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PubMedDate not supplied

Office staff savvy: quality staff-patient communications as a loss prevention strategy.

Based on the prevalence of medical error that continues to make headlines, you would think that physicians are so busy defending medical malpractice lawsuits that they don't have time to practice medicine. Although many physicians may feel like this, in fact, it is not the case. Contrary to what the media would have you believing, it is not "the conspiracy of silence" that's keeping physicians out of court. It's good, old-fashioned effective communication: courtesy, empathy, friendliness, and professionalism. Because the complexity of health care delivery imposes ever-greater demands on physicians' time, medical office staff play a larger-than-ever role in defining the tenor of physician-patient relationships. It has become incumbent on staff to become the physicians' partners in effectuating patient relationships built on quality communications. This article will discuss ways in which office staff can utilize effective communications to improve physician-patient relationships, thereby reducing professional liability exposures.

Communication↗

PubMed1992

Safe sex and women.

OBJECTIVE: Sexual behaviour, condom use, HIV knowledge and anxiety for women were examined to understand the range of sexual behaviours, predictors of safer sex and the extent of relapse. DESIGN: A cross sectional sample of women STD clinic attenders completed interviews and questionnaires. SETTING: Central London STD Clinic. SUBJECTS: 153 women drawn from consecutive attenders at a sexually transmitted disease (STD) clinic in inner London. RESULTS: A quarter of the sample had never responded to safe sex and a further 14% had been unable to maintain it over time. Anxiety and knowledge did not differ between safe and relapsed groups, but self efficacy and cognitive variables did. Those who maintained safe sex had significantly less sex. Ten percent of the sample had unprotected anal intercourse. Most women saw themselves in longer term relationships, yet a quarter had sex outside of the relationship and a fifth stated that their partners also did. HIV information gathering was passive and 74% felt they could not protect themselves against infection. High concern over HIV was monitored. Condom uptake was low and non-existent for anal intercourse. 25% had undergone HIV testing. These women did not differ significantly in terms of their behaviour from the untested women. CONCLUSIONS: HIV risks for women are a source of anxiety and tailored intervention is needed to reduce risk and promote dialogue and negotiation.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Determinants of condom use among young people in urban Cameroon.

To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people's perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents' self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly.

Adolescent↗

PubMed2002

Preparedness on the frontline: what's law got to do with it?

The article provides an overview of current work toward identifying core competencies for public health emergency and bio-terrorism response, including law-related competencies. It demonstrates how competency sets are interrelated and how they provide a framework for developing preparedness training for public health leaders, public health and health care professionals, law enforcement, public health attorneys, and others. The health and safety of America's communities hinge on the nation's public health workforce--the estimated 448,254 public health professionals and 3 million related workforce professionals who form the expanded public health system that protects us during times of national crisis and in our daily lives. The response capacity of our health agencies and communities and their ability to respond effectively will be unpredictable without adequate training. Education in the core competencies in emergency preparedness and bio-terrorism response is essential. Preparedness at the front-line means that public health leaders and administrators must be able to communicate information, roles, capacities, and legal authorities to all emergency response partners during planning, drills, and actual emergencies. Each public health worker must be able to describe his or her communication role in emergency response within the agency, with the media, and with the general public. Law enforcement and state government representatives must understand the legal powers of their agencies and of public health agencies for coordinated response, mitigation, and recovery efforts in a public health emergency event.

Biological Warfare↗

PubMed2005

Organization and staffing barriers to parent involvement in teen pregnancy prevention programs: challenges for community partnerships.

PURPOSE: To evaluate parent involvement in a Southern California teen pregnancy prevention community partnership project. Researchers expected to find parent and family-related participation barriers similar to those described in the family support literature, which they could address with program modifications. METHODS: Three phases of qualitative evaluation occurred: key informant interviews and focus groups with youth and parents; focus groups with service providers; and key informant interviews with service providers, their supervisor, and the collaborative coordinator. Theory-based, open-ended question guides directed the interviews and focus groups, and transcriptions were coded and themed using grounded theory methods. RESULTS: Parents and youth sought ways to improve connections and communication with each other, and parents welcomed parenting education from the project. Unexpectedly, the major obstacles to parent participation identified in this project were largely organizational, and included the assignment of parent involvement tasks to agencies lacking capacities to work effectively with parents, inadequate administrative support for staff, and the absence of an effective system for communicating concerns and resolving conflicts among collaborative partners. CONCLUSIONS: Youth serving agencies may not be the best partners to implement effective parent involvement or family support interventions. Collaborative leadership must identify appropriate partners, engender their cooperation, and support their staff to further the overall goals of the collaborative.

Adolescent↗

PubMedDate not supplied

Human proteomic databases: a powerful resource for functional genomics in health and disease.

