The mystique of first intercourse among college youth: the role of partners, contraceptive practices, and psychological reactions.
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The female condom: attitudes and experiences among HIV-positive heterosexual women and men.
The female condom is a potentially effective method for the prevention of HIV, other sexually transmitted disease, and pregnancy. This study describes attitudes toward and experiences with the female condom of 89 HIV-positive individuals (n = 56 women; n = 33 men) reporting heterosexual behavior. Qualitative interviews were conducted to inform the design and implementation of a cognitive-behavioral risk-reduction and health-promotion intervention. Most respondents (n = 78) had seen or heard of the female condom. However, relatively few (n = 14 women; n = 5 men) had used it at least once. Reactions from both women and men across user groups, regardless of favorable or unfavorable attitude or experience with the female condom, centered around a similar set of factors: aesthetics, difficulties with the male condom, male partner reaction, beliefs about efficacy, and lack of training. These findings underscore the need for additional research and comprehensive education efforts aimed at both technical use and communication skills-building in order to realize the potential of the female condom as an alternative barrier method.
Adult↗
Marital role dynamics during brief group psychotherapy: assessment of verbal interactions.
Examined the impact of brief group psychotherapy on the marital and sex roles of five volunteer couples who participated in two, 15-session, model therapy groups conducted approximately 2 years apart. Assessments are based on Hill Interaction Matrix (HIM) analysis of the style and content of marital partners' verbal behavior during the assessions. Results show that interactional correlates of traditional marital and sex role variations are attenuated, that communication between spouses is improved, and that the therapeutic quality of verbal behavior is enhanced over the course of therapy. Generally, from the perspective of interactional dynamics, these findings suggest that the group psychotherapy model that was being evaluated is an effective mode of brief, precrisis intervention for married couples.
Adult↗
Ideas crystallized on immunoglobulin superfamily-integrin interactions.
Interactions between immunoglobulin superfamily (IgSF) members and integrins are central to lymphocyte homing, leukocyte emigration into tissues at inflammatory sites, and in cell-cell interactions that lead to immune responses. Recent X-ray crystal structures reveal that the interaction of a divalent cation found in the integrin structure with an acidic residue from the IgSF partner may be important in binding.
Animals↗
Organizing ODIN: a case study in European academic co-operation. The ODIN Group.
The European Commission is an increasingly important source of funding for international research projects and is due to announce its Framework 5 program early in 1999. The Outcomes of Depression International Network (ODIN), funded from the current EC Biomed 2 program, is a case study in European academic co-operation. Its organization has three key elements. First, engaging the principal investigators: this has involved identifying potential partners, ensuring reciprocity of interests, effective co-ordination, 'dividing the spoils' in advance, and setting up good personal and electronic communication systems. Second, an esprit de corps has been created amongst the researchers, maintaining contact and consistency, and promoting higher degrees. Third, ongoing problems including difficulties in negotiations with the EC, divergence of detailed study methods, and isolation and demoralization amongst researchers, have been addressed. ODIN may provide a useful model for researchers wishing to set up international collaborative groups.
Academic Medical Centers↗
Binding, domain orientation, and dynamics of the Lck SH3-SH2 domain pair and comparison with other Src-family kinases.
The catalytic activity of Src-family kinases is regulated by association with its SH3 and SH2 domains. Activation requires displacement of intermolecular contacts by SH3/SH2 binding ligands resulting in dissociation of the SH3 and SH2 domains from the kinase domain. To understand the contribution of the SH3-SH2 domain pair to this regulatory process, the binding of peptides derived from physiologically relevant SH2 and SH3 interaction partners was studied for Lck and its relative Fyn by NMR spectroscopy. In contrast to Fyn, activating ligands do not induce communication between SH2 and SH3 domains in Lck. This can be attributed to the particular properties of the Lck SH3-SH2 linker which is shown to be extremely flexible thus effectively decoupling the behavior of the SH3 and SH2 domains. Measurements on the SH32 tandem from Lck further revealed a relative domain orientation that is distinctly different from that found in the Lck SH32 crystal structure and in other Src kinases. These data suggest that flexibility between SH2 and SH3 domains contributes to the adaptation of Src-family kinases to specific environments and distinct functions.
Humans↗
Expressed emotion and auditory evoked potentials.
The expressed emotion (EE) of key relatives has been shown to predict the course of illness in psychiatric patients. In this study, we examined whether there might be physiological correlates to the EE index in nonbiological key relatives of patients with affective psychoses. High-EE and low-EE relatives were compared concerning their slopes of the amplitude/stimulus intensity function (auditory evoked N1/P2-component). We found that the slopes were clearly steeper in the case of low-EE relatives. In comparing the slopes of all key relatives with those of an age-matched control group without psychiatrically ill partners, we could find no differences. Therefore, the slope differences between high-EE and low-EE relatives do not seem to reflect differences in the illness of partners. We speculated whether a steep slope as well as low EE could be associated with an action-oriented, impulsive communication style, which would prevent the development of an affectively tense communication pattern.
