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PubMed1988

Treatment outcome of secondary orgasmic dysfunction: a two- to six-year follow-up.

Sixty-six women reporting secondary orgasmic dysfunction and their partners, who received one of five group treatment formats, were sent questionnaires 2-6 years later. Thirty-eight of the women and 38 of the male partners responded to the follow-up questionnaires. Women who were not divorced and who did not receive additional treatment after group treatment (n = 28) showed consistent increases across time in their ability to experience orgasm during intercourse, improving from a mean coital orgasmic frequency of 9.5% before treatment to 36.9% at long-term follow-up. Sexual harmony and coital frequency showed similar increases following treatment but had returned to near baseline levels 2-6 years later. Divorced women and women who received additional treatment (n = 10) demonstrated greater declines in sexual harmony over the follow-up period than did their untreated counterparts. The subjects reported generally favorable reactions to treatment and stressed the importance of a treatment focus on communication and relationship skills. Regression analyses suggested the predictive importance of variables associated with the male partner's functioning. The implications of the results for clinical practice and for future research are discussed.

Adult↗
PubMed2004

Does parental involvement predict new sexually transmitted diseases in female adolescents?

BACKGROUND: African American female adolescents living in low-income urban areas are at increased risk for sexually transmitted diseases. OBJECTIVE: To determine if high levels of perceived parental supervision and communication were associated with reduced gonorrhea (GC) and chlamydia (CT) incidence in low-income, African American, sexually experienced female adolescents, aged 14 to 19 years, attending urban health clinics. DESIGN: A prospective cohort study was used to determine the predictive value for high levels of parental supervision and communication on GC and CT infection in 158 adolescent females. Multiple logistic regression analysis explored the association between incident infection and perceived parental supervision and perceived parental communication while controlling for relevant demographic and behavioral factors (age, religious involvement, school enrollment, a 2-parent household, having a main sex partner, and having concurrent sex partners). RESULTS: When adjusted for age and baseline GC and CT infection, high levels of perceived parental supervision were associated with reduced GC and CT incidence (adjusted odds ratio, 0.06; 95% confidence interval, 0.01-0.31). High levels of perceived parental communication were not associated with reduced GC and CT incidence (adjusted odds ratio, 0.55; 95% confidence interval, 0.21-1.42). CONCLUSIONS: The link between parental supervision and disease acquisition is particularly valuable because it provides evidence that parental supervision can result in lower sexually transmitted disease rates in urban high-prevalence populations. This is important for interventions designed to increase parental involvement as a strategy for promoting protective sexual behaviors in female adolescents because it indicates that increased parental involvement can also influence subsequent disease acquisition.

Adolescent↗
PubMed2002

Communication, conflict, and commitment: insights on the foundations of relationship success from a national survey.

The key relationship dynamics of communication, conflict, and commitment were investigated using data from a randomly sampled, nationwide phone survey of adults in married, engaged, and cohabiting relationships. Findings on communication and conflict generally replicated those of studies using more indepth or objective measurement strategies. Negative interaction between partners was negatively associated with numerous measures of relationship quality and positively correlated with divorce potential (thinking or talking about divorce). Withdrawal during conflict by either or both partners, though quite common, was associated with more negativity and less positive connection in relationships. The most frequently reported issue that couples argue about in first marriages was money, and in re-marriages it was conflict about children. Overall, how couples argue was more related to divorce potential than was what they argue about, although couples who argue most about money tended to have higher levels of negative communication and conflict than other couples. Further, while the male divorce potential was more strongly linked to levels of negative interaction, the female was more strongly linked to lower positive connection in the relationship. Consistent with the commitment literature, higher reported commitment was associated with less alternative monitoring, less feeling trapped in the relationship, and greater relationship satisfaction.

Adult↗
PubMed1999

The impact of relational activities on HMO organizational outcomes.

