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This article highlights Procter & Gamble's (P&G's) current success and future direction of creating consumer value and improving trading partner relationships through electronic data communication, including the future vision of the company's ultimate supply system and CPFR--Collaborative Planning, Forecasting, and Replenishment.
Compelling evidence exists that conflict and communication problems occur between nursing home staff and family members of residents. However, few interventions have been documented that simultaneously address the needs of both groups. The Partners in Caregiving program was created to train staff and family members in communication techniques and conflict resolution skills. Through a joint meeting with facility administrators, both groups also have the opportunity to influence facility practices. Evaluation data indicated that satisfaction with the program was extremely high, and that positive changes in staff-family interactions occurred.
The psychoanalytic situation is based on a dyadic concept where the relatives of the patient easily may be regarded as a disturbing element which should be eliminated as far as possible. In reality, however, there exist manifold interrelationships and feedback mechanisms among the psychoanalytic dyad and other significant relationships of a patient in psychoanalysis. The relational triangle of patient, partner and psychoanalyst is taken as an example to demonstrate within a sociological framework the process of competition of two primary one-to-one relationships mutually demanding exclusivity. Because of the inhibited communication between the analyst and the partner of the patient, this competition, however, cannot be settled obviously. It is rather shifted into the partner-relationship where it appears as a (originally iatrogenic) conflict of the couple which, then, easily may be misinterpreted by the psychoanalyst from a psychopathological point of view and not in terms of structural interrelations. In this process, a scapegoat function often is ascribed to the partner of the patient who is not able to disprove this interpretation and may react in a paranoid manner. The patient, on his part, in this situation often suffers from a loyalty conflict between his partner and his analyst which can be resolved in several modes. One pattern of solution is the splitting of the transference into a totally "good" and a totally "bad" relationship, the negative side generally ascribed to the partner-relationship. The different viewpoints of Kohut and Kernberg regarding these splitting phenomenons in the transference are discussed, and also the problem, whether a protracted narcissistic transference as required by Kohut for the treatment of narcissistic personalities must not lead to undue impairment of a concurrent real relationship of the patient. There is the question whether the present state of psychoanalytic technique can do justice to relational triangle as presented here from a sociological point of view, or whether they rather are denied (out of structural reasons, too) by a dyadic conception which does not correspond to the post-symbiotic reality of adult patients, even when a disturbance on the so-called prae-oedipal level is attested to them.
The management of chronic diseases such as diabetes is becoming a crucial issue in developed countries. Innovative communication technologies should now be included as new partners in the health care system. These technologies can help both in managing patients and measuring quality of care. Internet-based health promotion programs may improve compliance with treatment. Decision systems are available on the Net to help patients monitoring their diet and insulin doses. The use of electronic medical record shared on Internet may help both physicians and patients to monitor on the long term the effect of interventions. It is now time to perform appropriate trials to determine, beside other interventions, the precise role of innovative communication technologies in diabetes management.
This paper reports results of a study of prenatal diagnosis patients who lost pregnancies. The women felt they shared much in common with their male partners and generally felt understood and supported by the men. However, many of the women also saw their responses to the loss as different from those of their male partners. A variety of coping patterns were adopted by the women in the face of these differences. Implications are considered for preventive efforts to minimize distress; treatment approaches to help couples who experience greater difficulties; and future research directions.
PURPOSE: To examine the patterns, facilitators, and barriers to disclosure of HIV seropositivity in an adolescent population and to determine the relationship between disclosure and condom use. BACKGROUND: In recent years, public health efforts have focused on methods to prevent the transmission of the Human Immunodeficiency Virus (HIV). These efforts have included safer sex education, skill building and self-efficacy training, behavioral change techniques, and encouragement of serostatus disclosure to sexual partners. In 1990, the Centers for Disease Control and Prevention (CDC) funded 10 hemophilia treatment centers to develop and implement a theory-based behavioral intervention to prevent the sexual transmission of HIV. METHODS: A baseline survey, focusing on barriers to safer sex, the influence of parents, peers, and sexual partners, alcohol and drug use, and communication and disclosure patterns, was administered to 321 young males (ages 12 to 25) with hemophilia and HIV. RESULTS: Fifty-eight percent of the sexually experienced adolescents did not disclose their HIV status to their most recent sexual partners (i.e., nondisclosers) compared to 42 percent who reported that either they informed their partners or their partners already knew their HIV status (i.e., disclosers). There was no correlation between disclosure and condom use. The most significant predictor of disclosure was the perception that peers would disclose their HIV status. CONCLUSION: The results suggest that disclosure does not necessarily facilitate condom use in this population. This conclusion may have implications for future public health efforts in HIV prevention. Rather than focusing primarily on the promotion of serostatus disclosure, behavioral interventions should emphasize the practice of safer sex, utilizing peer educators and support networks.
