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PubMed1994

Making homework work at home: the parent's perspective.

This article views homework through the eyes of parents in a rural area whose children with disabilities spent a majority of their time in general education classrooms. The qualitative analysis of data from individual interviews, focus groups, and parent action research logs yielded five themes: (a) Parents felt ill-prepared to help their children with homework; (b) parents wanted more information about the classroom teachers' expectations of their child and of their roles as parents in helping with homework; (c) parents wanted their children to be given individualized homework assignments; (d) parents valued hands-on homework and projects in which the whole family could participate; and (e) parents wanted a two-way communication system that would allow them to become partners on their child's instructional team.

Communication↗
PubMed1999

How adult beliefs shape the speech communities of a child who has multiple disabilities.

Ethnographic and micro-ethnographic techniques were used to investigate how the strategies employed by two adults (a mother and a physical therapist) to initiate and maintain interactions with a 2-year-old child with multiple disabilities were reflective of the adult partner's beliefs and values about communication in general and about this child in particular. Results indicate that the physical therapist believed in using the child's existing abilities as the primary reference point for establishing a speech community with the child. The mother used the demands of the larger, mostly nondisabled speech community as her primary reference point. How these differences affect the nature of the child's membership and level of independence in these speech communities is discussed.

Adult↗
PubMedDate not supplied

Building a sense of teamwork within the organization. Getting along with your practice partners.

Experiencing teamwork is positive, energizing and motivating, writes Joan Wagner Zinober, Ph.D., M.B.A., in the third article of her series on the management and leadership of people. What is not so well known, however, is the impact of destructive professional relationships on the bottom line. Zinober offers guidelines on how to promote positive working relationships among practice partners.

Communication↗
PubMed1977

Sex therapy and marital counseling for the disabled.

The myth that handicapped people have no sexual needs has been recently dispelled. Professional concern is now present for their sexual rehabilitation, ideally starting shortly after injury, surgery or disease and continuing in specialized clinics for sexual counseling and therapy. The patients are referred either in couples or as singles, married or non-married. Therapy is similar to that for able-bodied individuals: the couple is seen together, then separately and finally together again for detailed discussion. Both the disabled and his or her partner learn that when open, honest communication is possible and sexual potential is present, a mutually rewarding sexual relationship can be obtained and developed.

Persons with Disabilities↗
PubMed1988

Assessment and support of sexual functioning in 458 men seeking genitourinary reconstructive surgery.

Horton and associates focused on an aspect of genital reconstructive surgery: restored or improved sexual functioning. The availability a physician skilled in the application of modern sexual counseling has been demonstrated in a group of 458 men to assist in maximizing the benefit of such surgery on patients' sexual and coital success. The sexual therapist was a valued member of the team approach to patient care. The necessity of psychiatric assessment for some was apparent, as it would be in any population of patients seeking plastic or corrective surgery. The association of the sexual therapist with various mental health professionals was important. The recognition of mental and emotional difficulties was primary, but the further skills the sexual therapist brought by application of sexual therapy techniques was also important. Men disadvantaged sexually by genital abnormality gained from a sensitive and educational approach, one that included their partners in the context of open communication and offered specific suggestions for their own specific needs and situations. Sexual therapy techniques and skills instruction added a vital dimension to the complete care of these men seeking correction of genital abnormalities. The techniques and approaches themselves were fairly straightforward and simple, as well as fairly standardized. Described by Masters and Johnson, Jones and others, they were clearly effective in enhancing comfort with sexuality and less pressured approaches to sexual behavior, and ultimately in enhancing sexual functioning itself.

Gender Identity↗
PubMed1995

HIV-1 infection among low income women attending a Siriraj sexually transmitted disease clinic: sociodemographic differentials.

From August 1993 to October 1994, 322 women attended or were referred to a female sexually transmitted disease clinic, were studied for the prevalence of HIV infection. No subject had a history of commercial sex work, injection drugs use or blood transfusion within the past 8 years. The majority of women belonged to the low socioeconomic stratum. HIV-1 antibody was found in the sera of 38 women (11.8%). HIV-1 seropositivity was not associated with any type of current sexually transmitted disease such as genital ulcers, serologic markers of syphilis or other sexually transmitted disease as well as history of past sexually transmitted disease within the past 2 years. Significant differential factors were found between the HIV-1 seropositive and seronegative women for self risk assessment and ability to communicate concerns with the husband or partner regarding HIV infection/AIDS. Programs are urgently needed for HIV/AIDS prevention and control to low-income communities and to determine what factors enable the HIV-1 seronegative women to be more assertive in their relationship and whether these skills can be enhanced to eliminate future episodes of STD and transfer these skills to the more vulnerable low-income women. Early diagnosis and prevention of HIV infection among women is a priority for public health interventions both in industrialized and in developing countries.

Adolescent↗
PubMed1993

Outreach programs and their effects within the Cancer Information Service network.