Adult↗
The effect of children upon the marriage relationship.
A marital questionnaire, completed by 40 fertile and 50 infertile couples, revealed greater unanimity of response between childless partners, who may however have been tempted to idealize their relationship. It is suggested that parenthood may limit the scope of communication between spouses. Childlessness may be stressful but it can also make for closer mutual affinity in the couple's thoughts and feelings.
Adult↗
In vitro studies on the maturation of mesencephalic dopaminergic neurons.
The use of neural culture is illustrated by the study of the in vitro development of a well defined neuronal system in the brain: the mesencephalic dopaminergic neurons of the rodent species. After a brief survey of its ontogenetic development, the various experimental techniques for its study in vitro are described. Such an approach has allowed the discovery of influences brought by a target area, like the striatum, on the maturation of these neurons. A new kind of local morphogenic interactions between these neurons and their glial partners is also reported.
Animals↗
In the shadow: the impact of chronic illness on the patient's partner.
This study focuses on the partners of patients with chronic illness. Through intensive interviews with the patients' partners and their general practitioners (GPs), the problems the partners experience are explored and analyzed in terms of the support the GP may provide. A description is given of the main problems partners of chronically ill patients have to cope with and the tasks these imply for their everyday life. The attitude and communication skills of the GP are a key factor in whether he or she will play an important supporting role in the case of chronic illness in the family.
Adult↗
Bench-to-bedside review: dealing with increased intensive care unit staff turnover: a leadership challenge.
Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward.
Humans↗
[Treatment of neglected and abused children and their families in the context of complicated divorce].
INTRODUCTION: Coceptualisation of complicated divorce, as an escalation of systemic dysfunctioning in a highly disturbed and unbalanced system, acquires attributes of trauma-organised-system, and yields itself for therapeutic interventions. COMPLICATED DIVORCE ISSUES: The authors comment on their experience while treating families sent by Court order in divorce custody disputes, with explicit aim of evaluating parental competence. This type of systemic dysfunction is severely affecting communication styles, family rules and norms, whereas parenting is frequently marked by tendency to repeat relational-style experienced in marital, partners' conflicts. Feelings of discontent and resentment are projected onto children, and may take form of disqualifications, rejection, discrimination or else, those feelings stemming out of personal ambition such as favoring children. Parental rivalry worsens these processes, leading to attempts of establishing inappropriate level of control over children (instrumentalisation or favorisation). Therefore, care and protection of children is inadequate and children are emotionally neglected DISCUSSION AND CONCLUSION: Many of these highly disturbed families, especially those sent by Court order are engaged in a network of different social, legal and mental health institutions. Intervention plans are thus conceived and specifically tailored to suit individual families, confronting dysfunctional patterns and appealing to enhance parental responsibilities. Overcoming family crisis of complicated divorce where childresn's emotional needs are neglected is highly indicated for systemic intervening. The authors discuss their experience in treating such families and offer their questions, dilemmas and recommendations.
Child↗
International collaboration in genetic nursing.
Collaboration across national borders presents unique challenges and opportunities. A desire to expand your understanding of healthcare issues, and a willingness to share time and intellectual resources generously, contribute to successful collaboration. This is especially useful in small but rapidly developing healthcare specialities, such as genetic nursing. By outlining the benefits of work between two nurses in the UK and the US, this article argues that specialist nurses can benefit from international collaboration where the partners share problem solving and mentoring on common professional issues.
Communication↗
[A questionnaire study in the county of Stockholm on transmission control of chlamydia infections. Too many physicians neglect the contact tracing].
Since 1989 the reporting of chlamydia infections is regulated by the Contagious Diseases Act, which stipulates that a physician who detects chlamydia is obliged to trace the patient's sexual partner(s). Up to 1994 the annual decrease in the number of chlamydia cases was 20 percent, which did not meet the goal stipulated by the County Council. A questionnaire study was carried out concerning diagnosis, treatment and public health intervention in chlamydia patients seen by general and private practitioners. While the clinical management was seen to adhere to the recommendations of the National Board of Health, adequate tracing of sexual contacts was not carried out in 20-45 per cent of the cases. In a major urban area, such as the County of Stockholm, referral of all chlamydia cases to specialist clinics could possibly improve not only the care of the patients but also the success rate in reaching their sex partners.
Adolescent↗
['Doctor, I don't want to know that'--exploring denial in patients with lung cancer].