At the start of this review, factors were deemed trophic if they stimulated mitosis, permitted neural cell survival, promoted neurite sprouting and growth cone motility, or turned on a specific neuronal phenotype. The in vitro evidence from cell cultures is overwhelming that both neurotransmitters and neuropeptides can have such actions. Furthermore, the same chemical can exert several of these effects, either on the same or on different cell populations. Perhaps the most striking example is that of VIP, which can stimulate not only mitosis, but also survival and neurite sprouting of sympathetic ganglion neuroblasts (Pincus et al., 1990a,b). The in vivo data to support the in vitro experiments are starting to appear. A role for VIP in neurodevelopment is supported by in vivo studies that show behavioral deficits produced in neonatal rats by treatment with a VIP antagonist (Hill et al., 1991). The work of Shatz' laboratory (Chun et al., 1987; Ghosh et al., 1990) suggests that neuropeptide-containing neurons, transiently present, serve as guideposts for thalamocortical axons coming in to innervate specific cortical areas. Along similar lines, Wolff et al. (1979) demonstrated gamma-aminobutyric acid-accumulating glia in embryonic cortex that appeared to form axoglial synapses and suggested the possibility that gamma-aminobutyric acid released from the glia might play a role in synaptogenesis by increasing the number of postsynaptic thickenings. Meshul et al. (1987) have provided evidence that astrocytes can regulate synaptic density in the developing cerebellum. The work of Zagon and McLaughlin (1986a,b, 1987) has shown that naltrexone, an antagonist of the endogenous opioid peptides, affects both cell number and neuronal sprouting. Lauder's laboratory (Lauder et al., 1982) has shown a role for 5-HT in regulation of the proliferation of numerous cell types. These studies illustrate another important point, that neurotransmitters and neuropeptides function in communication not only between neurons, but also between neurons and glial cells, and between glial cells. Given that astrocytes can express virtually all of the neural receptors and can produce at least some of the neurotransmitters and neuropeptides, they must now be considered equal partners in the processes of intercellular communication in the nervous system, including the trophic responses. The actions of neurotransmitters and neuropeptides have to be considered in terms of a broad spectrum of actions that range from the trophic actions described in this review, to the classic transmitter actions, to potential roles in neurotoxicity.(ABSTRACT TRUNCATED AT 400 WORDS)
This study examined the concordance between parents' assessment of their interpersonal conflict resolution with each other and their children's perception of the same. 61 parent dyads responded to the 1984 Communication Patterns Questionnaire of Christensen and Sullaway while their children completed the 1992 Children's Perception of Interparental Conflict Scale by Grych, Seid, and Fincham. Mothers' and fathers' perceptions of their conflict resolution were significantly correlated. Analysis indicated that overall, children's perception of interparental conflict was related to their mothers' perception of the communication patterns between themselves and their partner. However, this relationship was confounded with sex of the child indicated by different patterns of intercorrelations between mothers', fathers', and children's perceptions for boys and girls.
Previous studies have suggested that facial displays in the presence of others are influenced by the relationship with accompanying persons. In these studies, subjects participated with friends or strangers, without any focus on social interactions between partners. In the current study, pairs of friends or strangers viewed film clips expected to elicit positive and negative affects; the control group participated without partners. We measured synchronous smiles between partners as a social interactive display, in addition to the duration and the frequency of smiles and frowns. Subjective emotion and social motive were also measured. Smiles were facilitated by the presence of a friend than a stranger or the condition of lone participation, regardless of stimulus valence. Synchronous smiles and the communication motive were also enhanced with a friend than with a stranger. These results suggested that the expression of smiles was facilitated by the communication motive and social interactions between partners.
