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PubMed1997

Social pretend play in Korean- and Anglo-American preschoolers.

Ninety-two preschoolers (46 Anglo- and 46 Korean-American) were observed during free play activities and videotaped in an experimental toy play setting. Cultural differences were examined in the frequency of social pretend play, communicative strategies, and pretend play themes. Anglo-American children engaged in more pretend play during free play activities than Korean-American children. In the experimental setting, there were no cultural differences in the frequency of pretend play; however, there were significant differences in children's communicative strategies and in their play themes. Korean-American children's play included everyday activity and family role themes, whereas Anglo-American children enacted danger in the environment and fantastic themes. Anglo-American children described their own actions, rejected their partners' suggestions, and used directives, whereas Korean-American children described their partners' actions and used tag questions, semantic ties, statements of agreement, and polite requests. The findings suggest that play is a common activity for most children. However, the thematic content and the communicative strategies used to structure and maintain pretend play are influenced by culture.

Acculturation↗
PubMed1985

Integration of male bisexuality and marriage.

Eighteen couples who had originally entered therapy because of conflicts created by the husband's bisexuality were studied to determine the dynamics and adjustment of their marriages. All the couples, to varying degrees, had been openly dealing with the husband's bisexuality for at least two years. Through questionnaires and psychological instruments, couples indicated that openness and communication helped the relationship. The greatest difficulties they encountered were in their sexual relationships. Marital satisfaction and adjustment was found to be negatively correlated with increasing age, number of children, later onset of homosexual activities, increased emotional involvement with male partners, increased numbers of people who know about the husband's homosexual activities, and increased sexual dissatisfaction and conflict. Basically, this study reinforced the notion that some marriages can survive by way of open communication, acceptance and understanding, dynamics which help compensate for the inherent conflicts these couples face.

Adult↗
PubMedDate not supplied

Lead for loyalty.

The greater the loyalty a company engenders among its customers, employees, suppliers, and shareholders, the greater the profits it reaps. Frederick Reichheld, a director emeritus of Bain & Company, offers advice on improving loyalty that is based on more than a decade of research. Primarily, he says, outstanding loyalty is the direct result of the decisions and practices of committed top executives with personal integrity. The "loyalty leader" companies--those with the most impressive loyalty credentials--are a diverse group, ranging from Vanguard and Northwestern Mutual to Chick-fil-A, Harley-Davidson, Intuit, and Enterprise Rent-A-Car. But beneath their surface variations lie six strikingly similar relationship strategies: 1. Preach what you practice. Executives must preach the importance of loyalty in clear, precise, powerful terms. 2. Play to win-win. It's not enough that your competitors lose; your partners must win. There's a clear connection, for instance, between a company's treatment of its employees and its attitude toward customers. 3. Be picky. A truly humble company knows it can satisfy only certain customers, and it goes all out to keep them happy. Careful selection of employees also plays an important role. 4. Keep it simple. Great leaders understand that they must simplify rules for decision making. 5. Reward the right results. Many companies reward employees who grab short-term profits and short-change those who build long-term value and customer loyalty. 6. Listen hard, talk straight. Long-term relationships require honest, two-way communication and learning. Exemplary leaders break through the cynicism of the times by showing they believe that an organization thrives when its partners and customers do.

Administrative Personnel↗
PubMed1992

Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners.

Multiple sclerosis (MS), an unpredictable neurologic disease, is sometimes called the crippler of young adults. This crippling effect often involves sexual functioning. Sexuality is an issue that is frequently difficult for clients, their partners and health care providers to discuss. To address this difficulty, a teaching pamphlet entitled, MS ... Will it Come Between Us? was produced. Open communication and creativity are helpful in dealing with problems frequently encountered by clients with MS: fatigue, impotence, decreased vaginal lubrication, bladder and bowel dysfunction. The pamphlet helps clients with these issues as well as the basics of sexuality as a whole.

Adaptation, Psychological↗
PubMedDate not supplied

Knowing what the others know: a study on interprofessional communication between nurses and medical doctors.

