Talking about sex. Speaking out about sexual problems can help find lasting solutions.
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Communication↗
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[Start of the "simply from love" initiative].
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Communication↗
Women's Heart Advantage Program: the impact 3 years later.
Yale-New Haven Hospital, in partnership with Voluntary Hospital Association (VHA Inc), launched the Women's Heart Advantage program in March 2001. Major program components implemented include (1) a comprehensive initial and ongoing internal communication program; (2) a health promotion initiative including a 24-hour, 7-days-a-week women's heart line staffed by nurses and an Internet health question-and-answer forum; (3) significant ongoing communication with nurses and physicians; (4) a community outreach effort to educate poor and minority women; and (5) an aggressive effort to secure financial partners to underwrite the cost of the program. Before launching the program, a telephone survey of 300 randomly selected New Haven County women ages 40 to 70 years was initiated in January 2001 and repeated in January 2002, 2003, and 2004. Findings include (1) the percentage of women who recognize heart disease as the number-one killer of women their age increased from 26% in 2001 to 59% in 2004, (2) the percentage of women who would call 9-1-1 or go directly to a hospital emergency department increased from 63% in 2002 to 83% in 2004, and (3) the percentage of women aware of recent Women's Heart Advantage program promotion grew from 33% in 2002 to 50% in 2004. Perhaps most importantly, the number of women with heart problems admitted through the hospital's emergency department increased from 1528 per year in 2001 to 1870 per year in 2004 (7.5% annual increase), whereas the number of men with heart problems admitted through the emergency department during the same time period has been relatively low (0.8% annual increase). By linking clinical, public health, and marketing expertise along with finding ways to partner with other organizations, the Women's Heart Advantage program has contributed to remarkable changes in women's awareness, knowledge, and behaviors, suggesting a model for approaching similar health-related problems.
Adult↗
[Patient rights alone are not enough, too many rights can also be harmful].
The nowadays running increased emphasis on patients rights can be seen positive as a way towards a "competent partner-patient". However, better health results to come out of it want mainly an important pre-condition, which we call "general renaissance of communication culture". This should work on the non-verbal, verbal and written level. We name the following examples on this way. -Schooling for communication, including the mechanism of "positivation", that we have introduced into basic psychotherapeutic schooling. -There are further levels of quality assurance, leading to quality amelioration via evaluation and motivation. The "Rasterzeugnis" (i.e. periodical doctors' certifications, which has become obligatory per legem now in Austria) is one of these instruments. -There are highly sensible territories like communication with the incurable as well as organ transplantations. -But also the seemingly so banal written doctor's report should be the subject of important ameliorations in the routine. Following a pure standpoint of the right with neglect of all said above, can be contra-productive. We give examples of the -patients' insight into medical documents as well as -simple juridical judgement of a patient's competence. Only by synopsis of right with communication, there can be reached an optimal result for the patient. This should run under the omnipresent principle of humanitas.
Austria↗
Prevention implications of AIDS discourses among South African women.
Social constructionist and feminist analyses have done much to extend the understanding of AIDS beyond the biomedical to include social accounts of the constitution of AIDS knowledge and meanings. However, these frameworks have not translated easily into realistic responses to the paradox of women being seen as responsible for HIV prevention, while they lack the power to implement safe sex behavior. This study explores the range and interplay of discursive themes which South African women drew on regarding AIDS and identifies constraints and opportunities for realistic prevention. The research involved 14 focus group discussions with women. Two main interpretative repertoires regarding AIDS were identified from the texts: one concerning the medicalization and the other the stigmatization of the disease. Although these representations were not unchallenged, the pervasive sense was of denial of own risk, fear, and fatalism. However, the analysis highlighted the complexity of issues to be faced in developing effective prevention initiatives.
AIDS Serodiagnosis↗
[Psychologic causes of erectile dysfunction].