Decoding of the genome information in terms of regulation and function will be the next great challenge in the life sciences in this millennium and indeed, today we are experiencing a rapid explosion of technology for the high throughput expression analysis of genes and their products (functional genomics). In particular, the field of proteomics is booming as proteins are often the functional molecules and represent important targets for the pharmaceutical industry. The proteomic technology is complex, and comprises a plethora of state-of-the-art techniques to resolve, identify and detect their interacting partners, as well as to store and communicate protein information in comprehensive two-dimensional polyacrylamide gel electrophoresis (2D PAGE) databases. Besides annotating the genome, these databases will offer a global approach to the study of gene expression both in health and disease. Here, we review the current status of human 2D PAGE databases that we are systematically constructing for the study of bladder cancer and skin ageing.

Databases, Protein↗

PubMed2005

The possessive self as a barrier to conflict resolution: effects of mere ownership, process accountability, and self-concept clarity on competitive cognitions and behavior.

The authors propose that people have difficulty managing conflict because they quickly develop ownership of arguments and positions they use in the dispute, that these arguments and positions become part of their (extended) self-concept, and that any opposition or counterargumentation therefore becomes an ego-threat. Four studies reveal that individuals value arguments and beliefs more when these are associated with the self and that anticipated or real opposition triggers ego-defensive cognition and behavior, including competitive communication, retaliatory responses, negative perceptions of the partner, and attitude polarization. These effects were weaker when epistemic needs were raised through process accountability or when individuals had high rather than low self-concept clarity. The authors conclude that because people develop ownership of arguments and make these part of their self-concept, conflict is difficult to manage and bound to escalate.

Adaptation, Psychological↗

PubMed2002

[Patient countersigned referral letters in schizophrenic disorders].

OBJECTIVE: Our aim was to discuss referral letters with psychotic patients and to assess patients views about this proceeding and about the letters. Also patients knowledge of their diagnosis was assessed. METHODS: The day after discussing the letter 80 patients were evaluated with a short questionnaire. RESULTS: 92 % of patients responded very positively to the discussion of the referral letter. Many patients appreciated the transparency and information and stated, that it improved the understanding of the illness and the doctor-patient-relationship. The day of hospital discharge 96 % of patients were able to name the exact diagnosis or an adequate replacement. CONCLUSIONS: Our results show, that the majority of psychotic patients - in contrast to previous experiences - responded very favourably to the referral letters, probably because they not only received the letter but also discussed the letter with their doctor and had the opportunity to correct false details before discharge. The encouragement of communication, the acceptance of patients as equal partners and the improvement of information, empower patients as active partners in care, which improves the course of the disease. Therefore patients should have the possibility to discuss the referral letter with their doctor.

Adaptation, Psychological↗

PubMed2005

Correlates of perceived difficulty in potentially disclosing HIV-positive test results: a study of low-income women attending an urban clinic.

BACKGROUND: The study identified correlates of women's perception that testing positive for HIV would be very difficult to communicate to friends, family members and sex partners. We also determined whether perceived disclosure difficulty was associated with HIV-testing intent. METHODS: Face-to-face interviews were conducted with 143 women attending an urgent care centre in Atlanta, Georgia. The centre served primarily low-income or indigent African-American women. A three-item scale (alpha = 0.81) assessed disclosure difficulty. Assessed correlates included selected social/contextual factors and intrapersonal factors. RESULTS: In controlled multivariate analyses, only the social/contextual factors were associated with HIV disclosure difficulty. Women perceiving an inability to cope with positive results were more likely to report high disclosure difficulty (P = 0.01). Women perceiving an inadequate support system and those believing that HIV would substantially complicate their lives were more likely to anticipate high disclosure difficulty (P = 0.006 and P = 0.03, respectively). Disclosure difficulty was not associated with intent for HIV-testing 'today' (P = 0.50) or within the next 12 months (P = 0.27). CONCLUSION: Findings provide initial evidence suggesting that selected social/contextual factors rather than intrapersonal factors are associated with anticipated disclosure difficulty of HIV-positive test results among low-income minority women, residing in the urban south. High levels of anticipated disclosure difficulty may not preclude HIV test acceptance.

AIDS Serodiagnosis↗

PubMed1988

Intimacy disorders and sexual panic states.

This paper explores the question: Is sexual avoidance a manifestation of intrapsychic barriers to emotional closeness? In some cases it clearly is, but in other cases it is the result of other determinants such as a partner's excessive demands for intimacy and communication and his or her intolerance for even normal emotional distance. Our finding that couples with this dynamic and with sexual aversions have an unusually high prevalence of panic disorder is considered in the light of its clinical implications.

Conflict, Psychological↗

PubMed2004

Attachment styles and violence within couples.

This study examined whether an individual's attachment style and/or a couple's combination of attachment styles predicted violence within the marriage and explored whether other variables moderated the risk of violence. Measures of attachment style were administered to 41 discordant couples who presented to four different clinics. The couples' presenting complaints were not violence, and those who did report violence on questioning did not manifest severe violence, i.e., requiring shelters or legal intervention. Self-report measures of violence and marital satisfaction, including problem-solving communication, were also given. Using analysis of covariance and logistic regression, the relative contributions to strength of predicting being a victim of conjugal violence were calculated. An anxious attachment style was a significant predictor of females being victims of violence and of men not being victims. A dismissive style in men was predictive of men being victims when entered into the model with problem solving communication. The combination of anxiously attached females and dismissive males was a potent predictor of violence, and longer duration of marriage and poor problem-solving communication added power to the prediction. Marital interaction, which is influenced by couples' attachment styles and problem-solving communication, is a significant factor in marital partners experiencing physical violence. For couples with milder levels of violence, a more nuanced approach (compared with the legally based approach used for severe violence) seems indicated.