Outreach programs have been part of the Cancer Information Service (CIS) program since its outset. The scope of work of the first two CIS contracts gave broad responsibilities to the local offices for public and professional education, responsibilities that were carried out in a diverse fashion with little national direction. As the National Cancer Institute (NCI) Office of Cancer Communications matured and became more directed, the CIS local offices began successfully to implement programs with the Office of Cancer Communications and through intermediary groups. The Partners in Prevention (PIP) effort, launched by NCI in 1984, was the first major national community education program in which all the CIS offices participated. Shortly after the inception of PIP, however, the outreach personnel were deleted from the CIS contracts, due to budget restrictions. When the outreach component was reinstituted in 1990, the structure of the program changed to a catalytic role, working with local media and intermediary organizations to bring the NCI program messages and materials to targeted audiences and memberships. Under the reconfigured CIS network, the outreach program will serve as a resource to both those community institutions that are funded by NCI and those that are not and will be proactive in intermediary development. This paper details the chronology of the program and presents some of the research issues that need to be addressed in the future.

Humans↗
PubMed1997

Effects of a skill-based intervention to encourage condom use among high risk heterosexually active adolescents.

OBJECTIVES: In this article we describe the development and testing of three behavioral interventions to reduce the risk of contracting HIV/AIDS and other sexually transmitted diseases among heterosexually active adolescents. METHODS: The interventions include a comic book, a videotape, and a group skill training curriculum that emphasize skill development--for communicating and negotiating condom use with partners, in addition to providing basic information. Participants included 228 youths sampled in juvenile detention and 168 youths sampled from public health STD and other similar clinics. The samples included both young men and women, and were comprised of African American and European American adolescents, ages 14-19. RESULTS: Examination of the relative efficacy of the interventions at three and six months following intervention show very few differences among conditions, despite the fact that the interventions contained most of the elements that previously have been defined as essential for effective interventions. CONCLUSIONS: In the discussion, we consider possible reasons for this outcome and make recommendations for future research.

Adolescent↗
PubMed1997

Nurse managed occupational health services without on-site clinical care delivery: a case example.

1. In this program management/community network model of occupational health services, the occupational health nurse is responsible for managing program development and implementation, with vendors providing the clinical services. 2. Occupational health nurses' primary areas of responsibility are occupational health, disability case management, ergonomics, and health promotion. 3. Successful management of program outcomes requires the occupational health nurse to continually assess employee/business needs, maintain communication with employees and management, and partner with the environmental, health, and safety team, other functional work groups, and vendors. 4. Effective management of contracts becomes critical to the process beginning with clear service requirements through the delivery of quality services.

Ambulatory Care Facilities↗
PubMed2003

A cooperative communication intervention for nursing home staff and family members of residents.

PURPOSE: This article reports on a randomized, controlled study of Partners in Caregiving, an intervention designed to increase cooperation and effective communication between family members and nursing home staff. DESIGN AND METHODS: Participants included 932 relatives and 655 staff members recruited from 20 nursing homes, randomly assigned to treatment and control conditions. Parallel training sessions on communication and conflict resolution techniques were conducted with the family and staff in the treatment group, followed by a joint meeting with facility administrators. RESULTS: Positive outcomes were found for both family and staff members in the treatment group. Both groups showed improved attitudes toward each other, families of residents with dementia reported less conflict with staff, and staff reported a lower likelihood of quitting. IMPLICATIONS: Multiple studies report significant interpersonal stress between family members of nursing home residents and facility staff members. Partners in Caregiving appears to be an effective way to improve family-staff relationships in nursing homes.

Adult↗
PubMed2005

Couple-focused support to improve HIV medication adherence: a randomized controlled trial.

OBJECTIVE: To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems. DESIGN: A randomized controlled trial (SMART Couples Study) conducted between August 2000 and January 2004. SETTING: Two HIV/AIDS outpatient clinics in New York City. PARTICIPANTS: Heterosexual and homosexual HIV-serodiscordant couples (n = 215) in which the HIV-seropositive partner had < 80% adherence at baseline. The sample was predominantly lower-income racial/ethnic minorities. INTERVENTION: Participants were randomly assigned to a four-session couple-focused adherence intervention or usual care. The intervention consisted of education about treatment and adherence, identifying adherence barriers, developing communication and problem-solving strategies, optimizing partner support, and building confidence for optimal adherence. OUTCOME MEASURES: Medication adherence at week 8 (2 weeks after the intervention) compared with baseline, assessed with a Medication Event Monitoring System cap. RESULTS: Intervention participants showed higher mean medication adherence at post-intervention when compared with controls whether adherence was defined as proportion of prescribed doses taken (76% versus 60%) or doses taken within specified time parameters (58% versus 35%). Also, participants in the intervention arm were significantly more likely to achieve high levels of adherence (> 80%, > 90%, or > 95%) when compared with controls. However, in most cases, effects diminished with time, as seen at follow-up at 3 and 6 months. CONCLUSION: The SMART Couples program significantly improved medication adherence over usual care, although the level of improved adherence, for many participants, was still suboptimal and the effect was attenuated over time.

Adult↗
PubMed1994

Integrity promoting care of demented patients: patterns of interaction during morning care.

