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PubMed2006

Having sex and condom use: potential risks and benefits reported by young, sexually inexperienced adolescents.

PURPOSE: This study determines what young adolescents themselves identify as the potential positive and negative outcomes of having sex, using a condom and not using a condom. METHODS: Using written surveys, 418 ethnically diverse ninth graders, 86% of whom had never had sex, responded to a scenario describing two adolescents who had sex. One randomly selected group read a scenario in which a condom was used; the other group read a scenario in which no condom was used. All participants were asked to list the risks and benefits of having sex. Depending on the scenario read, participants were asked to list the risks and benefits of either using or not using a condom. Responses were coded thematically. Percentages of responses were compared with chi-square analysis in total and by gender. RESULTS: Participants spontaneously identified a broad range of health and psychosocial risks and benefits of having sex, using a condom and not using a condom. A strong aversion to pregnancy was evident, and the risks of sexually transmitted disease/human immunodeficiency virus (STD/HIV) and condom malfunction were commonly mentioned. Benefits of using a condom included pregnancy and STD prevention. Benefits of both having sex and of not using a condom included improving the relationship, fun, and pleasure. Gender differences emerged across questions. CONCLUSIONS: Communication with adolescents regarding safe sexual activity could benefit from widening the communication from a focus on health risks to include discussion of the psychosocial risks and benefits that adolescents themselves think about with respect to sex and condom use.

Adolescent↗
PubMed2005

Exploration of patients' needs for information on arrival at a geriatric and rehabilitation unit.

AIM: The aim of this study was to gather information about patients' needs prior to transferring from an acute care facility to a rehabilitation setting that could assist patients to engage actively in rehabilitation activities upon entering the unit. BACKGROUND: The provision of information is an important aspect of health care as it assists patients to become informed and actively participate in this care. Improved recovery has been associated with patients' adherence to care regimes. METHOD: Semi-structured interviews were undertaken with a convenient sample of nine patients shortly after admission/transfer to a rehabilitation unit and with four of these patients after discharge. The intent was to learn what information patients receive prior to admission to the rehabilitation unit, whether this information is useful and whether different information would be more useful to facilitate patients' engagement in the activities central to rehabilitation treatment. RESULTS: Interviews revealed that, generally, patients received very little information about what to expect on admission to the rehabilitation unit and patients' engagement was more dependent on perceptions about rehabilitation. Thematic analysis identified that, in general, rehabilitation was perceived as 'a ticket out' and 'a good thing'. In relation to provision of information of participants identified that 'doesn't matter that I don't know'; 'information is not always meaningful' and 'I will adjust in my own time'. RELEVANCE TO CLINICAL PRACTICE: Health professionals need to recognize that patients are often compliant with decisions made while they are inpatients of the current health care system. Even though patients may 'actively participate' in rehabilitation processes it is often still as a passive recipient of health care.

Activities of Daily Living↗
PubMedDate not supplied

e-Ouch: usability testing of an electronic chronic pain diary for adolescents with arthritis.

OBJECTIVES: The aim of this study was to evaluate the usability of the e-Ouch electronic chronic pain diary in adolescents with juvenile idiopathic arthritis. METHODS: A qualitative usability testing approach with semistructured, audiotaped interviews with two iterative cycles was used. A purposive sample of 10 adolescents per cycle was drawn from a rheumatology clinic in a university-affiliated pediatric tertiary care center. Participants were provided with a brief demonstration of the diary and then asked to use the diary "thinking aloud" to record the pain they experienced: (1) when they woke up that morning, (2) during that afternoon, and (3) from the previous evening. Adolescents were then asked a series of open-ended questions addressing ease of use of the diary. Qualitative thematic analysis was used to generate categories and emerging themes from interview data. RESULTS: All of the adolescents stated the e-Ouch diary was very easy to learn, use, and understand and was satisfying to complete. Participants took less than 9 minutes to complete all three of the diary entries with minimal errors. The usability evaluation revealed aspects of the interface that were suboptimal (eg, VAS slider) and impeded the performance of certain tasks. Adolescents generated ideas on how the diary interface could be improved. CONCLUSIONS: A multifaceted usability approach provided important insight regarding the use of technology by adolescents with arthritis and, more specifically, for understanding how adolescents can more effectively use an electronic chronic pain diary.

