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PubMed2006

A case-control study of factors associated with HIV infection among black women.

OBJECTIVE: To identify social, behavioral and epidemiologic factors associated with HIV infection among HIV-infected and HIV-uninfected black women residing in North Carolina. DESIGN: A case-control study conducted in August 2004 in North Carolina. METHODS: Cases were 18-40-year-old women with HIV infections diagnosed from 2003-2004. Controls were 18-40-yearold, HIV-negative heterosexually active women recruited from HIV testing sites. Five focus group discussions were also conducted with women not participating in the case-control study. RESULTS: Multivariate analyses of 31 cases and 101 controls showed that HIV-positive women were more likely to receive public assistance [adjusted odds ratio (aOR) 7.3; 95% confidence interval (CI) 2.1, 26.0], to report a history of genital herpes infection (aOR 10.6; 95% CI 2.4, 47.2), and were less likely to have discussed a variety of sexual and behavioral issues relevant to risk of HIV infection with their male partners (aOR 0.6; 95% CI 0.4, 0.8). Focus group participants indicated that financial and social demands created competing challenges for making HIV prevention a priority. CONCLUSIONS: Inadequate communication between black women and their sexual partners may create barriers to sexual and behavioral risk reduction. A multidimensional approach that addresses both biological factors such as herpes infection and socioeconomic factors may be needed to reduce HIV transmission in this population.

Adult↗
PubMed1993

Attitudes of males on contraception: a KAPE survey.

Acceptance of Family Planning services has been at a very slow pace in Africa. It was generally believed that the African male, due to his conservatism, was an obstacle to the acceptance of contraception by the African female. The study however showed that this was not true. The attitude of the African male towards contraception has changed drastically during the last thirty years, from ultra-conservatism during the 60s to very liberal in the 80s and 90s. Further it can be said that the African male is as well informed and has the same degree of Family Planning and child spacing acceptance-level as his counterpart in the developed world. However the African male does not accompany his partner for Family Planning Counselling. The study showed that most African men associate Family Planning with the use of condoms and not other methods such as the pill or the intrauterine devices.

Botswana↗
PubMed1991

Strategies used to communicate route directions by telephone: a comparison of the performance of 7-year-olds, 10-year-olds and adults.

Standard outcome measures used in a referential communication (route finding) task showed that 7-year-olds were inferior to 10-year-olds and adults in terms of adequacy of messages provided (as speakers) and selection of referent (as listeners). Because the task involved negotiation of route directions by telephone, a richer dialogue resulted than is usual in referential communication studies. This made possible an analysis of the strategies used and revealed differences untapped by the standard measures. The types of strategies used (components, numbering, directional, minimal) varied as a function of age, with the adults using much directional information and the children very little. Much of the younger children's description was either minimal or used inadequately specified mature strategies. Adults frequently used dual strategies (e.g. directional + numbering). Older children showed little evidence of these individually but achieved them, in practice, through dialogue with their partners. Age differences in quantity of communication (number of turns) were found to be linked to strategy use. The advantages of the telephone as an experimental medium of communication are discussed.

Adult↗
PubMed1996

Voices of impoverished Brazilian women: health implications of roles and resources.

This qualitative study was based on individual interviews with 75 Brazilian women in an impoverished peri-urban squatter community (favela) in southeastern Brazil. The purposes of the study were to describe women's role involvement in domestic and employment contexts; identify stresses and satisfactions of maternal, spousal, and employment roles; and assess personal and environmental role constraints and resources from the perspective of women's health. The analytic approach to the interview data was qualitative content analysis, through which thematic categories of maternal, spousal, and employment role satisfactions and stresses were identified by the researchers. Women's unrelenting work in the face of harsh social and economic environments was a broad theme woven throughout the women's descriptions of their lives. The confluence of role constraints affecting the participants' lives included poverty, marginalization, abuse, and lack of support and recognition by partners and society. In order to overcome great adversity and meet heavy role demands, these women relied on self, faith in God, family, and health resources. Implications for women's health promotion are discussed.