Communication and cooperation between experts from different specialties is a necessary element of professional competence. We have set up a research program to investigate cognitive aspects of interprofessional and interdisciplinary communication. We assume that successful communication essentially relies on communicants' ability to take the perspective of the other, i.e., assessing the background knowledge, expertise, plans, and so on, of one's co-communicators. The present paper reports on an interview study with medical doctors and nurses from three paediatric oncology units. The research interview was especially designed to allow for a detailed assessment of the professionals' ability to take their work-partners' perspective. Two areas will be examined: The ability to assess the work demands resulting from parental questions, and the use of differences in professional perspectives for prognosis. With respect to parental questions, doctors' and nurses' assessments of their respective work partner's task demands turned out to be only partly correct. Furthermore, the results suggest that doctors do not effectively benefit from nurses' experiential knowledge about patients when venturing prognoses. Educational measures designed to improve interprofessional communication could help to overcome these deficits.

Child↗
PubMed1997

Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania.

Determinants of multiple sexual partners and condom use among adults were assessed through a population-based survey in one urban, one semi-urban and one rural community in the Arusha region, northern Tanzania. The study samples were obtained by randomly selecting clusters of 10 households from the 3 communities. Informed verbal consent was sought from each respondent for participation in the study. High-risk sexual behaviours and condom use were assessed using a structured questionnaire. It was observed that significantly more men than women reported having multiple sexual partners (49% vs 25.2%; OR = 1.69; 95% CI = 1.51-1.90) and urban men were significantly more likely to report having multiple sexual partners than men in rural areas. In both men and women, early sexual debut was associated with having multiple sexual partners while travel, alcohol use, and sex under the influence of alcohol were significantly associated with multiple sexual partners in men only. AIDS-related discussion was significantly associated with having fewer sexual partners in both men and women. Of the 1551 respondents, 320 (20.6%) reported having ever used a condom and of the 320 respondents who had ever used a condom, 34 (10.6%) reported having used it at the last sexual intercourse. Significantly more men than women reported having ever used a condom (34.1% vs 14.1%; OR = 1.77; 95% CI = 1.56-2.01). In both men and women, early sexual debut and being young, unmarried, travelling out of the Arusha region and having multiple sexual partners were associated with increased condom use. For both men and women, frequent discussion of AIDS with family members or friends was associated with increased condom use. These data suggest that interventions targeting adolescents and young adults may be effective for control of HIV transmission in Tanzania. In particular, creation of opportunities for people to come together and discuss AIDS might be an important strategy.

Adolescent↗
PubMed1999

Combining mutations in the incoming and outgoing pheromone signal pathways causes a synergistic mating defect in Saccharomyces cerevisiae.

Mating pheromones stimulate Saccharomyces cerevisiae yeast cells to form a pointed projection that becomes the site of cell fusion during conjugation. To investigate the role of mating projections, we screened for mutations that enhanced the weak mating defect of MATa ste2-T326 cells that are defective in forming pointed projections. These cells are also 10-fold more sensitive to alpha-factor pheromone because ste2-T326 encodes truncated alpha-factor receptors that are not regulated properly. Mutations in AXL1, STE6 and FUS3 were identified in the screen. AXL1 was studied further because it is required for efficient a-factor pheromone production and for selecting the site for bud morphogenesis. Mutation of AXL1 did not enhance the morphogenesis or pheromone sensitivity defects of ste2-T326. Instead, the synergistic mating defect was apparently due to decreased a-factor production because the axl1Delta ste2-T326 cells mated well with a sst2 alpha mating partner that is supersensitive to a-factor. When combined with a wild-type mating partner, the ste2-T326 axl1Delta cells failed to mate because they did not lock cell walls, one of the earliest steps in conjugation. Analysis of axl1Delta in combination with other mutations that cause defects in morphogenesis or pheromone sensitivity (e.g. bar1, sst2, afr1) indicated that both phenotypes of ste2-T326 cells, supersensitivity to alpha-factor and the defect in forming pointed projections, contributed to the synergistic mating defect. We suggest a model that the synergistic mating defect is caused by the combined effects of ste2-T326 and axl1Delta on the presentation of a-factor to partner cells. Altogether, these results demonstrate an important linkage between the incoming and outgoing pheromone signals during the intercellular communication that promotes yeast mating.