This study uses data from a representative sample of sexually active adults in urban Mozambique to examine the effectiveness of the JeitO condom social marketing (CSM) project in increasing condom use among men and women at risk of contracting HIV. More specifically, this study tests the hypothesis that exposure to programme interventions (communications and access) increases condom use with non-regular partners. Exposure to the CSM programme is high, and multivariate analyses show that exposure to CSM advertising and communications and knowledge of a condom source are associated with higher reports of condom use with non-regular partners. Analyses of regional differences in condom use show that knowledge and use of condoms with non-regular partners are higher than the national average in all four provinces where the CSM project has been operating for longer (18 months vs. 6 months). Multivariate analyses show that the above-average level of condom use in the capital, Maputo, can be attributed to the higher socioeconomic status of this population, but the above-average level of condom use among men and women in Sofala and Manica provinces is due, in part, to their high level of exposure to the CSM programme. These findings indicate that the JeitO CSM project's behaviour-change communications and condom distribution are effective in encouraging safer sex practices among persons engaged in sex with non-regular partners.
The goal of this study was to provide evidence for the feasibility and effectiveness of conducting voluntary counseling and testing (VCT) for HIV in a bathhouse setting. Four hundred ninety-two men participated in bathhouse-based VCT offered at a single venue over a 13-month period. A convenience sample of 133 of these testers was assessed at 2 points: immediately before and 3 months after testing. Thirty-eight percent of men in the sample reported unprotected anal intercourse (UAI) with 1 of their 2 most recent partners in the 3 months before testing, and 48% of those men had not otherwise been tested for HIV in the previous 12 months. Results showed that in the months after VCT, men were less likely to engage in UAI, decreased their frequency of engaging in sex while drunk or high, and were more likely to communicate about HIV with their sexual partners. Bathhouse-based VCT seems to be a feasible approach for reaching significant numbers of men at risk for HIV and shows preliminary evidence of effectiveness in changing some specific HIV-related risk and precautionary behaviors.
BACKGROUND AND OBJECTIVES: The Undergraduate Medical Education for the 21st Century (UME-21) project encouraged the formation or enhancement of partnerships between medical schools and health care organizations distinct from the traditional teaching hospitals. The purpose was to prepare medical students in nine content areas that were components of the UME-21 project. Despite their importance today to medical schools, such partnerships with health care organizations are a challenge to develop and maintain in the midst of a rapidly changing health care environment. This article categorizes the partnerships formed and discusses the benefits and the barriers encountered in such collaborations. METHODS: Information about the partnerships was abstracted from written reports from each of the UME-21 partner schools. Additional information was obtained from personal communications with external project representatives and from a post-project survey presented to all UME-21 partner schools. RESULTS: The eight partner schools established or enhanced 32 educational partnerships with external organizations. External partner organizations contributed to curriculum planning and implementation, course development and presentation, and provision of clinical sites and preceptors. Twenty-seven of 32 initial affiliations continued in some form beyond the contract period. CONCLUSIONS: Partnerships formed as part of the UME-21 project improved medical students' exposure to the health care system and their knowledge and skills for effective practice in the 21st century health system. Barriers encountered included financial pressures, changes in leadership, different organizational missions and priorities, and preexisting prejudices against new relationships. Factors associated with successful partnerships include the presence of a health care organization and an academic "champion" dedicated to the project, strong individual relationships, and a medical school commitment to involve external partners.
The purposes of this study were (1) to assess individuals' self-reports of communication and their reports about their spouses' communication in order to examine the congruence of spousal views and (2) to investigate whether each report provided unique information about observed marital interactions. These associations were evaluated in a sample of 119 longtime married couples. The Verbal Aggression and Cooperation subscales from the Conflicts and Problem-Solving Scales were used as measures of negative and positive aspects of communication. The findings indicated that self-reports of both verbal aggression and cooperation were strongly associated with the same individual's report of his or her spouse's verbal aggression and cooperation. Conversely, self-reports were only moderately associated with reports made by spouses (e.g., the husband's report of his wife's communication). Hence, within-reporter agreement was higher than between-reporter agreement about marital communication. When entered into regression models, reports made by spouses, but not self-reports, explained unique variance in observations of marital hostility and affection. There was one exception: Wife self-report of verbal aggression explained unique variance in coders' ratings of wife hostility, controlling for husband report of wife verbal aggression. Findings indicate the importance of assessing partners' views of one another's communication for the most accurate portrayal of marital interactions. Implications for research and clinical work are discussed.