Adult↗
PubMed2006

Chimpanzees (Pan troglodytes) learn to act with other individuals in a cooperative task.

We presented two chimpanzees with a task in which they were required to pull each end of a rope simultaneously to drag blocks supporting food into reach. The chimpanzees did not succeed in initial tests. They did not immediately understand the necessity for cooperation, and they did not adjust their behavior to work with the partner. However, the frequency of success gradually increased as the number of sessions increased and the task was varied. They began to look at the partner frequently, wait if the partner was not holding the rope, and pull the rope in synchrony with the partner. However, they did not use interactive behaviors or eye contact to synchronize their behavior. One chimpanzee was then paired with a human partner in the same situation. After initial failures, the chimpanzee began to solicit the human partner for cooperation: looking up at his face, vocalizing, and taking the partner's hand. When this chimpanzee was again paired with the chimpanzee partner, no soliciting behavior was observed. Thus, the chimpanzees could learn to coordinate their behavior through trial and error. Communicative behavior emerged during the task, but the communication differed according to the identity of the partner.

Animals↗
PubMed1992

[Contact tracing routines for genital chlamydia infections used by Norwegian physicians. A questionnaire study].

Notification of partner(s) is recommended as a measure to control the epidemic of genital chlamydial infection. We surveyed a random sample of Norwegian general practitioners and privately practising gynaecologists. Only one in five general practitioners initiated notification of partner(s) after diagnosing a patient with genital chlamydial infection. A proposed new Communicable Diseases Act will make it mandatory to notify the partner in the event of such infections. 49% of general practitioners are in favour of the proposal, 21% oppose it while 30% remain uncertain. After implementation of similar legislation, Sweden has experienced a decline in the incidence of genital chlamydial infection. We believe increased notification of partner would help to control the Norwegian epidemic.

Chlamydia Infections↗
PubMed1998

Factors affecting patient-physician communication for abused Latina and Asian immigrant women.

BACKGROUND: Domestic violence is one of today's most serious health issues. Abused Latina and Asian immigrant women face unique barriers to the discussion of abuse with health care providers. This research was undertaken to identify any provider-related factors that may affect patient-provider communication for these women. METHODS: Qualitative data were collected using semistructured focus group interviews with abused Latina and Asian immigrant women. Participants were recruited through urban community-based organizations. Twenty-eight immigrant women with histories of domestic violence participated in four focus groups: two groups of Latina women and two groups of Asian women. Iterative readings by independent researchers identified provider-related factors affecting patient-provider communication. RESULTS: The study participants identified the provider behaviors that demonstrate trust, compassion, and understanding as elements that improve patient-provider communication. In addition, participants wanted providers to initiate discussions about partner abuse. CONCLUSIONS: Improved understanding of factors that may affect abused immigrant patients' communication may assist health care providers in offering meaningful support and assistance to these patients. Providers, administrators, policy makers, and educators should consider these factors when developing policy, protocols, and educational curricula for a variety of health care settings.

Adolescent↗
PubMed2006

Determinants of HIV/AIDS risk behaviors in expectant fathers in Haiti.

Haiti has an HIV/AIDS epidemic of the highest magnitude outside of sub-Saharan Africa. Factors such as relationship power imbalances, traditional gender role acceptance, and patriarchal belief systems that devalue women's sexuality have increased Haitian women's vulnerability to HIV infection. Because of these influences and since the HIV epidemic is largely heterosexually transmitted, it is important to understand the role that men's beliefs and behaviors play in the continuing risk of young men and women in Haiti. The purpose of this study was to gather information from male community members through semi-structured interviews in order to describe the prevalence of HIV/AIDS risk behaviors (e.g., condom use, number of sexual partners) among expectant fathers in Haiti and identify predictive psychosocial variables of HIV/AIDS risk behaviors. Results from this study showed that men who were not married (OR = 0.22, p = 0.05) and men who had medium (OR = 22.50, p < 0.001) and high sexual communication (OR = 36.51, p < 0.001) were more likely to use condoms. This study also showed that high stigma associated with HIV (OR = 16.07, p < 0.05), low HIV knowledge (OR = 0.10, p < 0.01), and high decision making power (OR = 62.52, p < 0.001) were predictors of multiple sex partners for the expectant fathers in the sample. HIV prevention programs should be designed to increase knowledge about HIV transmission, treatment, prevention and personal risk of contraction as well as correct misconceptions about individuals with HIV or AIDS and promote sex communication among partners.