Cell Cycle↗
PubMed2006

Evaluating the treatment of eating disorders from the patient's perspective.

OBJECTIVE: This study investigated the evaluation of treatment of eating disorders (EDs) from the patient's perspective in a large community based sample in the Netherlands. It investigated perceived helpfulness of different types of treatment. Furthermore it investigated which patient and treatment characteristics contribute to the evaluation of treatment. METHOD: The Eating Disorder Examination questionnaire was administered to 44 anorexia nervosa (AN), 43 bulimia nervosa (BN), 69 EDNOS (ED not otherwise specified), and 148 former ED patients. A questionnaire specifically designed for the purpose of this study addressing treatment history and patient's evaluation of their treatment was administered. RESULTS: There is a substantial patient and doctor delay in seeking and finding treatment. Treatment in specialized ED centers, self-help groups, and treatment with a partner were reported to be most helpful. Beneficial components of treatment reported in specialized ED centers refer to the communication skills of professionals, the therapist-patient working alliance, the contact with peers, and the focus of treatment on both ED symptoms as well as underlying issues. CONCLUSION: The patient's perspective on treatment of EDs does provide recommendations for the improvement of treatment of EDs that will facilitate clinical decision making and treatment planning.

Adult↗
PubMed2006

Perceptions towards condom use, sexual activity, and HIV disclosure among HIV-positive African American men who have sex with men: implications for heterosexual transmission.

Disproportionately high HIV/AIDS rates and frequent non-gay identification (NGI) among African American men who have sex with men or with both men and women (MSM/W) highlight the importance of understanding how HIV-positive African American MSM/W perceive safer sex, experience living with HIV, and decide to disclose their HIV status. Thirty predominately seropositive and non-gay identifying African American MSM/W in Los Angeles participated in three semi-structured focus group interviews, and a constant comparison method was used to analyze responses regarding condom use, sexual activity after an HIV diagnosis, and HIV serostatus disclosure. Condom use themes included its protective role against disease and pregnancy, acceptability concerns pertaining to aesthetic factors and effectiveness, and situational influences such as exchange sex, substance use, and suspicions from female partners. Themes regarding the impact of HIV on sexual activity included rejection, decreased partner seeking, and isolation. Serostatus disclosure themes included disclosure to selective partners and personal responsibility. Comprehensive HIV risk-reduction strategies that build social support networks, condom self-efficacy, communication skills, and a sense of collective responsibility among NGI African American MSM/W while addressing HIV stigma in the African American community as a whole are suggested.

Adult↗
PubMed2005

An audit of contact tracing for cases of chlamydia in the Australian Capital Territory.

BACKGROUND: Contact tracing is one of the central pillars of the management of sexually transmitted infections. The aims of this audit were to determine the yield of chlamydia infection from contact tracing the sexual partners of individuals diagnosed with chlamydia and to evaluate and compare the effectiveness of contact tracing undertaken at the Communicable Diseases Control Section (CDCS) of Australian Capital Territory (ACT) Health and the Canberra Sexual Health Centre (the clinic). METHODS: A retrospective review of the notification records and contact-tracing documentation was undertaken at CDCS and the clinic from 1 September 2002 to 30 September 2003 (13 months). RESULTS: The background rate of chlamydia in those tested in the ACT community is 3-5%. During the study period, 512 cases of chlamydia were notified to CDCS. Of these, 351 were referred for contact tracing, 293 by CDCS and 98 by the clinic. Of the 437 nominated sexual contacts (average of 1.12 per index case), 272 (62.2%) were contacted, 125 (28.6%) were tested and 51 (11.7%; 95% CI 8.8-15.1) tested positive for chlamydia (15.5%; 95% CI 11.5-20.6% in sexual contacts of CDCS index cases and 7.8%; 95% CI 4.8-12.5% in those of the clinic patients). Contact tracing through the CDCS reached significantly more nominated sexual contacts (78.4% v. 41.7%; P = 0.001) and significantly more of the nominated sexual contacts of index cases reported to CDCS were described as tested (34.7% v. 20.8%; P = 0.01). The average time taken to identify each chlamydia-positive sexual contact was 6.8 hours. CONCLUSIONS: Contact tracing more than doubled the case finding effectiveness of chlamydia screening, but was time consuming. These results suggest that provider-initiated contact tracing has clinical and public health value, but that the cost-effectiveness of this approach to chlamydia control should be further evaluated.