Adult↗

PubMed1995

Barriers to condom use among women attending planned parenthood clinics.

Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's Perception, Peer's Perception, Pleasure/Intimacy, Communication, and Low Perceived Need. Multivariate analyses revealed significant group differences on only two barrier factors: Pleasure/Intimacy and Low Perceived Need. Low Perceived Need accounted for 13.5% of the variance in condom use. Women with low perceived need to use condoms were more likely to use oral contraceptives.

Adolescent↗

PubMed2001

Communicable disease epidemiology training in Northern Europe.

The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have a long tradition of collaboration in communicable disease epidemiology and control. The state epidemiologists and the immunisation programme managers have met regularly to discuss common challenges and exchange experiences in surveillance and control of communicable diseases. After the three Baltic countries (Estonia, Latvia and Lithuania) regained independence in 1991 and the Soviet Union dissolved, contacts were made across the old iron curtain in several areas, such as culture, education, business, military and medicine. Each of the Nordic communicable disease surveillance institutes started projects with partners in Estonia, Latvia, Lithuania or the Russian Federation. The projects were in such diverse areas as HIV surveillance and prevention, vaccination programmes and antibiotic resistance.

Curriculum↗

PubMed2000

[Multi-morbidity as a responsibility: 1,000 illnesses--one health. The physician's image 200].

The prototype physician 2000 A.D. will have to be able to recognise multimorbidity and its individual importance in a general medical and social sense. There will be a specifically challenge in the fields of individual prophylaxis, interdisciplinary communication, integration of all nursing and treating partners and the ethical judgement between individually useful and theoretically possible treatment options. Medical education and social systems will have to provide enough knowledge and skills as well as opportunities to allow this necessary development of our future physicians 2000 A.D.

Austria↗

PubMed1989

Proteolytic control over formation of enzymic complexes of the mitochondrial inner membrane.

Assembly of enzymic complexes of the mitochondrial inner membrane is an intricate process involving import of protein precursors from the cytosol and from the mitochondrial matrix, proteolytic processing of the precursors, covalent and noncovalent attachment of prosthetic groups to apoproteins, diffusion of proteins in the membrane in search of their partners, etc. The aim of the present communication is to draw attention to that, concurrent with all these events, proteolysis of mitochondrial inner membrane proteins occurs, which in some cases is rapid and can play a prominent part in correcting polypeptide compartmentation, subunit stoichiometry in complexes, overall amounts of proteins and mutual arrangement of complexes in the membrane.

Biological Transport↗

PubMed1998

Communicative competence as perceived by adults with severe speech impairments associated with cerebral palsy.

The effects of aided message length (single-word vs. phrase-generated messages) and partner feedback (presence vs. absence of expanded message repetitions) on perceptions of the communicative competence of an adult augmentative and alternative communication (AAC) system user were examined. Subjects consisted of 12 nonambulatory adults with severe speech impairments associated with cerebral palsy. Four scripted videotaped conversational conditions involving the AAC system user and a typically speaking partner were employed to manipulate the two independent variables. A balanced incomplete block design was used. Following each viewing, subjects completed a questionnaire designed to assess the communicative competence of the AAC system user. Results indicated that neither independent variable had an impact on the subjects' ratings of communicative competence. Findings are compared with those from an earlier investigation, and clinical implications are discussed.

Adult↗

PubMed1994

Communication among preschoolers with and without disabilities in same-age and mixed-age classes.

Communicative interactions of preschool children with and without disabilities in classrooms of same or mixed ages were compared. Sixteen children with developmental disabilities (most with mild or moderate mental retardation) and 32 children without disabilities between 1.5 and 4.5 years of age were randomly assigned at the beginning of the school year to either a same- or mixed-age grouping of 6 children. They were observed 6 months later interacting with classmates in a standard free-play environment. Results showed that children in mixed-age classes took more turns in conversations with partners with disabilities than did children in same-age classrooms. They also received more turns from their partners with disabilities, which were more often responses than initiations in the mixed-age as compared to same-age classes. In contrast, during communicative interactions with partners without disabilities, children in both types of classes did not significantly differ in number or types of turns. Children of a similar developmental level also had similar communicative interaction styles.

Age Factors↗

PubMed1975

Alcohol's effect on some formal aspects of verbal social communication.

The effects of alcohol on formal aspects of social communication were studied by scoring transcripts of verbal discussions between dyads in alcohol and placebo sessions. At a low dose (3.83 to 1.0 ml/kg), alcohol significantly (P Less than .01) increased the amount of and overlap in communications, and tended to decrease subjects' acknowledgement of their partners' statements. At a high dose (1.5 ml/kg), the rate of overlap in speech was additionally increased, but there was a leveling off or reversal of the drug's effect on amount of communication. The subjects' blood alcohol levels were not related to the drug's effect.

Adult↗