Adolescent↗
PubMed2025

Defining Gaslighting in Gender-Based Violence: A Mixed-Methods Systematic Review.

In both public and academic discourse, gaslighting has gained increased attention, especially regarding psychological abuse, power imbalance, and gender-based violence (GBV). However, the term gaslighting is often inconsistently defined and conflated with broader forms of manipulation. It is also largely examined in the context of intimate partner violence (IPV), which ignores its occurrence in other forms of GBV. The present study presents a systematic review that synthesizes interdisciplinary academic literature to create a comprehensive framework of gaslighting. This framework includes the specific tactics that are used by perpetrators of gaslighting, the social-psychological outcomes experienced by survivors, and the role of systemic inequalities and social power dynamics. A search across multiple databases identified 96 records that discussed gaslighting in relation to GBV. Thematic analysis revealed a two-part framework for understanding gaslighting: (a) gaslighting tactics, which were categorized into cognitive and perceptual manipulation, emotional and psychological abuse, power dynamics and control, and additional forms of manipulation and (b) survivor outcomes, including disruptions to perception and memory, emotional distress, social isolation, and resistance strategies. The findings show that gaslighting is more than just an interpersonal act; it is sustained within social structures, where perpetrators use identity factors and forms of marginalization to exploit survivors. Overall, this review presents a comprehensive definition of gaslighting that illustrates its epistemic nature and its intersection with systemic oppression. It is suggested that future research studies gaslighting in GBV contexts beyond IPV, while practice and policy efforts should seek to enhance recognition and support for survivors.

Humans↗
PubMed2026

Navigating Social Media: Balancing Connectivity With Media Literacy to Combat Misinformation and Protect Mental Well-Being.

BACKGROUND: The pervasive use of social media has created a complex digital ecosystem where high connectivity coexists with significant challenges, including the rapid spread of misinformation, particularly regarding mental health, and documented negative impacts on psychological well-being. Platform architectures designed for engagement maximization have been identified as central factors in both issues. OBJECTIVE: This paper critically analyzes the interconnected relationships between social media use, misinformation dissemination, and mental health impacts, with particular attention to psychiatric misinformation across diagnostic categories (e.g., depression, anxiety, ADHD). A primary objective is to evaluate the potential of advanced critical digital literacy frameworks to serve as protective mechanisms against these dual threats. METHODS: A systematic search was conducted following PRISMA 2020 guidelines across APA PsycInfo, PubMed, JSTOR, and Google Scholar for literature published between January 2018 and March 2026 (updated from the original 2023 search). The search yielded 2672 records. After removing 624 duplicates, 2048 records underwent title and abstract screening, with 1802 excluded. The remaining 246 full-text articles were assessed for eligibility, resulting in 86 studies included in the final qualitative synthesis. Inter-rater reliability was established (Cohen's κ = 0.82). Quality assessment was conducted using the Joanna Briggs Institute Checklist, AXIS, and CASP tools, with findings weighted by methodological quality. A thematic analysis was undertaken to synthesize findings. RESULTS: The analysis reveals that core architectural features of social media platforms, algorithmic curation and engagement-based metrics, simultaneously foster environments ripe for misinformation spread and contribute to psychological distress, including anxiety, depression, and harmful social comparison. Psychiatric misinformation specifically (e.g., inaccurate claims about treatment effectiveness, diagnostic criteria, and medication side effects) represents a growing concern, particularly on image- and video-based platforms. The findings indicate that conventional media literacy approaches focused solely on fact-checking are insufficient. Instead, a critical digital literacy framework encompassing algorithmic awareness, data literacy, and emotional awareness is essential for building user resilience, with evidence from high-quality systematic reviews supporting this approach. CONCLUSIONS: Navigating the complexities of modern social media requires an integrated approach combining "pedagogies of play" for experiential skill development with advocacy for structural change (e.g., algorithmic transparency, well being by design principles). This dual strategy empowers individual users to critically engage with digital content while advocating for ethical platform design, thereby safeguarding both mental well-being and democratic discourse. Implications for educators, mental health professionals (including competencies for addressing patient encounters with psychiatric misinformation), policymakers, and platform designers are discussed.

