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PubMed2006

Why worry? Worry, risk perceptions, and willingness to act to reduce medical errors.

Through the domain of medical errors, the role of worry and perceived risk in precautionary behaviors was examined in a convenience sample (N = 195, mean age = 42 years, 71% female). Worry was linked to fatality estimates. A model of the antecedents and consequences of worry also was tested. Risk characteristics such as dread and preventability, negative reactivity, and vulnerability to medical errors appeared to motivate worry about medical errors. Worry about medical errors was a better predictor of intentions to take precautionary actions than were risk perceptions. An understanding of how worry influences preventive efforts will help in building communication strategies to the public and in effectively engaging patients in the role of vigilant partner in care.

Adult↗
PubMed1990

Keeping your staff. Part 2. Performance related pay in practice.

Staff are one of the greatest assets a practice has, and effective communication and motivation is rewarding for all parties. Three years ago Charles Scola and his partners introduced a performance related pay (PRP) scheme into their busy general dental practice. Here, he discusses the resulting benefits and also some of the teething problems they have encountered.

Dental Staff↗
PubMed1996

The shape of female mating preferences.

The "shape" of a female mating preference is the relationship between a male trait and the probability of acceptance as a mating partner. The shape of preferences is important in many models of sexual selection, mate recognition, communication, and speciation, yet it has rarely been measured precisely. Here I examine preference shape for male calling song in a bushcricket (katydid). Preferences change dramatically between races of a species, from strongly directional to broadly stabilizing (but with a net directional effect). Preference shape generally matches the distribution of the male trait. This is compatible with a coevolutionary model of signal-preference evolution, although it does not rule out an alternative model, sensory exploitation. Preference shapes are shown to be genetic in origin.

Animals↗
PubMed2003

The parent-adolescent relationship education (PARE) program: a curriculum for prevention of STDs and pregnancy in middle school youth.

The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs). The program includes content about reproduction, STDs and Acquired Immune Deficiency Syndrome (AIDS), contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills. A randomized treatment or control group design is used to assign parent-child dyads to an experimental education group (social learning) or an attention-control group (traditional didactic teaching). Three post-program maintenance or booster sessions are held at 6-month intervals and at times prior to peak teen conception periods to reinforce the knowledge and skills learned. Pre- and posttests for parents and students assess group differences in parental involvement and communication, contraception, sex attitudes and intentions, sex behaviors (initiation of sexual intercourse, frequency, number of partners, contraceptive practices, refusal skills), and the incidence of pregnancy.

Adolescent↗
PubMed1997

Health risk factors and health-seeking behavior in lesbians.

Lesbians may engage in behavior that places their health at risk and may delay health care and screening more than do their heterosexual counterparts. This article examines influences on lesbians' health risk factors and health-seeking behaviors. A statewide, self-administered survey of members of a lesbian community organization was performed. Univariate and bivariate analyses were calculated, and linear regression was used to examine models of health risks and health-seeking behavior. Of 324 respondents, 90% had disclosed sexual orientation to at least one provider, 22% reported seeking care without symptoms (preventive care), and 23% reported waiting until symptoms are at their worst or never seeking care. Young age, belief in the importance of lung cancer, difficulty of getting health care when needed, reliance on the partner for health support, and fewer male partners were all associated with greater health risk for lesbians. Difficulty obtaining health care, difficulty communicating with the primary care provider, discomfort in discussing depression, and degree of comfort in discussing menopause were all associated with a delay in seeking health care. Sensitive communication with lesbians and further identification of lesbians' specific barriers to care may improve health-seeking behavior and provide more opportunities for screening and risk factor counseling in this population.

Adolescent↗
PubMed2001

Crystal structure of an activated form of the PTS regulation domain from the LicT transcriptional antiterminator.