Video-recorded morning care sessions (n = 49) of demented nursing home patients (n = 5), were analyzed before, as well as after, training of the staff in integrity promoting care. A phenomenological-hermeneutic analysis was performed based on the Erikson theory of "eight stages of man" and musical notations were used for the analysis of courses of events. The analysis revealed five main patterns of interaction; positive, negative, intermediate, negative/intermediate turned into positive by the patient, and negative/intermediate turned into positive by the caregiver. Before the training, negative and intermediate patterns dominated (58%), while positive patterns dominated (84%) after the training. The positive patterns of interaction were characterized by the caregiver communicating with the patient as a competent partner, showing humanity, respect and support. The activity was carried out in intimacy. This led to the patient displaying more and more ability.

Baths↗
PubMed1977

Effects of communication about interpersonal process on the evolution of self-disclosure in dyads.

In an earlier investigation, like-sex partners in an acquaintance exercise were found to match their mean levels of intimacy. This "consensus" was achieved through the adoption of asymmetric roles, whereby one partner would consistently set the pace with respect to intimacy, and the other would reciprocate. It was proposed that such unilateral control of the dyad's evolution would be replaced by shared control if partners were encouraged to discuss the problem of how intimate to be with one another. As predicted, role asymmetry gave way to role symmetry when such communication took place. In addition, partners were able to match their mean levels of intimacy during the exercise without recourse to matching on a moment-to-moment basis. In place of a monotonic increase in intimacy, dyads followed a curvilinear course marked by an accelerated increase and a subsequent tapering off or decrease in intimacy level. The findings are discussed in relation to the more general question of how consensus is achieved in the social construction of an encounter or relationship.

Communication↗
PubMed1989

Knowledge of AIDS, use of condoms and results of counselling subjects with asymptomatic HIV2 infection in The Gambia.

A questionnaire administered to subjects seen during a serological survey in The Gambia revealed that knowledge of AIDS and HIV infection was limited. Males, those with a secondary education and people who lived in urban areas had a better understanding but only 17% of women seen in rural areas had any knowledge of the condition. Only 8% of the subjects seen had used condoms in the preceding 12 months; during this time half of them had done so on less than five occasions. Subjects with a secondary education were more likely to have used condoms. A counsellor met 31 asymptomatic seropositive subjects identified during this survey on two occasions. In the majority, the information given caused anxiety rather than modification of behaviour and, at the time of the second interview, only one subject had discussed the situation with the partner and begun using condoms. Some of the cultural factors which may affect the outcome of counselling in an African society are discussed in the light of these findings.

Acquired Immunodeficiency Syndrome↗
PubMed2004

The Development of Anticipatory Smiling.

When do infants begin to communicate positive affect about physical objects to their social partners? We examined developmental changes in the timing of smiles during episodes of initiating joint attention that involved an infant gazing between an object and a social partner. Twenty-six typically developing infants were observed at 8, 10, and 12 months during the Early Social-Communication Scales, a semistructured assessment for eliciting initiating joint attention and related behaviors. The proportion of infant smiling during initiating joint attention episodes did not change with age, but there was a change in the timing of the smiles. The likelihood of infants smiling at an object and then gazing at the experimenter while smiling (anticipatory smiling) increased between 8 and 10 months and remained stable between 10 and 12 months. The increase in the number of infants who smiled at an object and then made eye contact suggests a developing ability to communicate positive affect about an object.

Journal Article↗
PubMed1990

The combined oral contraceptive. A practical guide.

Prescribing the combined oral contraceptive pill is a rewarding combination of hands-on clinical medicine, logical therapeutics, prevention, and patient education. Lowest dose with the least side-effects is the overriding principle of prescribing. It is important to spend time teaching patients and partners how to manage their pill-taking and to be responsible for their medication and prevention follow up.

Adult↗
PubMed2001

Dealing with the risks of unwanted pregnancy and sexually transmitted infections among adolescents: some experiences from Kenya.

Studies have suggested the persistence of risky sexual practices among adolescents in Kenya but relatively less is known about the perceptions, norms and gender relations that govern the sexual behaviour of adolescent females and males, or the strategies they use to deal with the twin risks of unwanted pregnancy and STI/HIV infection. This study was, therefore, conducted to explore these issues through data drawn from 16 FGDs among 184 rural male and female adolescents aged 15-19 years in Makueni District of Eastern Kenya. Findings suggest that adolescents are quite aware of risky behaviours and the protective role of abstinence, faithfulness to one uninfected partner and condom use. However, adolescents face a number of obstacles in translating this knowledge into safer sex practices. Misinformation concerning ways to protect themselves abound. Both females and males report reticence in communicating about sexual matters and contraception with their partners. At the same time, they are reluctant to seek condoms in public places for fear of disclosure and reproach. Females face difficulties in negotiating safe sex, in reconciling the desire for condom use with norms demanding submissiveness and lack of assertiveness in contraceptive decision-making. Findings suggest the need for programs that promote communication skills among young male and especially female adolescents, and that seek to change masculine and feminine gender ideologies and redress gender double standards.

Adolescent↗