The authors discuss the most frequent psychological causes of impaired erectility. The most important psychogenic factors for the development and persistence of erectile impairment is in their opinion anticipative anxiety, performance orientation, the partner's negative reaction to rare failure, the observer's attitude, antisexual upbringing, monotony of sexual intercourse, persisting sexual myths and unsuitable attitudes, impaired communication of the couple, different sexual preferences,psychic and sexual traumas and pathological mental conditions. However, as personality characteristics of the patient and the quality of his partnership may play a decisive part in the development of this disorder the authors feel that it is a mistake to confine the diagnosis and treatment only to the area of sexual reactivity and sexual behaviour.
Erectile Dysfunction↗
[Modernization of methods amd technical means of information supply of piloted space flights].
The goal was to lay basis for a change to modern, adequate to international standards technology of the biomedical data transfer to and from the orbital complex, and setting-up a computer network to link all partners in the medical care systems for space missions. Main sources of the board biomedical information were identified as well as associated restrictions on communication capabilities and upgrading the in-flight procedures. Advantages of INTERNET were analyzed and the need for high-speed digital downlink of the biomedical data was substantiated.
Computer Communication Networks↗
Looking while listening and speaking: eye-to-face gaze in adolescents with and without traumatic brain injury.
PURPOSE: The purpose of this study was to address the lack of quantitative data on eye-to-face gaze (also known as eye contact) in the literature on pragmatic communication. The study focused on adolescents and young adults with traumatic brain injury (TBI), as gaze often is included in social skills intervention in this population. METHOD: Gaze times were calculated for participants with TBI (n = 16) and their typically developing (TD) peers (n = 16) engaged in 3-min extemporaneous conversations. RESULTS: The TD group members looked at the face of their conversation partner an average of 62% of the time while listening and 43% of the time while speaking, versus 67% and 51%, respectively, for the TBI group. There were no significant between-groups differences in average gaze times, but the within-group variability was significantly greater in the TBI group. IMPLICATIONS: As there was no evidence of a uniform trend in gaze times among participants with TBI, general intervention to increase eye contact does not appear warranted. Instead, goals must consider that gaze is a highly complex behavior, not necessarily indicative of attention to one's partner, and that there are potential reasons for gaze aversion in individuals with cognitive limitations.
Adolescent↗
Barriers to condom use and needle cleaning among impoverished minority female injection drug users and partners of injection drug users.
This study was undertaken to describe sexual behaviors and drug use and other factors that inhibit condom use and needle cleaning among impoverished women who are injection drug users (IDUs) or sexual partners of IDUs. This study also investigated whether risky sexual behavior or barriers to risk reduction differ with ethnicity and level of acculturation. Survey instruments to assess drug and sexual activity were administered to 378 African American and Latina women recruited primarily from homeless shelters and drug recovery programs. The most commonly cited barriers to condom use were belief that partners did not have acquired immunodeficiency syndrome (AIDS), lack of knowledge about where to get and how to use condoms, and discomfort discussing condom use with partners. African American women were more likely to report having multiple partners and unprotected sex, and more likely to report barriers in using, discussing, and obtaining condoms. Latina women were more likely to report partners' dislike of condoms. African American and highly acculturated Latina women were more likely to be IDUs than less acculturated Latina women. The most pervasive barriers for needle cleaning were not having personal needles, being high and not interested in needle cleaning, and not having disinfectant available. In a multiple logistic regression analysis for engaging in unprotected sex and cleaning needles, not ethnic or acculturation differences were found after controlling for selected demographic characteristics and risk factors. The data indicate a need to increase the supply of free or low cost condoms, to provide easily accessible sites for obtaining condoms, to supply clean needles,and to focus counseling for women on negotiating condom use with partners and the skillful and correct placement of the condom.
Adolescent↗
Couples' support-related communication, psychological distress, and relationship satisfaction among women with early stage breast cancer.
This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress and relationship satisfaction. Videotapes were coded with the Rapid Marital Interaction Coding System. Analyses focused on partner responses to patient self-disclosures. During cancer-issue discussions, patients reported less distress when partners responded to disclosures with reciprocal self-disclosure and humor and when partners were less likely to propose solutions. Fewer links between partner responses to patient self-disclosures and distress were found in general-issue discussions. Results suggest partner responses play a role in women's adaptation to breast cancer.
Adult↗
The next pandemic: anticipating an overwhelmed health care system.