Sexually transmitted disease, such as the fatal HIV disease, continues to threaten the health of young women. Adolescents have typically been inconsistent users of effective strategies that prevent the spread of disease during sexual activity. Communication practices related to disease-related sexual protection have received little attention as a variable separate from sexual protection. The purpose of this study was to explore the relationship among different types of interpersonal communication of young women and their new sexual partners and their implementation of disease-related sexual protection. A sample of 163 young women who had experienced sexual intercourse completed the Safe Sex Behavior Questionnaire. Interpersonal communication was explored using the general-information-seeking (getting to know a partner), sexual self-disclosure, and specific-disease risk-information-seeking scales. These scales were combined; factor analysis revealed three subscales closely related to the original scales. Findings suggest that young women who seek specific information about their new sexual partner's disease risk status are more likely to implement sexual protective practices. These findings provide guidance to nurses who work with adolescent women in advising on aspects of interpersonal relationships that need to be enhanced to protect one's health status.
Based on a developmental social learning analysis, it was hypothesized that observing parental violence predisposes partners to difficulties in managing couple conflict. Seventy-one engaged couples were assessed on their observation of parental violence in their family of origin. All couples were videotaped discussing two areas of current relationship conflict, and their cognitions during the interactions were assessed using a video-mediated recall procedure. Couples in which the male partner reported observing parental violence (male-exposed couples) showed more negative affect and communication during conflict discussions than couples in which neither partner reported observing parental violence (unexposed couples). Couples in which only the female partner reported observing parental violence (female-exposed couples) did not differ from unexposed couples in their affect or behavior. Female-exposed couples reported more negative cognitions than unexposed couples, but male-exposed couples did not differ from unexposed couples in their reported cognitions.
Drawing on focus group discussions with adolescent and adult HIV-infected women between the ages of 16 and 45, this study explores the barriers to condom use among women infected with HIV. Although most of the participants were comfortable discussing condoms and sexuality, there was little, if any, negotiation of condom use with their male partners. Most of the participants used condoms inconsistently or not at all. Reasons for nonuse included a lack of trust in the reliability of condoms to protect them, a lack of desire for pregnancy prevention, and the male partner's refusal to use condoms. Women in discordant relationships explained their uninfected partner's refusal to use condoms as denial of the risk of contracting HIV or as a way of expressing their love for the infected partner. Women also had great difficulty in disclosing their HIV status to both family and partners. Prevention efforts to increase condom use among HIV-infected women should target both men and women and focus on negotiation and communication skills.
Chronic pain in one of the partners in a marriage causes profound changes in the marital relationship: roles and communication patterns are transformed, sexual relationships deteriorate, and the well partner frequently succumbs to distress and illness. In examining these changes, this article highlights the need for routine marital and family assessment and a family treatment approach for patients and their spouses.
This study used a modern theory of stress as a framework to strengthen the understanding of the relationship between neurobehavioural problems of TBI, family functioning and psychological distress in spouse/caregivers. The research was an ex post facto design utilising a cross-sectional methodology. Path analysis was used to determine the structural effect of neurobehavioural problems on family functioning and psychological distress. Forty-seven female and 17 male spouse/caregivers of partners with severe TBI were recruited. Spouse/caregivers who reported partners with TBI as having high levels of behavioural and cognitive problems experienced high levels of unhealthy family functioning. High levels of unhealthy family functioning were related to high levels of distress in spouse/caregivers, as family functioning had a moderate influence on psychological distress. Furthermore, indirect effects of behavioural and cognitive problems operating through family functioning intensified the level of psychological distress experienced by spouse/caregivers. Additionally, spouse/caregivers who reported high levels of behavioural, communication and social problems in their partners also experienced high levels of psychological distress. This study was significant because the impact of TBI on the spouse/caregiver from a multidimensional perspective is an important and under-researched area in the brain injury and disability field.