Three patients with lung cancer, a man aged 68, a woman aged 69 and a man aged 52, denied the nature or the severity of their disease in three different ways: temporary denial to evade acute emotional shock, full-blown persistent denial, and unjustified optimism respectively. The psychological mechanism of denial may become operational in patients confronted with an overwhelming disease. A less pronounced denial of medical information provided by physicians can be recognised in many patients. It may also be noticed in how individuals or groups of people sharing the same unbearable reality face up to the facts. Denial may be helpful in (temporarily) circumventing a serious problem but when the disease is serious, it may interfere in relationships with partners, relatives and friends. Denial must be differentiated from organicity, e.g. anosognosia in cerebral damage, by patient ignorance, or by vague communication from the medical community. A direct and blunt confrontation of denial may result in adverse effects due to a defensive mechanism being aggravated. Slowly providing the patient with pieces of information whilst taking into account his or her reaction, may provide a clue for gradual conformation to the medical reality.
Adaptation, Psychological↗
Seroprevalence of six infectious diseases among adults in the United States by race/ethnicity: data from the third national health and nutrition examination survey, 1988--94.
OBJECTIVE: To provide seroprevalence estimates for six selected infectious agents by various sociodemographic and risk behavior variables stratified by race/ethnicity for adults age 20 years or more. METHODS: Seroprevalence estimates for hepatitis A, B, and C, Toxoplasma gondii, Helicobacter pylori, and Herpes simplex-2 were calculated from data in the third National Health and Nutrition Examination Survey, 1988-94 utilizing weights to account for differential oversampling by race/ethnicity and nonresponse to the interview and examination. Standard errors and 95% confidence intervals were calculated taking into account the complex sample design. RESULTS: Age-adjusted prevalence estimates and 95% confidence intervals are presented for three enteric infectious diseases hepatitis A, Toxoplasma gondii, Helicobacter pylori, as well as three blood-borne/sexually transmitted diseases, hepatitis B, hepatitis C, and Herpes simplex-2 stratified by race/ethnicity and by various demographic factors including gender, poverty index, population size of area of residence, country of birth, household crowding, and years of education. In addition, estimates are presented for the three blood-borne/sexually transmitted diseases by various risk behaviors that include marital status, age at first sexual intercourse, number of lifetime sexual partners, cocaine use, and marijuana use.
Adult↗
The impact of AIDS on state public health legislation in the United States: a critical review.
This article reviews and analyzes the current public health legislation in 17 states and the District of Columbia in the United States. These states were selected and grouped into high, medium, and low incidence based on their annual AIDS incidence rates. Data were collected through a combination of library research and direct communications with the various state health departments. Four major areas of legislation were reviewed: HIV antibody testing and reporting; confidentiality and partner notification; personal control measures: and AIDS antidiscrimination laws. In general, majority of the states have treated the AIDS epidemic as a public health problem and not as a moral or criminal issue. Some states with higher incidence such as New York and California have developed the least restrictive laws and responded with stronger AIDS antidiscrimination legislation. The states with medium incidence have more restrictive measures and the low incidence states have less legislation and fewer regulations related to AIDS. AIDS educators should be aware of the implications of the varied legislation and regulations on AIDS education and prevention. They should play a strong advocacy role in promoting the development and application of measures that will facilitate the prevention and control of AIDS.
Acquired Immunodeficiency Syndrome↗
Sexual activity among adolescents in romantic relationships with friends, acquaintances, or strangers.
OBJECTIVE: To explore the influence of preexisting social ties between romantic partners (ie, knowing the partner as a friend or acquaintance before a relationship was considered "romantic" by the adolescent) on sexual risk behaviors among adolescents. DESIGN, SETTING, AND PARTICIPANTS: By using data from 6658 adolescents from Wave II of the National Longitudinal Study of Adolescent Health, we examined associations between preromantic social ties between partners and several sexual risk behaviors using logistic regression analyses. MAIN OUTCOME MEASURES: Whether the couple had intercourse, and if they did have intercourse, whether the couple talked about contraception or sexually transmitted infections and whether one of them used some method of birth control every time they had sexual intercourse. RESULTS: Knowing one's partner as a friend (vs being acquaintances) before a romantic relationship was protective against engaging in sexual intercourse for male and female adolescents (odds ratios and 95% confidence intervals, 0.66 [0.51-0.86] and 0.76 [0.62-0.94], respectively). For female adolescents, sexually active relationships with partners they had not known before the romantic relationship began were less likely to include discussions of sexually transmitted infections or contraception, and were less likely to include consistent use of birth control (odds ratios and 95% confidence intervals, 0.37 [0.22-0.62] and 0.62 [0.39-0.99], respectively). Preromantic social ties did not play a statistically significant role for these outcomes among male adolescents (odds ratios and 95% confidence intervals of friends and of those who had not met, respectively, are 0.85 [0.60-1.18] and 0.90 [0.50-1.63] for talking about sexually transmitted infections or contraception and 0.93 [0.66-1.30] and 1.17 [0.71-1.96] for always using birth control). CONCLUSION: The existence and nature of an adolescent's prior relationship with a future romantic partner have significant implications for an adolescent couple's later sexual decisions, but patterns differ for male and female adolescents.
Adolescent↗