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PubMed2005

Sex and relationships for HIV positive women since HAART: a quantitative study.

OBJECTIVE: To investigate current levels of sexual activity, enjoyment, condom use, and other factors affecting sexual behaviour in a sample of women living with HIV. METHOD: Participants were self selected. A cross sectional design using semi-structured questionnaires was employed. 82 HIV positive women completed questionnaires asking about demographics, relationships, sexual behaviour, and safer sex practices. The Hospital Anxiety and Depression Scale (HADS) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were administered. RESULTS: 28% of women had had no sexual partners since diagnosis. Mean time diagnosed was 69 months, range 4-191 months. Time since diagnosis was not associated with having had a sexual partner. 59% of women had a current sexual partner, half reporting intercourse in the past month. Infrequent sex (84%), avoidance (84%), non-communication (69%), and dysfunction (60%) were among the most prevalent sexual difficulties. Endorsement of HIV impaired sexual enjoyment was associated with reduced sexual frequency (p = 0.006) and sexual dysfunction (p = 0.042). Sexual dissatisfaction was associated with infrequency of sex (p = 0.037), avoidance (p = 0.02), and non-communication (p = 0.032). Clinically significant levels of anxiety and depression were reported in 60% and 38% of cases, respectively. Depression was associated with avoidance of sex and higher total GRISS scores (p = 0.006 and p = 0.042). 60% of respondents stated that they "always" used condoms; a trend was observed between reduced condom use and higher levels of depression and anxiety (p = 0.09 and p = 0.06, respectively). CONCLUSION: Sexual difficulties, including abstinence, were prevalent in this sample indicating the potential for interventions addressing the psychosexual needs of HIV positive women and their partners.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Optical communication aids in rehabilitation.

Two types of low-cost optical communication aids for non-vocal paralyzed patients are described: one based on reflection via mirrors and the other based on refraction via prisms. The recognition by the partner, when the handicapped person looks straight via the mirror/prism into his eyes, is crucial in the selection of the corresponding symbol in this communication process. The configurations in which the mirrors/prisms are arranged in aids of one- or two-dimensions, respectively. Preceding the choice of an advanced eye-controlled aid, eye defects can be detected using two-dimensional aids. Both types of optical communicators have been used in rehabilitation. The prism-aids appeared to be preferable to mirror-devices and to ETRAN-window in the communication process for speech replacement or in playing simple games.

Communication Devices for People with Disabilities↗
PubMed2005

[Psychosocial characteristics of deaf people: evaluation of data from a special outpatient clinic for the deaf].

In this publication, data from a special outpatient clinic for deaf patients in a general hospital are presented. All members of the treatment team have competency in sign language. From the patients who consecutively attended the outpatient clinic, 352 were investigated for medical and psychosocial problems. In social contacts, there is a strong orientation towards other deaf people, and communication is mainly based on sign language. Of the deaf patients, 85% of their partners are also deaf, whereas only 10.1% of children of the deaf group are also deaf. The prevalence of selected psychiatric disorders (ICD 10 F1, F2, F3, F4, F6) in deaf people was found to be similar to that in hearing populations, with the exception of somatoform disorders, which seem to be more frequent in the deaf. Deaf people also more often present with somatic and other complaints such as nervousness, anxiety, and stress. With specific outpatient clinics for the deaf in which members of the therapeutic team are competent in sign language, access to health services is equally possible for deaf people.

Adolescent↗
PubMed1979

[The epidemiology of breast neoplasms].

In an epidemiologic study the risks of breast cancer were assessed. An evaluation of the distribution of different tumor stages revealed that more information, in a larger sense more civilization, workship and the life in town makes women more curious and brings them to go sooner to the doctor. A lack of information correlates with more advanced stage of tumor. Significantly more childless women suffer of breast cancer, but a high number of children is no protection. In women with 3 and more children yet more advanced stages were seen. This may be interpreted by isolation, lack of information and distress. A significantly high number of breast cancer patients lost one of their parents by death before the age of 20, which confirms the psychosomatic theory of cancerogenesis (overcoming of the "Objektverlust" in early childhood). The incidence of depressive states before the onset of the disease is significantly higher. A reduced capacity to communicate was also observed. The exploration of sexual behaviour showed more frequently a reduced sexual activity correlated to cohabitarche, number of partners, alibidimia, unwanted pregnancy and masturbation. The ability of adequate sexual life was deeply disturbed by disease and therapy. Following primary therapy intelligent guidance of the patient may avoid occurrence of disturbances of sexual communication.