INTRODUCTION: In September 2005, an overview of current health care system planning efforts was presented to the audience at the Yale University Ethics Symposium on Avian and Pandemic Influenza. The speaker, also the author of this article, provided the audience with a summary of what was being undertaken with the use of federal preparedness funds to improve the overall infrastructure of the health care system. All of Connecticut's 31 acute care hospitals, the Veteran's Administration Hospital in West Haven, Hospital for Special Care, Gaylord Rehabilitation Hospital, Natchaug Psychiatric Hospital, and the state's 13 Community Health Centers are currently recipients of federal preparedness funds. Federal funding for this planning comes from Health Resources and Services Administration, Department of Health and Human Service's National Bioterrorism Hospital Preparedness Program. OBJECTIVES: This article outlines the planning activities around pandemic influenza that the state's health care system partners started in 2004-2005 and also those they are currently participating in or will be participating in the next 12 to 15 months. The article highlights the key objectives and strategies that health care facilities will be using in this planning. There are four major objectives that each health care facility's Emergency Operations Plan must address. They are: increasing bed availability, developing strategies to deal with the potential staffing shortages, developing strategies for dealing with potential critical equipment and pharmaceutical shortages, and, lastly, the implementation of education, training and communication strategies for their health care workers and the public they serve. These plans, and all the activities needed to operationalize the plans, such as education, training, drills, and exercises, will include their key partners, i.e., local health departments, local emergency management, police, fire, and Emergency Medical Services. This article will describe this work plan in detail. METHODS: Descriptive information was obtained through the author's observations and personal experiences, in addition to governmental guidance, reports, and plans. CONCLUSION: The "all-hazards" planning currently being undertaken by the key health care system partners in Connecticut as a result of federal funding for preparedness post 9/11 has fostered great working relationships between these entities and their local, regional, and statewide planning counterparts. Many of the specific grant dollars being provided to these facilities can assist in the planning that must be done for pandemic flu.
Connecticut↗
Intimacy as an interpersonal process: the importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges.
H. T. Reis and P. Shaver's (1988) interpersonal process model of intimacy suggests that both self-disclosure and partner responsiveness contribute to the experience of intimacy in interactions. Two studies tested this model using an event-contingent diary methodology in which participants provided information immediately after their social interactions over 1 (Study 1) or 2 (Study 2) weeks. For each interaction, participants reported on their self-disclosures, partner disclosures, perceived partner responsiveness, and degree of intimacy experienced in the interaction. Overall, the findings strongly supported the conceptualization of intimacy as a combination of self-disclosure and partner disclosure at the level of individual interactions with partner responsiveness as a partial mediator in this process. Additionally, in Study 2, self-disclosure of emotion emerged as a more important predictor of intimacy than did self-disclosure of facts and information.
Communication↗
Developing BSN leaders for the future: the Fuld Leadership Initiative for Nursing Education (LINE).
The Helene Fuld Leadership Initiative in Nursing Education (LINE) program was designed to enhance beginning leadership competencies of baccalaureate nursing students. Given the increasing need for strong and effective leadership throughout the health care system, and the demands new graduates encounter as they move into practice, the LINE program is built on the premise that leadership skills must be instilled at the undergraduate level. The program achieves its goal through an intensive 5-day institute focused on assessing and developing the leadership competencies of nurse educators and their clinical partners to enable them to be effective agents of curriculum change in their home institutions. The institute also assists participants to redesign their baccalaureate nursing (BSN) curricula to ensure that students learn to: (1) work effectively within and across complex, integrated organizational and institutional boundaries; (2) think and act from the perspective of a system; and (3) communicate, negotiate, lead, and facilitate change within health care organizations. D. Goleman's (1998) framework of emotional intelligence, which addresses both personal competence (managing oneself) and social competence (handling one's relationships with others) provides the framework for operationalizing leadership in the BSN curriculum. To date, 26 BSN programs and their clinical partners have participated in the LINE program, which has the potential to influence the beginning leadership development of more than 2,400 BSN students. Program outcomes reveal that education-practice collaboration, professional networking, individual leadership development of nurse educators and their clinical partners as change agents, and the integration of leadership experiences at all levels of the BSN curriculum are important in developing beginning leadership competencies in BSN students.