OBJECTIVE: To report the findings of an empirical study of health maintenance organization (HMO) organizational outcomes and relational activities in HMO-pharmaceutical manufacturer relations. STUDY DESIGN: A mailed survey of a national random sample of 273 HMOs. SUBJECTS AND METHODS: Data were obtained from 111 HMOs regarding their inter-organizational relations with a pharmaceutical manufacturer. Respondents reported on 3 relational activities (initiating behavior, flexibility, bidirectional communication) and 4 HMO organizational outcomes (long-term orientation, equity in sharing costs and benefits, commitment between partners, financial performance). Also, 3 control variables were assessed: number of enrolled beneficiaries, HMO type, and estimated annual acquisition costs of pharmaceuticals. Four multiple regression analyses were performed, each with one organizational outcome variable as the dependent variable. Measures of relational activities and the control variables were the independent variables in the regressions. RESULTS: The response rate was 40.7%. All 3 relational activities showed significant associations with HMO organizational outcomes. Two relational activities (bidirectional communication, initiating behavior) showed significant and positive associations with a long-term orientation. Independent practice association (IPA)-model HMOs were less likely to report a long-term orientation toward a pharmaceutical manufacturer than other types of HMOs (adjusted R2 = 0.40). Bidirectional communication and flexibility were significantly and positively associated with the equity of costs and benefits (adjusted R2 = 0.29). Commitment had significant positive associations with all 3 relational activities (adjusted R2 = 0.50). All 3 relational activities had significant positive associations with financial performance. HMOs with an annual acquisition cost > $2 million were less likely to report favorable financial performance associated with a pharmaceutical manufacturer than were HMOs with lower costs (adjusted R2 = 0.42). CONCLUSION: Relational activities, such as initiating behavior, flexibility, and bidirectional communication, can facilitate positive outcomes for HMOs. It is important for all parties interested in healthcare to recognize that managing care creates a tension between achieving patient outcomes and organizational outcomes.

Communication↗
PubMed1992

The communication abilities of 2- to 4-year-old twins.

The speech and language abilities of pre-school multiple-birth children (MBC) are often reported to be impaired. In this study, teh syntactic, semantic, pragmatic, articulation and phonological skills of 19 sets of MBC were assessed. The comparisons made were between MBC and matched singleton controls, between siblings within multiple-birth sets, and for each multiple-birth child with different conversational partners (sibling versus speech and language therapist). The results indicated that the MBC performed more poorly than the singleton controls on measures of syntax and phonology. Whilst there were quantitative and qualitative similarities between siblings' linguistic abilities, their phonologies were not identical, and the MBC's speech and language changed with different conversational partners. The implications of the results for the existence of 'twin language', choice of language sample for assessment of functional communication and the need for preventive intervention programmes are discussed.

Child Language↗
PubMedDate not supplied

Developing management systems with cross-cultural fit: assessing international differences in operational systems.

Experiences in the Yunnan Maternal and Child Health Project, a 6-year CAN 6 million dollars bilateral initiative implemented in 10 counties (population 2.4 million) in Yunnan, China, are used to illustrate management approaches that successfully bridge cross-cultural differences in operational systems between donor and recipient countries. Donor institutions, local implementing agencies, and partner executing organizations each operate within specific assumptions about how governance structures, financial and administrative systems, human resource infrastructure, communications systems, and monitoring and reporting mechanisms function. These 'system domains' vary across cultures and countries, and become more evident as projects deal with capacity constraints, concerns about accountability, and rapid socioeconomic and political change during implementation. Management teams must be able to identify areas of poor fit among operational systems and respond appropriately. An assessment tool is offered, which management partners can use, as a basis for joint reflections on potential risks, identification of mitigation strategies, and establishing operational systems that are a fit for the funder as well as for partner agencies responsible for executing the project.

Canada↗
PubMed2000

Maintenance of safer sexual behaviours: evaluation of a theory-based intervention for HIV seropositive men with haemophilia and their female partners.