Chlamydia Infections↗
PubMed2006

Family context and HIV risk among youth in psychiatric care: what pediatricians can do.

PURPOSE OF REVIEW: The HIV/AIDS epidemic is one of the most widespread public health problems today. Teens with mental health concerns are particularly vulnerable to infection because they engage in higher rates of risky behaviors than their peers. Families are vital influences in protecting teens from HIV exposure, but parents often feel unprepared to discuss sexual behavior with teens. This review provides an overview of the role of teens' mental illness in HIV risk and suggests guidelines for pediatricians to facilitate parents' ability to keep teens safe from risky behaviors. RECENT FINDINGS: Young people account for more than 50% of new infections each year, and mental health problems are related to increased risk taking via inconsistent condom use, multiple partners, and decreased assertiveness. Parents can protect youth from engaging in HIV risk behaviors through supervision, providing support, and communicating effectively about sexual topics. SUMMARY: Pediatricians can support parents in keeping youth safe from HIV infection by openly discussing ways to reduce teens' risk of exposure. Talking to families about risks, empowering parents to address issues with teens, and providing referrals for parents to build a network of support can reduce mental health problems and HIV risk among teens.

Adolescent↗
PubMed2004

Facilitators and barriers for co-ordinated multi-agency services.

BACKGROUND: Greater collaboration between agencies and the need to improve interagency working is a key policy priority. The lack of co-ordinated multi-agency working in children's services has been highlighted in many research studies. Evidence on the facilitators of and barriers to such working and the outcomes for children and families of co-ordinated services is important to inform local developments. METHODS: Literature on multi-agency working was reviewed as part of the evidence gathering to inform the Children's National Service Framework. Searches were mainly concentrated on existing reviews, plus recent studies which included children's services and were not covered by the reviews obtained. RESULTS: There is little evidence on the effectiveness of multi-agency working itself or of different models of such working in producing improved outcomes for children and families. However, reviews of evidence on multi-agency working provide consistent findings on facilitators and barriers, including: clear aims, roles and responsibilities and timetables that are agreed between partners; a multi-agency steering group, commitment at all levels of the organizations involved and good systems of communication and information sharing, including IT systems, are central; support and training for staff in new ways of working is needed. There is some evidence that interprofessional programmes of continuing education can help to remove barriers to joint working. CONCLUSIONS: Existing research provides useful information for organizations developing multi-agency services. However, there is a need for methodologically sound research which investigates the outcomes of different models of multi-agency working in services for children, includes assessment of cost effectiveness, and explores the ways in which the factors identified as facilitating multi-agency working relate to outcomes.

Child↗
PubMed2004

Interactive telemedicine as a tool to avoid a digital divide in the world.

An efficient way of closing the gap in medical care between the EU and its Mediterranean partners is the use of satellite-based networks for telemedical applications. Using standard hardware components and specially designed communication software (WinVicos) various telemedical applications (teleconsultation, telementoring, teleteaching, etc.) have been realized. Two telemedical networks which have been designed and developed recently, MEDASHIP (Medical Assistance for Ships) and EMISPHER (Euro-Mediterranean Internet-Satellite Platform for Health, medical Education and Research), are presented.

Computer Communication Networks↗
PubMed1982

The social nature of early conflict.