Communication↗
Acoustic patterns and communicative functions of phrase-final F0 rises in German: activating and restricting contours.
Acoustic features and communicative functions of phrase-final F(0) rises starting before an accented-vowel onset are analysed in a corpus of German unscripted speech. Two conversational conditions are examined: turn-yielding and turn-holding. The most important feature distinguishing rises in these two conditions is the range proportion, which differentiates between two patterns as follows: (1) raised pitch on the accented syllable and restrained pitch movement in the tail of the contour, (2) lowered pitch on the accented syllable and extended pitch movement in the tail. The first pattern is seen as a restrictive gesture, e.g. preventing the dialogue partner from turn taking. The second one is viewed as an activating gesture, inviting the coparticipant to contribute.
Communication↗
The present and future role of the consultant physician with an interest in infection. Council of the British Society for the Study of Infection.
The Council of the British Society for the Study of Infection (BSSI) has considered the present and future role of the Consultant Physician with an interest in infection. The BSSI is anxious to set standards and improve the quality of care delivered to patients with infection; to give advice on the prevention and management of infection and to provide such services economically to assist Health Managers in the purchase of infection-related medical services appropriate to the needs of the community they serve. New approaches to the care of infected patients are reviewed where the Clinical Specialist, Microbiologist and Consultant in Communicable Disease Control (CCDC)--in Scotland, Consultant in Public Health Medicine (CPHM)--work together in a team. As the U.K. moves closer to its European partners in 1992, it seems timely for each specialty to make a clear statement about its training programme and the requirements expected of a fully trained Consultant in each discipline. Comparisons between the ratio of Consultants with a special interest in infection and the population are made, where known, between U.K. and other European countries. A model job description for the U.K. clinical specialist is therefore being made available, the present inadequate numbers of consultants are stated and recommendations made to expand urgently the number of Consultant Physicians with an interest in infection.
Consultants↗
Improving information systems in Europe: EURETHNET.
The efforts of the European Commission to create a "European Research Area" in the field of biotechnology are accompanied by a growing demand for an ethical discourse. Cultural differences between the European Union's member states create a vital need to improve bioethical information structures in Europe so as to foster European bioethics discourses and to cope with ethical pluralism. Responding to the need for an increased European contribution to the international discussion on ethics in medicine and biotechnology, some of Europe's leading bioethics institutions have joined forces to establish the international network "EURETHNET". 18 partners from nine European countries agreed to develop an information network and knowledge base in the field of ethics in medicine and biotechnology. This short communication displays the aims, scope and realisation of the network.
Bioethics↗
Dating violence prevention with at-risk youth: a controlled outcome evaluation.
This study evaluated a community-based intervention to help at-risk teens develop healthy, nonabusive relationships with dating partners. Participants were 158 14-16-year-olds with histories of child maltreatment who were randomly assigned to a preventive intervention group or a no-treatment control group. They completed measures of abuse and victimization with dating partners, emotional distress, and healthy relationship skills at bimonthly intervals when dating someone. Intervention consisted of education about healthy and abusive relationships, conflict resolution and communication skills, and social action activities. Growth curve analyses showed that intervention was effective in reducing incidents of physical and emotional abuse and symptoms of emotional distress over-time. Findings support involvement of youths in reducing the cycle of violence as they initiate dating in midadolescence.
Adolescent↗
United we stand? The effects of a couple-coping intervention on adjustment to early stage breast or gynecological cancer.
Cancer diagnosis affects the psychological well-being of both patients and their partners, and effective coping has been suggested to be a conjoint process of mutual support. Ninety-four married women with early stage cancer and their partners were randomly assigned to couples-based coping training (CanCOPE), individual coping training for the woman, or a medical education control. Couples' observed support communication and self-reported psychological distress, coping effort, and sexual adjustment were assessed at diagnosis, after cancer surgery, and at 6- and 12-month follow-ups. CanCOPE produced significant improvements in couples' supportive communication, reduced psychological distress and coping effort, and improved sexual adjustment. Training in couples rather than individual coping was more effective in facilitating adaptation to cancer.
Adaptation, Psychological↗