A theory-based HIV risk-reduction intervention was developed for HIV-positive men with haemophilia and their HIV-negative female romantic partners. The intervention was based on Prochaska and DiClemente's Transtheoretical Model which describes behaviour change as an incremental, stage-based process. The intervention targeted both communication about safer sex and safer sex behaviours (consistent condom use or abstinence from vaginal intercourse). A total of 255 males and 158 females from six funded haemophilia treatment centres or patient organizations (and 27 associated subsites) participated in the study. Baseline and follow-up (15 months after baseline) measures were administered to assess safer sexual behaviours, communication about safer sex and condom self-efficacy. A quasi-experimental, repeated measures design was utilized to compare two naturally occurring groups; those who received the full intervention package and those who received incomplete or no intervention components. Significant intervention effects for safer sex behaviours, communication about safer sex and condom self-efficacy were identified for the male participants, with those receiving the full intervention package demonstrating better outcomes at follow-up. Women who received the full intervention package were more likely to report the use of a condom by their male partner during the last act of vaginal intercourse.

Adult↗
PubMed2006

Predicting marital distress and dissolution: refining the two-factor hypothesis.

Measures of communication, hostility, and neuroticism taken from 85 couples from Germany before marriage were used to predict marital outcomes 5 years later. Hostility and neuroticism discriminated between couples who separated or divorced after 5 years and those who remained married, whereas communication discriminated between married-satisfied and married- dissatisfied couples. Only hostility and neuroticism predicted marital satisfaction at 18 months, suggesting that these factors contribute to rapid, early declines in marital functioning. The authors conclude that poor communication alone cannot account for the full range of marital outcomes and that skill-based models of marriage can be strengthened by considering relatively rare exchanges between partners (e.g., aggression) and their enduring vulnerabilities (e.g., neuroticism).

Communication↗
PubMed2001

Communication about prostate cancer between men and their wives.

OBJECTIVES: Metastatic prostate cancer is a serious disease that affects both men and their intimate partners. We explored the perceptions of men who have been treated for metastatic prostate cancer and the views of their wives regarding the changes that were caused by prostate cancer and its treatment. STUDY DESIGN: We conducted retrospective focus group interviews with married men and separate focus groups with their wives. POPULATION: Twenty married men (11 white and 9 African American) with an average age of 69 years (range=60-82 years) and 7 of the wives (5 white and 2 African American) participated in our study. Thirteen of the men were treated with orchiectomy, and 7 received monthly hormone ablation therapy. OUTCOMES MEASURED: We compared the accounts of husbands and wives concerning the diagnosis and treatment of prostate cancer. RESULTS: The participants' accounts indicate little spousal communication about the implications of prostate cancer on their lives. In particular, couples appear to talk little about their emotions, worries, and fears. CONCLUSIONS: Although wives have a profound interest in their husbands' prostate cancer, actual communication about the disease, its treatment, and the feelings it evokes may be less than we believe. Noncommunication in marriages might indicate that these couples are at increased risk for poor adjustment to prostrate cancer.

Adaptation, Psychological↗
PubMed1999

Avoiding unwanted pregnancy--the role of communication, information and knowledge in the use of contraception among young Norwegian women.

Despite relatively easy access to contraceptives, a liberal attitude to pregnancies out of wedlock and a widespread family planning education in schools, too a high number of adolescent women in Oslo, the capital of Norway, become pregnant and resort to abortions. The aim of this study was to identify some new entry points to sexuality, contraceptive, abortion and post-abortion counselling. Using a qualitative approach, we interviewed 102 young women in Oslo who were seeking either an abortion or contraceptives. The study demonstrated that contraceptive awareness is good, but that there are different levels of consistency in contraceptive use among women, and that even women with few partners and fairly good contraceptive compliance sometimes experience unplanned pregnancy. The study reviews some issues of importance where communication with young women could be improved. These issues include better formal information about OCs, increased information on emergency contraception, better condom promotion, and an attempt to involve better informed adults, including paramedical professional counselling. In addition, contraceptive prescriptions should accord to the type of behaviour and the relationships the young women have.

