowledge available to the students, they estimated their knowledge as insufficient and defined HIV more correctly than AIDS. Knowledge did not increase the use of safe sex but limited sexual behaviour. Religion had an importance for sexual behaviour. Female students were more sexually active than male students. The feelings towards HIV/AIDS were more often negative than positive or neutral and the students felt stronger negative feelings towards AIDS than HIV. The negative feelings were often based on fear. The differences between the faculties were minimal.

Adult↗

The Internet and access to evidence: how are nurses positioned?

BACKGROUND: Published literature that describes the use of the Internet by nurses is scant, but it does reveal that there has been a delay in the acceptance of the Internet as a workplace tool by the medical community and, in particular by nurses. AIMS: The purpose of this article is to report on a study of how often and from what location nurses accessed the Internet, as well as the types of information they were seeking. In addition, our goal was to compare nurses' Internet use with that of physicians and the public at large, and to highlight structural and institutional challenges to nurses' use. METHODS: Surveys (1996 and 1998) of Alberta Registered Nurses were used to examine their use of technology at work and at home. Additional data sources were used to compare nurses to physicians and to the general public. RESULTS: While nurses' Internet and e-mail use at home increased over the 2-year period and was comparable with other groups, Internet use at work was low compared with other groups despite adequate workplace access. CONCLUSIONS: Nurses are more likely to value interpersonal contact, and prefer to use personal experience and communication with colleagues and patients rather than on-line and traditional sources of practice knowledge. In order for an information source to be seen as valuable in the clinical setting, contextually relevant information needs to be accessed quickly and efficiently. Energies should be focused on constructing information systems that address the particular needs of nurses.

Attitude to Computers↗

Cardiac surgery for arrhythmias.

Cardiac arrhythmia surgery was initiated in 1968 with the first successful division of an accessory AV connection for the Wolff-Parkinson-White syndrome. Subsequent surgical procedures included the left atrial isolation procedure and right atrial isolation procedure for automatic atrial tachycardias, discrete cryosurgery of the AV node for AV nodal reentrant tachycardia, the atrial transection procedure, the corridor procedure, and the maze procedure for atrial fibrillation, the right ventricular disconnection procedure for arrhythmogenic right ventricular tachycardia, and the encircling endocardial ventriculotomy, subendocardial resection procedure, endocardial cryoablation, the Jatene procedure, and the Dor procedure for ischemic ventricular tachycardia. Because of monumental strides in the treatment of most refractory arrhythmias by endocardial catheter techniques during the past decade, the only remaining viable surgical procedures for cardiac arrhythmias are the maze procedure for atrial fibrillation and the Dor procedure for ischemic ventricular tachycardia. Nevertheless, the 25 to 30 years of intense activity in the field of cardiac arrhythmia surgery provided the essential foundation for the development of these catheter techniques and represent one of the most exciting and productive eras in the history of medicine. In one short professional career, we have witnessed the birth of arrhythmia surgery, its adolescence as an "esoteric" specialty, its prime as an enlightening yet exhausting period, and finally its waning years as a source of knowledge and wisdom upon which better methods of treatment have been founded. One could hardly ask for a more rewarding experience.

Arrhythmias, Cardiac↗

Future directions for gerontology: a nursing perspective.

This paper discusses the contribution nursing has made to the development of person-centred services, and the influence of gerontology upon such developments. It examines traditional attitudes to medicine and nursing, when curing was all-important and caring treated as secondary and the shift away from this attitude to a more holistic approach to nursing, where the dignity of the patient is an important issue. It argues that good practice utilizes different sources of knowledge, including intuitive knowledge, and discusses the integrated programme of policy, development, research and education activities that the Royal College of Nursing is developing. The options currently available to anyone wishing to study gerontology are discussed, and the pros and cons of the current emphasis on broad-based clinical and educational experience prior to specialization analysed. The key aim of the RCN is to develop the specialism of gerontological nursing and the quality of care experienced by older people. With this end in view, this paper describes the education programme being developed by the RCN, leading to the award of Gerontological Nurse Specialist--a person able to demonstrate knowledge of rehabilitation, clinical assessment, health care assessment and a holistic knowledge of the ageing process.

Aged↗

The person in secular and in Orthodox-Catholic bioethics.

The following demarcates the sens of the human person in Orthodox-Catholic bioethics from the family of senses proper to secular bioethics and philosophy. The radically different sources of knowledge about the senses proper to each discipline suggest that the importation of philosophical and secular psychological distinctions and analyses into true Christianity's concern with the human person, is fundamentally misguided. This suggestion is confirmed by examination of the articles of Crosby, Glannon, Hoswepian, and Meador and Shuman.

Anencephaly↗

A comparison between John Dewey's theory of inquiry and Jean Piaget's genetic analysis of intelligence.

This article compares John Dewey's theory of inquiry with Jean Piaget's analysis of the mechanisms implied in the increase of knowledge. The sources for this paper are Dewey's studies on logic and the theory of inquiry and Piaget's historical-critical and psychogenetic investigations. Three major conclusions result from the comparison: first, there are significant convergences between the two theories; second, Piaget's developmental analysis makes explicit what is programmatic in Dewey's investigations; and, finally, Piaget is incorrect in characterizing Dewey's pragmatism as a method that does not meet the criteria of intelligent activity.

Adaptation, Biological↗