Adult↗
PubMed2005

Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men.

This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.

Adult↗
PubMed1994

Adolescent contraceptive use and communication: changes over a decade.

Sexual experiences of 186 adolescents in 1979 were compared to those of 215 adolescents in 1989 who were recruited from the same university to determine if there was an increase over the decade in "safe sex" practices. Self-reported condom use increased between 1979 and 1989 for very first intercourse as well as first intercourse with current partner, although condom use was still far from universal. For other behaviors, there were sexual career changes (i.e., changes from first to current partner) but not decade changes. The percentage of respondents using any method of contraception and the percentage who discussed contraception with their partner increased from first to current partner, but did not increase between 1979 and 1989. The very first intercourse with first partner remained especially troubling since contraceptive use was very low and discussions about contraception prior to sex were very infrequent.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Influence of sexual abuse on HIV-related attitudes and behaviors in adolescent psychiatric inpatients.

OBJECTIVE: To investigate the associations between sexual abuse and human immunodeficiency virus (HIV)-related attitudes and behaviors of adolescents with a psychiatric disorder. METHOD: HIV-related knowledge, attitudes, and behaviors were examined by self-report assessment of adolescents admitted to a psychiatric hospital (N = 100). A subsample (n = 30) completed a role-playing exercise regarding HIV-preventive behavior that was scored for the degree of effective communication by raters blind to the subjects' abuse history. RESULTS: HIV-related risk behaviors were prevalent, including unprotected sexual intercourse (67%) and multiple partners (27%) among the sexually active (71% of the total). Also frequent were alcohol and drug use (25%) and sharing cutting instruments (22%) among those engaged in self-cutting behavior (62%). The 38% of the sample identified as having a history of sexual abuse indicated significantly poorer self-efficacy concerning condom use than their peers. Abused females scored significantly lower on the self-efficacy of condom use scale and reported significantly more frequent alcohol use than nonabused females (p = .003). A hierarchical multiple regression that controlled for consistency of condom use and tolerance of people with acquired immunodeficiency syndrome found that abuse history uniquely accounted for 16% of the variance in condom use self-efficacy. Analysis of the videotaped role-play found that abused adolescents were significantly less competent and had more difficulty in effective communication than their peers (p = .003). CONCLUSION: A history of sexual abuse is associated with impaired safe sexual decision-making and HIV-preventive communication skills, even in this already at-risk group. This study also underscores the importance of actively addressing these issues in the context of clinical care.

Adolescent↗
PubMed2002

A sequential analysis of private and social speech in children's dyadic communication.

The purpose of this study was to perform a sequential analysis of private and social speech in children's dyadic communication. To investigate the communication patterns, a category system was applied to the communication of 64 paired third (M = 8 years and 8 months) and fifth (M = 10 years and 8 months) graders, while playing with a Lego-set (construction material). The results revealed that: (a) at both grades, when one child addresses the other child about the task, it is highly probable that the latter will address the first child immediately afterwards and will adapt to task-related semantic content; (b) at both grades, children's private speech about the task stops them from communicating a task-related production to their partner immediately afterwards; (c) at third grade, task-relevant private speech favors the prolongation of the break in interpersonal communication and the use of inner speech by both children; and (d) at fifth grade, children are more able to distinguish private speech from social speech than at third grade.

Age Factors↗
PubMed2003

Subjective quality of life and sexual functioning after germ-cell tumour therapy.