Humans↗
PubMed2006

A promising method for identifying cross-cultural differences in patient perspective: the use of Internet-based focus groups for content validation of new patient reported outcome assessments.

OBJECTIVES: This proof of concept (POC) study was designed to evaluate the use of an Internet-based bulletin board technology to aid parallel cross-cultural development of thematic content for a new set of patient-reported outcome measures (PROs). METHODS: The POC study, conducted in Germany and the United States, utilized Internet Focus Groups (IFGs) to assure the validity of new PRO items across the two cultures--all items were designed to assess the impact of excess facial oil on individuals' lives. The on-line IFG activities were modeled after traditional face-to-face focus groups and organized by a common 'Topic' Guide designed with input from thought leaders in dermatology and health outcomes research. The two sets of IFGs were professionally moderated in the native language of each country. IFG moderators coded the thematic content of transcripts, and a frequency analysis of code endorsement was used to identify areas of content similarity and difference between the two countries. Based on this information, draft PRO items were designed and a majority (80%) of the original participants returned to rate the relative importance of the newly designed questions. FINDINGS: The use of parallel cross-cultural content analysis of IFG transcripts permitted identification of the major content themes in each country as well as exploration of the possible reasons for any observed differences between the countries. Results from coded frequency counts and transcript reviews informed the design and wording of the test questions for the future PRO instrument(s). Subsequent ratings of item importance also deepened our understanding of potential areas of cross-cultural difference, differences that would be explored over the course of future validation studies involving these PROs. CONCLUSION: The use of IFGs for cross-cultural content development received positive reviews from participants and was found to be both cost and time effective. The novel thematic coding methodology provided an empirical platform on which to develop culturally sensitive questionnaire content using the natural language of participants. Overall, the IFG responses and thematic analyses provided a thorough evaluation of similarities and differences in cross-cultural themes, which in turn acted as a sound base for the development of new PRO questionnaires.

Attitude to Health↗
PubMed2006

A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use.

OBJECTIVES: To determine the effectiveness and cost-effectiveness of non-pharmacological interventions (excluding subjective barriers) in the prevention of wandering in people with dementia, in comparison with usual care, and to evaluate through the review and a qualitative study the acceptability to stakeholders of such interventions and identify ethical issues associated with their use. DATA SOURCES: Major electronic databases were searched up until 31 March 2005. Specialists in the field. REVIEW METHODS: Selected studies were assessed and analysed. The results of two of the efficacy studies that used similar interventions, designs and outcome measures were pooled in a meta-analysis; results for other studies which reported standard deviations were presented in a forest plot. Owing to a lack of cost-effectiveness data, a modelling exercise could not be performed. Four focus groups were carried out with relevant stakeholders (n = 19) including people with dementia and formal and lay carers to explore ethical and acceptability issues in greater depth. Transcripts were coded independently by two reviewers to develop a coding frame. Analysis was via a thematic framework approach. RESULTS: Ten studies met the inclusion criteria (multi-sensory environment, three; music therapy, one; exercise, one; special care units, two; aromatherapy, two; behavioural intervention, one). There was no robust evidence to recommend any non-pharmacological intervention to reduce wandering in dementia. There was some evidence, albeit of poor quality, for the effectiveness of exercise and multi-sensory environment. There were no relevant studies to determine the cost-effectiveness of the interventions. Findings from the narrative review and focus groups on acceptability and ethical issues were comparable. Exercise and distraction therapies were the most acceptable interventions and raised no ethical concerns. All other interventions were considered acceptable except for physical restraints, which were considered unacceptable. Considerable ethical concerns exist with the use of electronic tagging and tracking devices and physical barriers. Existing literature ignores the perspectives of people with dementia. The small number of participants with dementia expressed caution regarding the use of unfamiliar technology. Balancing risk and risk assessment was an important theme for all carers in the management of wandering. CONCLUSIONS: There is no robust evidence so far to recommend the use of any non-pharmacological intervention to reduce or prevent wandering in people with dementia. High-quality studies, preferably randomised controlled trials, are needed to determine the clinical and cost-effectiveness of non-pharmacological interventions that allow safe wandering and are considered practically and ethically acceptable by carers and people with dementia. Large-scale, long-term cohort studies are needed to evaluate the morbidity and mortality associated with wandering in dementia for people both in the community and in residential care. Such data would inform future long-term cost-effectiveness studies.