Breast Neoplasms↗
PubMed2006

Improving nursing practice and patient care: building capacity with appreciative inquiry.

Appreciative inquiry is a philosophy and methodology for promoting positive organizational change. Nursing leaders at 6 community hospitals are partnering with the authors on a project that uses appreciative inquiry to improve communication and collaboration, to increase nurse involvement in decision making, and to enhance cultural awareness and sensitivity. In this article, the authors describe appreciative inquiry, how hospitals are using it, and the initial lessons learned.

Communication↗
PubMedDate not supplied

The context of condom nonuse among older adolescents and young adults.

This exploratory-descriptive study examined the context of condom nonuse among older adolescents and young adults. The convenience sample consisted of 23 freshman university students (18 to 20 years of age) in a rural state. Participants were asked to describe situations when condoms were not used. The responses were content-analyzed using an inductive process. Descriptions (n = 86) were identified and analyzed for common themes. The seven themes were assessment of risks, location and timing of sexual experience, extraneous events, communication about condoms, feelings of the moment, contraceptive responsibility, and relationships between sexual partners. The findings suggest strategies to promote condom use when working with older adolescents and young adults.

Adolescent↗
PubMedDate not supplied

Emerging infections: getting ahead of the curve.

The early history of infectious diseases was characterized by sudden, unpredictable outbreaks, frequently of epidemic proportion. Scientific advances in the late 19th and early 20th centuries resulted in the prevention and control of many infectious diseases, particularly in industrialized nations. Despite these improvements in health, outbreaks of infectious disease continue to occur, and new infections emerge. Since 1987, the National Academy of Science's Institute of Medicine (IOM) has published three reports that have identified erosion of the public health infrastructure among the factors contributing to new and reemerging infectious diseases. In partnership with many public and private organizations in the United States and abroad, the Centers for Disease Control and Prevention (CDC) has developed a strategic plan that addresses the priorities set forth in the IOM reports and serves as a guide for CDC and its partners to combat emerging microbial threats to health. Laboratory-based surveillance, better communication networks, and improvements in the public health infrastructure are the cornerstones of the strategy. Emerging Infectious Diseases, a new periodical produced by CDC, will serve as a forum for exchange of information about incipient trends in infectious diseases, analysis of factors contributing to disease emergence, and development and implementation of prevention measures.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

[Problem based learning by distance education and analysis of a training system].

This article presents and analyses a training system aiming at acquiring skills in nursing cares. The aims followed are the development: --of an active pedagogic method: learning through problems (LTP); --of the interdisciplinary and intercultural approach, the same problems being solves by students from different disciplines and cultures; --of the use of the new technologies of information and communication (NTIC) so as to enable a maximal "distance" cooperation between the various partners of the project. The analysis of the system shows that the pedagogic aims followed by LTP are reached. The pluridisciplinary and pluricultural approach, to be optimal, requires great coordination between the partners, balance between the groups of students from different countries and disciplines, training and support from the tutors in the use of the distance teaching platform.

Attitude of Health Personnel↗
PubMed2005

Men's decision-making about predictive BRCA1/2 testing: the role of family.

Men who have a family history of breast and/or ovarian cancer may be offered a predictive genetic test to determine whether or not they carry the family specific BRCA1/2 mutation. Male carriers may be at increased risk of breast and prostate cancers. Relatively little is known about at-risk men's decision-making about BRCA1/2 testing. This qualitative study explores the influences on male patients' genetic test decisions. Twenty-nine in-depth interviews were undertaken with both carrier and noncarrier men and immediate family members (17 male patients, 8 female partners, and 4 adult children). These explored family members' experiences of cancer and genetic testing, decision-making about testing, family support, communication of test results within the family, risk perception and risk management. Implicit influences on men's testing decisions such as familial obligations are examined. The extent to which other family members--partners and adult children--were involved in testing decisions is also described. It is demonstrated that mothers of potential mutation carriers not only perceive themselves as having a right to be involved in making this decision, but also were perceived by their male partners as having a legitimate role to play in decision-making. There was evidence that (adult) children were excluded from the decision-making, and some expressed resentment about this. The implications of these findings for the practice of genetic counseling are discussed.