Adolescent↗
PubMed1990

Affect and attention in children with Down syndrome.

The association of the affective responsiveness and attention regulation with communication and language skills of children with Down syndrome was examined. Results both replicate and extend previous research on the attentional and affective characteristics of children with Down syndrome. These children tended to look more often to the face of the social partner but less often to nonfocal toys. They also tended to shift affect expressions more frequently but did not differ from MA-matched nonretarded children in overall durations of affect. The association of these variables with communication and language indicated that the more positive affect displayed toward people and the shorter the average looks to the partner's face, the higher the verbal language skills of young children with Down syndrome.

Affect↗
PubMed2000

E-mail communication between medical students and schoolchildren: A model for medical education.

OBJECTIVE: To examine e-mail communication between student physicians and schoolchildren, in the context of a school-based tobacco prevention program, as a way to teach communication skills and model physician-patient interactions. DESIGN: Twenty medical students and pediatric residents were partnered with groups of children as part of HealthQuest, a tobacco prevention program implemented in 2 kindergarten through grade 12 Vermont schools. Medical students and residents acted as mentors for their group and provided support to the schoolchildren through e-mail and occasional site visits. E-mail messages were transmitted and stored in a Web server and monitored by preceptors. Content analysis of the messages was performed to identify emerging themes. RESULTS: During the 2-year intervention period, 1187 messages were exchanged between children, teachers, and the student physicians. Thirty-two percent (n = 383) of the messages involved tobacco, of which 54% addressed health effects; 23% were related to social influences of tobacco use, 15% to cessation by parents and others, and 7% to cessation by students. Other categories included nontobacco health issues (n = 135), personal questions (n = 294), and classroom information (n = 735). Many inquiries required medical students and residents to research their answers, and several required collaboration with preceptors, because the questions raised serious medical or psychosocial issues. With feedback, medical students and residents adjusted their responses so that they were appropriate for the developmental level of the children. CONCLUSIONS: The e-mail component of this program provided important learning opportunities for student physicians in tobacco control, child development, communication skills, and developing a physician-patient relationship. This model also offers potential benefits for medically underserved pediatric populations. Arch Pediatr Adolesc Med. 2000;154:1258-1262.

Child↗
PubMed2005

[Interaction patterns in male and female suicide attempters].

UNLABELLED: The present study aimed to assess the interaction dynamics of suicidal patients' close relationships using the Consensus Rorschach method. Our sample consisted of 24 male and 8 female patients and their spouses as well as 30 control couples. We have analysed the couples' behavior in situations where communication difficulties ("communication crisis") have arisen, comparing communication of female and male patients to controls. Results have shown that couples with suicide history expressed more passive and passive emotional messages, with evident signs of problem solving difficulties. Male patients frequently expressed helplessness, while female patients showed poor emotional control. CONCLUSIONS: difficulties in communication and conflict management as well as lack of empathy and perspective taking observed in the relationships of these couples can be explained by disturbances in the bonding process (probably both in patients and partners); which indicates the need for individual and family therapy.

Adaptation, Psychological↗
PubMed1984

The helping process in couples.

This study examined couples' informal helping interactions, that is, how partners helped each other with their psychological problems. Fifty-three couples participated in a communication sampling task in which they took each of two roles, discloser and helper (analogous to client and therapist). Audiotapes of the interactions were subsequently categorized according to helper response modes and rated on global measures of problem solving, understanding, and supportiveness. The most frequent helper response modes were question, advisement, and interpretation; reflection was infrequently used. There were no differences in helping communication associated with gender or sex-role self-concept. The important characteristic of the helpers' communication was not the type of response used, but the evaluative quality of the response. Helpers who were more satisfied with their relationships tended to be more understanding and supportive. Also, interactions rated as more understanding and supportive tended to be experienced as more helpful by the disclosers.