Confusion↗
PubMed2006

Empirical evidence for symbiotic medical education: a comparative analysis of community and tertiary-based programmes.

BACKGROUND: Flinders University has developed the Parallel Rural Community Curriculum (PRCC), a full year clinical curriculum based in rural general practice in South Australia. The examination performance of students on this course has been shown to be higher than that of their tertiary hospital-based peers. AIM: To compare the learning experiences of students in the community-based programme with those of students in the tertiary hospital in order to explain these improved academic outcomes. METHOD: A case study was undertaken, using an interpretivist perspective, with 3 structured interviews carried out over 2 academic years with each of 6 students from the community-based programme and 16 students from the tertiary hospital. The taped interviews were transcribed and analysed thematically using NUD*IST software. RESULTS: The community-based programme was successful in immersing the students in the clinical environment in a meaningful way. Four key themes were found in the data. These represented clear differences between the experiences of the community-based and hospital-based students. These differences involved: the value that students perceived they were given by supervising doctors and their patients; the extent to which the student's presence realised a synergy between the work of the university and the health service; opportunities for students to meet the aspirations of both the community and government policy, and opportunities for students to learn how professional expectations can mesh with their own personal values. CONCLUSION: This study has provided empirical evidence for the importance of the concept of symbiosis in understanding quality in medical education.

Attitude of Health Personnel↗
PubMed2003

Assessing village authenticity with satellite images: a method to identify intact cultural landscapes in Europe.

The village with its characteristic zones of different land use from the center to the periphery is a basic unit of Europe's cultural landscapes. However, loss of the authentic pre-industrial village structure characterized by a fine-grained structure of arable land and wooded grasslands is a threat to both cultural heritage and biodiversity in many rural landscapes. Therefore, it is important that the extent and rate of change of such authentic villages in a landscape can be monitored. We studied to what extent loss of authenticity with increasing time after abandonment can be assessed by quantitative analysis and visual interpretation of satellite images. The study was carried out in the Bieszczady Mountains, SE Poland in 1999. Using Landsat Thematic Mapper data from 1998, both the grain size of landscape elements (size of fields) and land-cover composition (encroachment of shrub and forest) were quantitatively described 6 type villages representing different stages of deterioration of the authentic village structure. Historical maps were used to delineate the border of the villages and the former extension of forest and open land was measured. The present land use and the degree of abandonment expressed as grain size and forest encroachment were mapped using satellite data. Deterioration occurred along 2 transformation paths: abandonment and ultimately becoming forest, or intensified agriculture, respectively. To validate these results we classified 22 other villages in a 1000 km2 area by visual interpretation of the original satellite images into 1 of 4 types. We then collected historical data on human population changes over the past six decades. The classification of village authenticity was clearly related to the rate of human population decline. We address the importance of validating and applying this approach for rapid assessment of the authenticity of cultural landscapes in European regions being subject to ongoing as well as expected future change, related to expansion of the European Union. Finally, we argue that the village represents a scale at which integration of natural and social sciences is possible.

Agriculture↗
PubMed2026

"It was good because they have a relationship with us": A qualitative study on low-threshold buprenorphine treatment at syringe services programs.