The conflicts of 24 pairs of previously unacquainted 21-month-old children were examined for social hallmarks at several levels of analysis. Each child was observed with the same partner for 15 min on 3 consecutive days. On the fourth day half the dyads were rearranged such that each child now was paired with a new partner; the remaining children returned to meet their usual partners. Conflicts were defined dyadically as 1 child's protesting, resisting, or retaliating against an act by the peer; 217 were recorded across the 4 days, 84% of which were struggles over toys. The disputes possessed a patterned interactive structure and explicit communicative content, and 75% of the object struggles were preceded or followed by socially pertinent events. The extent of conflict neither increased nor decreased over days, nor were there reliable differences between acquainted peers on the fourth day. However, the outcome of 1 conflict affected the next; a child who lost a dispute was more likely than the winner to initiate the next. Moreover, the findings suggested that dyadic as well as dispositional factors influenced conflictual behavior; the children's tendency to initiate disputes on the fourth day could be predicted from their initiations on the first 3 days for both groups, but prediction of their tendency to yield to the peer's demands for objects was only possible for the group who retained the same partners.

Aggression↗
PubMed2004

Shadow Bowl 2003: a collaborative exercise in community readiness, agency cooperation, and medical response.

This paper describes a model for homeland security, community readiness, and medical response that was applied during an operational exercise around Super Bowl XXXVII. In addition, it describes the products provided by private companies involved in the exercise and how they would have contributed to a medical disaster had one occurred. The purpose of Shadow Bowl was to demonstrate community readiness and medical response to a mass casualty event. The goals of the project were to: (1) provide enhanced public safety using an advanced communication network and sensor grid; (2) develop mass casualty surge capabilities through medical reach-back; and (3) build a collaboration model between civilian, military, public, and private partners. The results of the Shadow Bowl Exercise accentuated the value of new telehealth and disaster medicine tools in treating large numbers of patients when infrastructure overload occurs.

Communication↗
PubMed2004

Quality of parent communication about sex and its relationship to risky sexual behavior among youth in psychiatric care: a pilot study.

BACKGROUND: The number of HIV infections among adolescents is increasing, and youth in psychiatric care are at particular risk because of their high rates of risky sexual behavior. METHODS: As part of a larger longitudinal study examining AIDS-risk behavior among adolescents in psychiatric care, this pilot study investigated the relationship between parent communication about sex and sexual risk-taking among treatment-seeking adolescents. Adolescents reported their risky sexual behavior (e.g., inconsistent condom use, sex with multiple partners), and parents reported how frequently they bring up topics related to sex, HIV/AIDS, and birth control. Parents and adolescents participated together in videotaped discussions of fictional vignettes describing situations related to sex, birth control, and AIDS/HIV. Quality of the parent-teen discussions was coded based on a system developed by Whalen, Henker, Hollingshead, and Burgess (1996) to code AIDS-related discussions. RESULTS: Quality but not frequency of parent-teen communication was associated with adolescent sexual risk-taking, and ethnic differences in communication were found. CONCLUSIONS: Findings from this pilot investigation underscore the importance of studying the relationship between parent-teen communication and risky sexual behavior among troubled youth and provide direction for the development of family-based intervention programs that focus on parental behavior during conversations with teens.

Adolescent↗
PubMed2000

Entertainment-education and HIV/AIDS prevention: a field experiment in Tanzania.

Entertainment-education is the process of designing and implementing an entertainment program to increase audience members' knowledge about a social issue, create more favorable attitudes, and change their overt behaviors regarding the social issue. The results of a field experiment in Tanzania to measure the effects of a long-running entertainment-education radio soap opera, Twende na Wakati (Let's Go with the Times), on knowledge, attitudes, and adoption of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention behaviors are presented. Multiple independent measures of effects and the experimental design of this study confer strong internal and external validity regarding the results of this investigation. The effects of the radio program in Tanzania include (1) a reduction in the number of sexual partners by both men and women, and (2) increased condom adoption. The radio soap opera influenced these behavioral variables through certain intervening variables, including (1) self-perception of risk of contracting HIV/AIDS, (2) self-efficacy with respect to preventing HIV/AIDS, (3) interpersonal communication about HIV/AIDS, and (4) identification with, and role modeling of, the primary characters in the radio soap opera.

Adolescent↗