Adult↗
PubMed1995

The Rehabilitation Activities Profile: a validation study of its use as a disability index with stroke patients.

OBJECTIVE: This study evaluates the criterion, content, and construct validity of the Rehabilitation Activities Profile (RAP) in patients with stroke. This instrument is constructed for screening, monitoring, and prognosis purposes to assist clinical rehabilitation. It consists of 21 activities, covering the domains communication, mobility, personal care, occupation, and relationships. Disabilities and perceived problems are assessed in parallel on two four-point severity scales. The disability sum scores of the first four RAP domains were used in the analyses presented in this article. DESIGN: An inception cohort of stroke patients was studied during 26 weeks. Patients that were still hospitalized on the 14th day after stroke were included. The functional assessments took place 2, 3, 4, 8, 12, and 26 weeks after stroke. SETTING: The patients were visited at the hospital, at home, nursing home, or rehabilitation center. PATIENTS: 125 patients were included in the study. After 26 weeks, 105 patients were still alive; 18 patients had died, and 2 patients were lost to follow-up. MAIN OUTCOME MEASURES: The RAP, Barthel Index (BI) and Frenchay Activities Index (FAI). RESULTS: The domain "mobility+personal care" correlated highly with the BI score (r: 0.87 to 0.90). The domain "occupation" correlated with the FAI score before the stroke and 26 weeks after stroke (r: 0.72, 0.73, respectively). The disability sum score of the domain "mobility+personal care" allowed a prediction of the living arrangement 26 weeks after stroke (receiver operator characteristic area surface: 0.90). The same domain showed significant differences (p < 0.05) in the 8-week disability sum score for most living arrangements. Exceptions were rehabilitation center versus intermediate care in a nursing home (p = 0.23) and acute care hospital versus chronic care in a nursing home (p = 0.45). Hypotheses on subgroup differences in mean scores in the domains "communication" and "mobility+personal care" could be confirmed (the discerned subgroups were: gender, having a partner, motor deficit of upper or lower extremity, urinary incontinence, higher cortical deficits, conjugate deviation of the eye, coma, hemianopsia). CONCLUSION: The disability sum scores of the RAP can be used as discriminative, evaluative, and predictive indexes.

Aged↗
PubMed2003

Molecular and phylogenetic characterization of Zyx102, a Drosophila orthologue of the zyxin family that interacts with Drosophila Enabled.

Adherens junctions, which are cadherin-mediated junctions between cells, and focal adhesions, which are integrin-mediated junctions between cells and the extracellular matrix, are protein complexes that link the actin cytoskeleton to the plasma membrane and, in turn, to the extracellular environment. Zyxin is a LIM domain protein that is found in vertebrate adherens junctions and focal adhesions. Zyxin's molecular architecture and binding partner repertoire suggest roles in actin assembly and dynamics, cell motility, and nuclear-cytoplasmic communication. In order to study the function of zyxin in development, we have identified a zyxin orthologue in Drosophila melanogaster that we have termed Zyx102. Like its vertebrate counterparts, Zyx102 displays three carboxy-terminal LIM domains, a potential nuclear export signal, and three proline-rich motifs, one of which matches the consensus for mediating an interaction with Ena/VASP (Drosophila Enabled/Vasodilator-stimulated phosphoprotein) proteins. Here we show that Zyx102 and Enabled (Ena), the Drosophila member of the Ena/VASP family, can interact specifically in vitro and that this interaction does not occur when a particular mutant form of Ena, encoded by the lethal ena210 allele, is used. Lastly, we show that the zyx102 gene and Drosophila Ena are co-expressed during oogenesis and early embryogenesis, indicating that the two proteins may be able to interact during the development of the Drosophila egg chamber and early embryo.

Alternative Splicing↗