The transcriptional antiterminator protein LicT regulates the expression of Bacillus subtilis operons involved in beta-glucoside metabolism. It belongs to a newly characterized family of bacterial regulators whose activity is controlled by the phosphoenolpyruvate:sugar phosphotransferase system (PTS). LicT contains an N-terminal RNA-binding domain (56 residues), and a PTS regulation domain (PRD, 221 residues) that is phosphorylated on conserved histidines in response to substrate availability. Replacement of both His207 and His269 with a negatively charged residue (aspartic acid) led to a highly active LicT variant that no longer responds to either induction or catabolite repression signals from the PTS. In contrast to wild type, the activated mutant form of the LicT regulatory domain crystallized easily and provided the first structure of a PRD, determined at 1.55 A resolution. The structure is a homodimer, each monomer containing two analogous alpha-helical domains. The phosphorylation sites are totally buried at the dimer interface and hence inaccessible to phosphorylating partners. The structure suggests important tertiary and quaternary rearrangements upon LicT activation, which could be communicated from the protein C-terminal end up to the RNA-binding domain.

Amino Acid Sequence↗
PubMed1976

Transmission of experimental rhinovirus colds in volunteer married couples.

Communicability of rhinovirus type 16 or type 55 was studied in 24 childless couples; on partner (the donor) was infected with laboratory-grown virus. Initially, both partners lacked antibody to the challenge agent. Rates of transmission between partners were 41% and 33% for type 16 and type 55, respectively. These rates are similar to those determined in epidemiologic studies of natural rhinovirus infection. Although the mucosa of the anterior nares was shown to be highly susceptible to infection (less than one 50% tissue culture infective dose [TCID50]), transmission rarely occurred unless (1) at least 1,000 TCID50 of virus was recovered from the donor's nasal washing, (2) the donor had virus on his hands and anterior nares, (3) he was at least moderately symptomatic, and (4) he spent many hours with his spouse. Since person-to-person transfer of rhinovirus was so dependent upon time spent together and shedding of large amounts of virus by the donor, it seems possible that the chain of infection could be interrupted by environmental manipulation.

Clinical Trials as Topic↗
PubMedDate not supplied

Partners in caring: a partnership for healing.

This article describes one organization's effort to create a family-friendly environment that supports the choice of patients for involvement of a family member or loved one in their care. Changing a culture requires a process that can emotionally drive the caregivers to agree with the need to change and sustain the efforts over a long period. This project, Partners in Caring, describes the philosophy, the journey of changing a culture, and the results achieved over a 7-year period. The Partners in Caring philosophy is "a commitment between a patient, care partner and healthcare team to a relationship of hands-on support based on compassion, communication and choice empowering people to heal in a nurturing manner." This concept laid a foundation for the development of a new model of care, which is described. The implementation has resulted in an improved patient and staff satisfaction and a decrease in patient complaints.

Attitude of Health Personnel↗
PubMed2005

Mass spectrometry-based approaches to protein-ligand interactions.

One of the greatest current challenges in proteomics is to develop an understanding of cellular communication and regulation processes, most of which involve noncovalent interactions of proteins with various binding partners. Mass spectrometry plays an important role in all aspects of these research efforts. This article provides a survey of mass spectrometry-based approaches for exploring protein-ligand interactions. A wide array of techniques is available, and the choice of method depends on the specific problem at hand. For example, the high-throughput screening of compound libraries for binding to a specific receptor requires different approaches than structural studies on multiprotein complexes. This review is directed to readers wishing to obtain a concise yet comprehensive overview of existing experimental techniques. Specific emphasis is placed on emerging methods that have been developed within the last few years.

Animals↗
PubMed2005

Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice.

Coordinated care is a defining principle of primary care, but it is becoming increasingly difficult to provide as the health care delivery system in the United States becomes more complex. To guide recommendations for research and practice, the evidence about implementation of coordinated care and its benefits must be considered. On the basis of review of the published literature this article makes recommendations concerning needs for a better-developed evidence base to substantiate the value of care coordination, generalist practices to be the hub of care coordination for most patients, improved communication among clinicians, a team approach to achieve coordination, integration of patients and families as partners, and incorporation of medical informatics. Although coordination of care is central to generalist practice, it requires far more effort than physicians alone can deliver. To make policy recommendations, further work is needed to identify essential elements of care coordination and prove its effectiveness at improving health outcomes.

Interprofessional Relations↗
PubMedDate not supplied

[Aspects of the psychology of the terminal stage of life].