PURPOSE: To evaluate the influence of germ-cell tumour therapy on sexual functioning and subjective quality of life (QL). To investigate the communication about sexual problems between patients, their partners, and doctors. In all, 474 patients treated for germ-cell tumours at the Department of Internal Medicine III, Ludwig-Maximilians-University Munich, from 1979 to 2000 were asked to complete a self-report questionnaire concerning psychosocial dimensions and subjective QL (QLS; Henrich and Herschbach, 2000). In total, 341 patients returned a completed questionnaire (response rate, 71.9%). The median age at survey was 41.9 years and the median follow-up period after therapy was 9.6 years. Persisting sexual sequelae were lower than in the current literature: decreased sexual desire (7.1%), erection (10.0%), orgasm (10.2%), ejaculation (28.8%), sexual activity (8.5%), and sexual satisfaction (4.8%). In QL the satisfaction with 'friends/acquaintances' (P<0.001) and 'family life/children' (P<0.001), is lower than in the healthy population. Correlations between functional scales and subjective QL were highly significant. There is a strong correlation between sexual satisfaction and global life satisfaction (Spearman's Rho: 0.48; P<0.01). A total of 61.4% of patients were not offered communication about sexual problems by their doctors and 21.2% were unable to talk with their partner about sexual issues. In conclusion, moderating psychosocial variables (e.g. personality factors, cognitive processes) should be investigated to clarify the relationship between life satisfaction (subjective QL) and functional impairments. Communication about sexual problems should be offered as a standard to patients treated for germ-cell tumours.

Adult↗
PubMed1990

Verbal behaviors of preschool stutterers and conversational partners: observing reciprocal relationships.

Standard counseling practices with the families of young stutterers include recommendations that listeners' negative verbal behaviors be modified in order to reduce the likelihood of stuttering. This study tested the hypothesis that stuttering and normal disfluencies in preschool stutterers are related to selected verbal behaviors in conversational partners. Twelve 2- to 6-year-old stutterers were video recorded while playing with their mother, father, and a familiar peer. The resulting videotapes were transcribed and two types of social communicative analyses (total number of words and utterances, verbal intent of the speaker) were undertaken. Results suggested that fathers used more words and utterances than mothers and peers. Parents provided more positive interactions with their stutterer offspring than did peers. Parents also asked significantly more negative and routine questions when talking to their stuttering child. Peer playmates were significantly more negative and generally commented more frequently when interacting with stutterers than did the parents. Stutterers were involved in significantly more positive interactions with their fathers. The frequency of fluency failures did not differ significantly when stutterers communicated with their mother, father, or peer partners. Implications regarding verbal styles of partners in relationship to the stuttering of preschool children are discussed.

Adult↗
PubMed2001

Parent-adolescent communication and sexual risk behaviors among African American adolescent females.

OBJECTIVE: To examine associations between parent-adolescent communication about sex-related topics and the sex-related communication and practices of African American adolescent females with partners, as well as their perceived ability to negotiate safer sex. DESIGN: A theory-guided survey and structured interview were administered to 522 sexually active African American females 14 to 18 years old. Recruitment sites were neighborhoods with high rates of unemployment, substance abuse, violence, and sexually transmitted diseases. Multivariate analyses, controlling for observed covariates, were used to identify the association of less frequent parent-adolescent communication with multiple assessed outcomes. RESULTS: Less frequent parent-adolescent communication (scores below the median) was associated with adolescents' non-use of contraceptives in the past 6 months (adjusted odds ratio [AOR] = 1.7) and non-use of contraceptives during the last 5 sexual encounters (AOR = 1.6). Less communication increased the odds of never using condoms in the past month (AOR = 1.6), during the last 5 sexual encounters (AOR = 1.7), and at last intercourse (AOR = 1.7). Less communication was also associated with less communication between adolescents and their sex partners (AOR = 3.3) and lower self-efficacy to negotiate safer sex (AOR = 1.8). CONCLUSIONS: The findings demonstrate the importance of involving parents in human immunodeficiency virus/sexually transmitted disease and pregnancy prevention efforts directed at female adolescents. Pediatricians and other clinicians can play an important role in facilitating parent-adolescent communication about sexual activity.