INTRODUCTION: Syringe service programs (SSPs) reach people who inject drugs with opioid use disorder (OUD) and are novel "low-threshold" venues to initiate buprenorphine treatment. The study investigated patients' experiences with SSP-initiated buprenorphine treatment, which could aid in improving buprenorphine treatment delivery at SSPs. METHODS: The study included 12 participants who completed qualitative exit interviews after a randomized controlled trial of buprenorphine treatment at SSPs. In the parent study, participants received buprenorphine treatment through an onsite model at an SSP or enhanced referral to a community health center based on the randomization sequence. Most participants started taking buprenorphine at home. Exit interviews included participants from both study arms, and the semi-structured interview guide focused on their experiences with clinicians, experiences initiating buprenorphine, prior experiences with OUD treatment, and perceptions about continuing buprenorphine treatment. Four researchers iteratively read, coded, and discussed each transcript, then they derived recurring themes using thematic analysis. RESULTS: Participants were mostly male, middle-aged, and 50% identified as Latino. Four main themes related to buprenorphine treatment initiation: 1) Onsite treatment facilitated buprenorphine prescription, but some participants also expressed a need for additional support; 2) Precipitated withdrawal complicated participants' buprenorphine initiation in both arms; 3) Participants largely experienced the SSPs as affirming and welcoming; and 4) Developing strong relationships with healthcare providers was critical to successful buprenorphine treatment initiation. CONCLUSIONS: The SSP-based model provided rapid access to buprenorphine prescriptions, but precipitated withdrawal was a common complication. Some participants desired additional support and guidance when they started taking buprenorphine at home. The findings point to a "low-threshold, high-touch" approach where participants receive expedited access to buprenorphine providers at SSPs but also additional support throughout the initiation process to avoid and/or manage precipitated withdrawal. Despite some challenges, SSP-based buprenorphine treatment was highly valued by study participants.

Humans↗
PubMed2005

Understanding practice change in community pharmacy: a qualitative study in Australia.

BACKGROUND: Much of the research on cognitive pharmaceutical services has focused on understanding or changing community pharmacist behaviour, with few studies focusing on the pharmacy as the unit of analysis or considering the whole profession as an organisation. OBJECTIVES: To investigate practice change and identify facilitators of this process in community pharmacy, with specific focus on the implementation of cognitive pharmaceutical services (CPS) and related programs. METHODS: Thirty-six in-depth, semistructured interviews were conducted with participants from 2 groups, community pharmacies and pharmacy "strategists," in Australia. The interview guide was based on a framework of organizational theory, with 5 subject areas: roles and goals of participants in relation to practice change; experiences with CPS; change strategies used; networks important to the change process; and business impacts of CPS. Interviews were transcribed verbatim and thematically content analyzed, using NVivo software for data management. RESULTS: Five key themes relating to the change process were derived from the interviews: change strategies (process- and behaviorally oriented); social networks (within and beyond the pharmacy); drivers of change (eg, government policy); motivators (eg, professional satisfaction); and facilitators of practice change (remuneration for implementation or service delivery, communication and teamwork, leadership, task delegation, external support or assistance, and reorganization of structure and function). CONCLUSION: The use of an organizational perspective yielded rich data from which an understanding of the practice change process in relation to CPS implementation was gained. Current programs for the implementation and delivery of CPS have not taken into account all of the factors that have the ability to facilitate change in community pharmacy. Not only do future programs need to be underpinned by these elements, but policy makers must include them when planning remuneration and dissemination strategies.

Australia↗
PubMed2004

Perpetrator methodology as a predictor of traumatic symptomatology in adult survivors of childhood sexual abuse.

This retrospective study explores, through quantitative and qualitative methods, the relationship of two variables (perpetrator relationship and perpetrator methodology) to posttraumatic and dissociative symptomatology. The quantitative sample comprised a nonpsychiatric group (N = 39) of Australian adults reporting sexual abuse histories. A MANOVA revealed that current levels of posttraumatic and dissociative symptomatology were significantly higher in the group reporting sexual abuse by a perpetrator in a relationship of trust, guardianship, or authority. The qualitative sample comprised a purposively selected subgroup of the quantitative sample (n = 20). Thematic content analyses of perpetrator methodology suggest that perpetrator strategies involving emotional manipulation, rather than the perpetrator relationship per se, appear to differentiate between groups with clinical or nonclinical levels of post traumatic and dissociative symptomatology. The combination of qualitative and quantitative methods provides integrated, contextualized data with implications for future research and clinical practice.