Six person-centered and six social-network-centered constructs are discussed in order to describe aspects of the terminal time of life: age attitude, death concept, surviving motivation, coping style, partner relatedness, experience of dying; degree of connection, bearing power, taking over, life-end-communication, dying accompany, mourning work. A life span theory of change in activity and social functions stands in the background.

Adaptation, Psychological↗
PubMed1984

Discrete regional distribution of biochemical markers for the dopamine, noradrenaline, serotonin, GABA and acetylcholine systems in the monkey brain (Cebus Apella). Effects of stress.

Brains from Cebus Apella monkeys have been mapped biochemically using a cryo-section technique which enables exact micro-dissectioning of tissue. Two neurotransmitters; noradrenaline (NA) and gamma-amino-butyric acid (GABA) were measured by gas chromatography-masspectrometry technique. In addition biochemical markers reflecting metabolic activity in the dopamine (homovanillic acid, HVA, 3, 4-dihydroxyphenylacetic acid, DOPAC), serotonin (5-hydroxyindoleacetic acid, 5-HIAA), noradrenaline (4-hydroxy-3-methoxy-phenylglycol, HMPG), acetylcholine (choline acetyltransferase, CAT) and GABA (glutamic acid decarboxylase, GAD) transmitter systems were assayed. The distribution of these transmitter markers roughly corresponded to earlier studies in other non-human primates, whereas similar studies on the human brain generally show lower concentrations and enzyme activities. One monkey exposed to severe stress immediately before death deviated from the normal animals with regard to HVA, 5-HIAA, GAD and GABA. For the study of neuroleptic drugs, and notably their neurological side-effects, Cebus Apella monkeys have turned out to be particularly useful. In our laboratory we have employed this species of monkey to develop a model for acute dystonia and tardive dyskinesia (Gunne and Barany 1976, 1979, Barany et al. 1979). As a first step in the topological mapping of brain neuro-chemistry in these animals we here present data from normal monkeys, not treated with neuroleptics. During the ongoing project there was an unplanned "stress experiment" in one monkey, which had a nightly fight with a cage partner and had to be sacrificed the morning after due to severe wounds. The present communication describes a method for obtaining well-defined samples from monkey brains and presents the data on homovanillic acid (HVA), 3.4-dihydroxyphenylacetic acid (DOPAC), 5-hydroxyindoleacetic acid (5-HIAA), noradrenaline (NA), 4-hydroxy-3-methoxy-phenyl glycol (HMPG), choline acetyltransferase (ChAT), glutamic acid decarboxylase (GAD), and gamma-amino-butyric acid (GABA) in discrete regions from 7 drug-naive control monkeys. Also data from the stressed animal are presented.

Animals↗
PubMedDate not supplied

Paternal perspectives of the childbirth experience.

This study examined the responses given by first-time fathers who were asked to describe their feelings about their childbirth experience. The fathers answered three open-ended questions about their feelings concerning labor and childbirth, and the paternal behaviors believed to be most useful to their wives during labor and delivery. Data from fathers who attended prenatal childbirth education classes were examined separately from fathers who did not attend. The findings indicated that for all fathers, regardless of prenatal preparation, the labor experience evoked generally positive responses in addition to a significant number of negative responses, while perceptions of the birth experience were primarily characterized by positive or very positive feelings. The results also indicated that the fathers perceived that they were most helpful to their partner during labor.

Adult↗
PubMed1998

[Virtual workshop for hospital management].

Due to a survey of the CKM insufficient communication among different professional groups is one of the main causes for unused quality reserves and neglected potentials of efficiency in German hospitals. An essential reason for this insufficiency lies in the traditional concepts of education which are designed for the specialties of the different professional groups. With this these concepts only impart key qualifications such as social authority, ability for communication and ability for problem-solving in a small amount. The goal of the virtual workshop is to train students and trainees in communication and interdisciplinary problem-solving early by working together on a practical case in a Virtual Workshop team. On the other hand all relevant persons to talk to are involved in order to support a qualified preparation of decisions: employees of the project hospital, partners from industry and members of universities.

Education, Medical↗
PubMed1995

Sexual communication in the age of AIDS: the construction of risk and trust among young adults.