Adolescent↗
PubMed2007

Family system characteristics and psychological adjustment to cancer susceptibility genetic testing: a prospective study.

This study examined prospectively the contribution of family functioning, differentiation to parents, family communication and support from relatives to psychological distress in individuals undergoing genetic susceptibility testing for a known familial pathogenic BRCA1/2 or Hereditary nonpolyposis colorectal cancer-related mutation. Family functioning, differentiation to parents, hereditary cancer-related family communication and perceived support from relatives were assessed in 271 participants for genetic testing before test result disclosure. Hereditary cancer distress (assessed by the Impact of Event Scale) and cancer worry (assessed by the Cancer Worry Scale) were assessed before, 1 week after, and 6 months after test result disclosure. Participants reporting more cancer-related distress over the study period more frequently perceived the communication about hereditary cancer with relatives as inhibited, the nuclear family functioning as disengaged-rigid or enmeshed-chaotic, the support from partner as less than adequate and the relationship to mother as less differentiated. Especially, open communication regarding hereditary cancer and partner support may be important buffers against hereditary cancer distress. Identifying individuals with insufficient sources of support and addressing the family communication concerning hereditary cancer in genetic counseling may help the counselee to adjust better to genetic testing.

Adult↗
PubMed2002

Cripto, a multifunctional partner in signaling: molecular forms and activities.

Within a multicellular organism, communication between cells is essential during development to ensure proper execution of cell migration, cell fate decisions, and differentiation events. It is also essential in the adult for the coordination of many physiological functions. Cell-to-cell communications often rely on the interaction of cell surface receptors with soluble or membrane-bound ligands. Receptors or ligands may interact with additional partners to trigger specific signaling cascades inside the cell. In most cases, partners act in a specific configuration, either as a diffusible "co-ligand" or a membrane-bound co-receptor. Here, we examine the case of Cripto, a signaling molecule that has prominent functions during vertebrate development. Conflicting results have suggested that Cripto has the unusual capacity to act both as a secreted ligand and as a cell surface component to control a single signaling pathway. Here, we review the recent experiments that attempt to reconcile those results. Furthermore, three reports have described the fact that Cripto is modified by the addition of sugar residues, including a rare case of fucosylation. These modifications are essential for Cripto function, suggesting that, as is the case for other key developmental or physiological regulators such as Notch or selectins, the activity of Cripto may be controlled by the extent of its glycosylation or fucosylation (or both).

Animals↗
PubMed2000

The roles of Australian chairs in clinical nursing.

Australian chairs in clinical nursing have been established in order to achieve more effective partnerships between academia and the health care sector in education, research and quality of nursing care. The aim of this study was to describe the goals, obstacles, supports and outcomes of such appointments. The study explored the perceptions of a purposive sample of Australian professors holding clinical chairs, stratified to ensure representation of both the geographical and clinical specialty diversity of the population. Eight professors were interviewed using semi-structured telephone interviews. The interviews covered three phases: role establishment, current foci and future developments. Qualitative analysis for common themes and areas of divergence was conducted with concurrent analysis providing the opportunity to seek confirmation for emerging themes. The participants highlighted the diversity of arrangements between university and health sector partners in establishing their respective roles. Clear communication was crucial to successful partnership arrangements. All roles included components of education, research and politics but the relative contribution of each of these areas depended to a large extent on the priorities of the employing partners. The participants felt the need to secure sustainable income sources and consolidate outcomes to ensure the continued viability of their positions. Clinical professorial nursing appointments provide one means of addressing perceived gaps in the links between the university and health care sectors, academia and clinicians, thus enhancing nursing education, research and politics. Through emphasizing common purpose and mutual respect, these positions can illuminate the crucial role nursing plays in Australian health care delivery.

Australia↗