Attitude↗
PubMed2001

Mother-infant responsiveness: timing, mutual regulation, and interactional context.

Mutual regulation during the naturalistic interaction of 150 mothers and their 4-month-old infants was investigated from a dynamic systems perspective. Microanalyses of a wide range of behaviors and analysis of contingencies indicated that a 3-s time period best captured contingencies. Both mothers and infants communicated primarily through vocal signals and responses, although maternal touches and infant looks also elicited responses. Although more expressive mothers did not have infants who behaved similarly, levels of contingent responsiveness between partners were significantly associated and occurred within distinct behavioral channels, suggesting coregulated interactional processes in which contingently responsive mothers shape their infants' communications toward mutual similarity. Mothers were more influential than infants over object play, whereas infants were more influential than mothers over expressive behavior. Interactional context consistently influenced contingent responsiveness; there was less mutual responsiveness when the infant was exploring, being held, or looking.

Adolescent↗
PubMed2004

Joint attention and children with autism: a review of the literature.

Preverbal communication and joint attention have long been of interest to researchers and practitioners. Both attending to social partners and sharing attentional focus between objects or events and others precede the onset of a child's first lexicon. In addition, these prelinguistic acts also appear to have important implications with regard to learning to socialize. The construct of joint attention has been noted as an early developing area prior to the transition to symbolic communication. Thus, the importance of joint attention in typically developing children, and the lack thereof in children with autism, has interested researchers for use in diagnosis and intervention for autism. That is, joint attention has been gaining momentum as an area that not only helps characterize children with autism, but also as a prognostic indicator and a potential intervention goal. In this paper, the status of the literature about initiation of joint attention by young typically developing children and young children with autism was examined. Empirical studies regarding joint attention behaviors, including eye gaze alternation, the use of protodeclaratives and protoimperatives, and studies that investigated joint attention as a predictor of language acquisition were reviewed. Possible areas for future research for children with autism are discussed.

Attention↗
PubMed2000

Technology evaluation of a USA-Mexico health information system for epidemiological surveillance of Mexican migrant workers.

From 1994 through 1996, federal, state, and nongovernmental organizations in Mexico and in the United States of America developed and piloted a Binational Health Information System for Epidemiological Surveillance of Mexican migrant workers. The system allowed data exchange for epidemiological surveillance between the state of Guanajuato in Mexico and the Commonwealth (state) of Pennsylvania in the United States, for case detection, prevention, and treatment, through shared contact investigation and case management of communicable diseases. The target population consisted of migrant workers traveling between Guanajuato and Pennsylvania to work mainly in the mushroom industry, and their sexual partners in their Mexican communities of origin. Computerized migrant health information modules were set up in Guanajuato and in Pennsylvania. Patient information and epidemiological surveillance data were encrypted and communicated electronically between the modules, using the WONDER communications system of the U.S. Centers for Disease Control and Prevention. Evaluation of the Guanajuato-Pennsylvania Binational Health Information System showed that major barriers to binational epidemiological surveillance and control are: a) lack of communication binationally; b) interrupted medical care due to migration; c) inconsistent diagnosis and treatment criteria between the two countries; d) lack of referral clinical records from one country to the other; and e) deficient legal regulations concerning binational clinical data transfer. To our knowledge, this is the first project that has successfully demonstrated the technological feasibility of a binational disease control system linking a state in the interior of one country with a state in the interior of another country, rather than just states in the border region. The project also advanced the understanding of health service organizational issues that facilitate or hinder communication, outreach, disease prevention, and organization of health care services for migrant workers in both Mexico and the United States. Despite the unprecedented success and potential bilateral benefits demonstrated by this project, serious structural and organizational deficits in the public health systems of both countries must be addressed before epidemiological surveillance can be achieved binationally.

Information Systems↗