Sexually transmitted diseases are extremely prevalent among youth, and it is only by understanding the processes involved in negotiating sexual relationships that effective prevention and intervention programs can be designed. This study explores sexual communication among young adults, how gender and sexual orientation influence negotiation for safer sex, the strategies employed for risk reduction, and the barrier to safer sex. It assumes sexual behavior as a communicative form, both reflective and reflexive, subject to interpretation, and created interactively within and between sexual partners. Data from in-depth interviews with 30 undergraduates at the University of California, Berkeley were triangulated with questionnaires (n = 159), secondary sources and informal interviews with university officials. Participants were representative of arts and science students, ethnically diverse and of varying sexual orientations. Interviews focused on the normative influences of family, school and friends regarding sexuality; and how relationships and sex were negotiated. They investigated how strategies for risk reduction, attitudes about HIV and testing, and contraceptive practices were managed differently by gender and sexual orientation and what the barriers to safer sex were in various situations. Interviews focused on the normative influences of family, school and friends regarding sexuality; how relationships were negotiated, and how trust and risk were constructed within relationships; how strategies for risk reduction, attitudes about HIV and testing, and contraceptive practices were managed differently be gender and sexual orientation; and what the barriers were to safer sex. Friends, the social culture at university, and the interaction of the two with the developmental tasks characteristic of the period between adolescence and adulthood were more important influences than parents or high school sex education classes in how sexual relationships were managed. How and whether friends talked about sex and practiced safe sex were strong normative influences in predicting safer sex among individuals. Negotiating for safer sex contains elements of impression management, requires assertiveness and takes constant effort, even among those who have made the most progress in incorporating it. Practicing safer sex involves a complicated process of sexual negotiation, requiring a degree of open communication about sexual desire and intent that is not widely available in this culture, and still less among young people. Risk and thus how sex is negotiated is assessed differently by gender, and varies further according to the degree of intimacy in the relationship or the sex act being contemplated. How sex is negotiated depends on the construction of risk and trust which differ by the type of relationship or sexual encounter being contemplated.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1998

Close relationships and safer sex among HIV-infected men with haemophilia.

The present study sought to inform future behavioural intervention efforts by obtaining information from HIV-positive heterosexual men with haemophilia about their attitudes towards close relationships, attitudes towards risk reduction practices, and actual risk reduction practices. HIV-infected males with haemophilia (n = 358) responded to a self-administered questionnaire. Men who reported being involved in a close relationship (n = 237) were compared to men who said that they were not involved at the time of data collection (n = 121). Involved men were more likely than uninvolved men to agree that close relationships provide benefits such as physical intimacy and communication, and that these benefits are important. Men who were not involved perceived more negative consequences of discussing HIV risk reduction with partners (including partner rejection and negative emotional reactions) than did involved men and were much more concerned about the potential negative consequences of risk reduction discussions. Involvement was associated with having disclosed HIV-seropositivity and having discussed HIV risk reduction. Risk reduction interventions for men with haemophilia who are not involved in close, sexual relationships should address positive and negative attitudes towards close relationships and towards discussing risk reduction. Interventions should emphasize communication skills and rehearsal of serostatus disclosure as well as of risk reduction discussions.

Adult↗
PubMed2005

[What does the language of Alzheimer patients have to do with the language of Paul Celan?].

Being in touch with severely demented patients requires a fundamental transformation in communication habits in medicine and in nursing. There is a need of reorientation away from an interpreting and often deficit-oriented aspect of communication towards attentive observance of unusual verbal and nonverbal signals and resources of the patient. Spontaneous and open communication with the patient outweighs the importance of a goal-oriented exchange of information and poses a significant challenge for all health and social professions. The well-being of persons with dementia depends mainly on the quality of communication and on the design of the milieu and the quality of everyday life. Interaction in nursing seems to be the crucial issue, including both spontaneity and creativity in the interaction partners, while respecting the personal boundaries of both the patient and the nurse in the necessary intimacy of the care environment. This essay shows important aspects and strategies of adequate communication with people with dementia from the perspective of medicine and of nursing. Ways to improve communication skills are shown, referring, among others, to the approaches by Kate Allan and John Killick (research fellows at Dementia Services Development Centre, University of Stirling).

Aged↗