Adaptation, Psychological↗
PubMed2002

Flood area and damage estimation in Zhejiang, China.

A GIS-based method to estimate flood area and damage is presented in this paper, which is oriented to developing countries like China, where labor is readily available for GIS data collecting, and tools such as, HEC-GeoRAS might not be readily available. At present local authorities in developing countries are often not predisposed to pay for commercial GIS platforms. To calculate flood area, two cases, non-source flood and source flood, are distinguished and a seed-spread algorithm suitable for source-flooding is described. The flood damage estimation is calculated in raster format by overlaying the flood area range with thematic maps and relating this to other socioeconomic data. Several measures used to improve the geometric accuracy and computing efficiency are presented. The management issues related to the application of this method, including the cost-effectiveness of approximate method in practice and supplementing two technical lines (self-programming and adopting commercial GIS software) to each other, are also discussed. The applications show that this approach has practical significance to flood fighting and control in developing countries like China.

China↗
PubMedDate not supplied

Better breathing or better living? A qualitative analysis of the impact of asthma medication acquisition on standard of living and quality of life in low-income families of children with asthma.

INTRODUCTION: Purchasing children's asthma medications places a burden on low-income families. The objective of this study was to explore how purchasing children's asthma medications influenced household purchasing behavior and quality of life in low-income families with no drug insurance. METHOD: Seventeen parents residing in the Greater Toronto Area with no drug plan and with household incomes below 45,000 US dollars (twice the U.S. poverty level) participated. Semi-structured interviews were conducted, emphasizing the topics of prescription drugs used and cost versus effectiveness; purchasing behavior and drug administration; effects of medication purchasing on the family; and payment assistance. Transcribed narratives were coded and analyzed thematically. RESULTS: Annual expenditures for asthma drugs were 300 US dollars to 3000 US dollars. Because asthma management was a high priority, foregone expenditures included paying for other family members' health needs, essentials (clothing, food, better housing), and nonessentials (recreation, vacations) and long-term investments, such as their child's future education and their retirement. Respondents believed quality of life was negatively affected. DISCUSSION: Not addressing the health concerns of family members, making sacrifices, and modifying investment decisions created sustained anxiety in families of children with asthma. Access to medication benefits would have a positive impact on quality of life. Health care providers can help to ensure that low-income families receive available assistance.

Adolescent↗
PubMed2002

Experiences at menopause of women in a non-English-speaking community: a qualitative study.

CONTEXT: It is important that clinicians appreciate the link between physiological disturbances and cultural meanings. The community surrounding the Baker Medical Research Institute in Melbourne, Australia includes a substantial number of women from a Greek-speaking background who attend the Menopause Clinic. OBJECTIVE: To demonstrate how qualitative methodologies can assist with the development of clinical services by employing them to elucidate the role of cultural variables in the ways in which Greek women view menopause, aging, illness and medicine. DESIGN: This was a qualitative study employing in-depth interviews on five separate occasions over 2 years, analyzed with thematic and ethnographic content analysis. PATIENTS: Subjects were 40 Greek-speaking women attending the Clinic, aged 45-60 years. RESULTS: There is an intricate association between experiences of the menopause and family relationships, problems raised by immigration and the cultural dislocation caused by it, beliefs and theories of the body, religion, and traditional approaches to healing and medicine. Many women had experienced unfavorable or unsatisfactory encounters with medicine in the past, reflecting lack of understanding of the women's experiences and failures of communication about clinical assessments and recommended treatments. Traditional therapies were often used without advising doctors. CONCLUSIONS: The study emphasizes the potential utility of qualitative research methods for improving clinical practice by elaborating the specific requirements of particular groups, and thereby allowing doctors to deliver services that are more acceptable to patients from both a cultural and an ethical point of view, and also more effective. The process established for the evolution of our clinic may serve as a model for other clinics seeking to direct themselves to the needs of particular social groups or communities.

Affect↗
PubMed2006

Approximate entropy as a measure of irregularity for psychiatric serial metrics.

OBJECTIVES: The quantification of subtle patterns in sequential data, and their changes, has considerable potential utility throughout psychiatry, including the analyses of mood ratings, heart rate, respiratory, and electroencephalographic recordings. METHODS: Approximate entropy (ApEn), a relatively recently developed statistic quantifying serial irregularity, has been applied in numerous studies throughout mathematics and other fields of study, especially biology. RESULTS: We discussed applications of ApEn, both extant and potential, of most relevance to psychiatrists. We provided a mechanistic interpretation of lowered ApEn values, and discusses the relationship between ApEn and other (both classical and complexity) measures of serial dynamics. We also briefly discussed cross-ApEn, a thematically similar quantification of two-variable asynchrony that can aid in uncovering subtle disruptions in complicated network dynamics. CONCLUSIONS: ApEn and cross-ApEn have significant potential to consequentially enhance present statistical methodologies of analysis of psychiatric data, in both clinical and in research settings.

Adult↗
PubMedDate not supplied

The converging epidemics of mood-altering-drug use, HIV, HCV, and partner violence: a conundrum for methadone maintenance treatment.

BACKGROUND: Accumulating evidence suggests that partner violence may be associated with HIV risk behavior and drug use among women in methadone maintenance treatment programs (MMTPs), yet the mechanisms linking these overlapping problems remain unclear. The main purpose of this qualitative study is to explore in detail how drug-related activities and HIV risk behavior occur in the context of a recent episode of partner violence among women in MMTPs. METHOD: We conducted and analyzed in-depth interviews with 31 women who reported having experienced physical or sexual violence by an intimate partner during the past year. Guided by existing research, feminist theory and trauma theory, we constructed a set of questions which were designed to explore multiple ways in which drug-related activities or HIV risk behavior may be linked directly or indirectly to the recent event. To examine the extent and significance of the woman sand/or her partner s drug-related activities or sexual HIV risk issues occurring immediately before, during and/or after the most recent event, we adapted a series of techniques for thematic analysis of qualitative data. RESULTS: Of the 31 women who reported recent events: 83.8 % (n=26) recalled recent events in which there was some drug-involvement; 40% (n=13) indicated that both she and her partner were involved in drug-related activities during the most recent event of partner abuse; 35% (n=11) reported that the partner was drug-involved; and only two women (6.4%) indicated that they alone had been drug-involved. One-fifth (19.3%, n=6) of the women indicated that they had used drugs immediately after the event because they were upset or in physical pain. One-fifth of the women (n=6) reported that they had coerced, unprotected sex during or after the most recent incident. CONCLUSIONS: The multiple ways in which the use of mood-altering drugs are related to partner violence and the occurrence of coerced, unprotected sex underscore the need to design specific interventions for preventing drug relapse, and HIV and HCV infection among abused women in MMTPs. Treatment and policy implications of study findings are discussed.

Adult↗
PubMed2003

[Spatial analysis on the distribution of hemorrhagic fever with renal syndrome by geographic information system in Haidian district, Beijing].

OBJECTIVE: To analyze the spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Haidian district, Beijing and to explore the geographical characteristics of HFRS in highly endemic areas. METHODS: Administration boundary layer was established under the background of 1:100,000 map in the ArcInfo 8.1 software. The HFRS cases from 1997 to 2002 were positioned on the map. Highly endemic areas were identified by spatial cluster analysis using SaTScan 3.0 software. Distribution of HFRS cases was shown in different colors and contours by spatial analysis of geographic information system (GIS). RESULTS: Spatial Cluster Analysis of confirmed cases of HFRS identified in 1997 - 2002 in Haidian district showed that HFRS patients were not randomly distributed. The highly endemic areas were founded in Sujiatuo township, Yongfeng township, Shangzhuang township, Wenquan town and Bei'anhe township (relative risk = 4.43, P = 0.001). A thematic map of HFRS in haidian district was set up. CONCLUSION: HFRS infections were not randomly distributed, since the distribution was related to geographic-environmental factors.

China↗