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PubMed2006

One woman's journey is a journey we all may share.

In recent years, there has been a growing awareness of the need to take account of the patient's own experience of illness. Although this is to be welcomed, it is also important to hear the stories of those most affected by the patient's illness, their partners, their families, their communities and those who care for them. 'On being both professional and human: one woman's journey' provides a powerful example of how narrative may assist clinicians to learn about communication, care, presence and the effect of illness and death on those left behind.

Attitude to Health↗
PubMed1999

Molecular genetics of tooth morphogenesis and patterning: the right shape in the right place.

Development of the mammalian tooth has for many years served as a useful model system for the study of cell-cell interactions in organogenesis. Early development of teeth (tooth buds) shows many morphological and molecular similarities with early development of other organs such as the lung, hair, kidney, etc. There has been much progress toward understanding epithelial/mesenchymal cell signaling in tooth germ formation. Advances in understanding the formation of different shapes of teeth (morphogenesis) at their correct positions in the jaws (patterning) has, until recently, been less forthcoming. We review here the latest ideas on the control of odontogenic patterning and morphogenesis. The stages of early tooth development are well-defined histologically and have been described in numerous textbooks. The progression from localized thickenings of oral epithelium to bud, cap, and bell stages provides an adequate description of the gross morphological changes seen in the epithelial cells of early developing tooth germs. Less obvious are the concomitant changes taking place in the dental (ecto)mesenchymal cells which originate from the cranial neural crest and which condense around the tooth bud epithelium. However, it is very clear that these mesenchymal cells are equal partners with epithelium during the early stages of tooth germ formation and undergo complex changes which, although not obvious histologically, are revealed with molecular (gene) probes. Genes identified as being important for the early communication between the epithelial and ectomesenchymal cells mainly comprise those which code for proteins which act as secreted signals between the cells (ligands) and those that code for nuclear proteins that act to control gene expression in response to the signals. Little is presently known about the changes in structural proteins such as cell adhesion molecules which are involved in mediating the physical interactions between cells and generating the morphological changes.

Animals↗
PubMed2000

Going underground and going after women: trends in sexual risk behaviour among gold miners in South Africa.

This paper examines trends in risk behaviour among South African gold miners, a population with an estimated HIV prevalence of 10-20%. The study is based on a 1995 and 1997 survey of a random sample gold miners in the town of Welkom, South Africa. The results show that the percentage of miners who perceived they were likely to contract HIV increased from 33% in 1995 to 35% in 1997 (P<0.01). The percentage who had 4 or more partners in the past year decreased from 25% to 13% (P < 0.01), and the percentage whose last sexual partner was their spouse increased from 56% to 70% (P<0.01). Condom use in last intercourse with a spouse increased from 18% to 26% (P < 0.05). Condom use with other partners was considerably higher (67%), but did not increase significantly from 1995. The most likely contributors to this behaviour change were the AIDS awareness programmes implemented by the mining industry and the behaviour change communications of a condom social marketing campaign targeted at miners and commercial sex workers in the mining community.

Condoms↗
PubMed1994

Vital links for today and tomorrow. With one stage of MIS development complete, an integrated delivery network looks to the future.

Over the past four years, Provenant Health Partners (PHP), Denver, has been developing and implementing a management information system to meet the organization's current needs. The system consists of the following information networks: Internal management; Electronic claims processing; Purchasing; Physician communications; Clinic communications; Physician practices; Other hospitals,offnaged health. In the past, PHP used the system primarily for traditional management and control purposes. Recently, however, the organization has extended the use of its data outputs to include internal and external marketing purposes as well. Clinical, service, and management quality data are now tracked and shared with internal and external constituents. PHP is also working to develop a health information system for the future. Such a system will include all the components of the current management information system, but will also facilitate effective health management of populations enrolled in the organization's integrated delivery network.

Colorado↗
PubMed1993

Kenyan university students' views on AIDS.

In view of the rapidly increasing number of AIDS cases reported in Kenya since 1984, a survey was conducted among Kenyatta University undergraduate students during October and November 1988 to gauge their knowledge, attitudes and practices with regard to the disease. A random sample of 344 individuals both men and women was interviewed. The results showed that almost everyone had heard about AIDS and the knowledge was spread evenly across gender. Although the students were able to identify the symptoms of a full blown AIDS victim, their knowledge on HIV was vague. Other findings were: that condoms were lowly rated as a strategy for minimizing the risk of contracting AIDS and the majority of the students attempted to reduce the chance of contracting the disease by having one sex partner. However, the students were apathetic about contracting the disease. In the event of becoming victims of AIDS, most of them indicated that they would not merely wait to die; instead they would commit suicide. In view of these findings, there is a case for educating this group on how to respond to the AIDS infection.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Previous experience in teleradiology could serve as a first lesson to telepathologists.

The author draws the following conclusions from twenty years of experience with teleradiology and in telemedicine in general. 1) Standardise now. Use existing standards, keep protocols open for other partners. The use of "protected" or "slightly" modified standards will not open the market. On the contrary, it will slow down developments in telepathology. How many manufacturers are capable of exchanging images over normal communication lines (analog or ISDN) with others than themselves? 2) Develop adequate user-interfaces. Priority levels should be set. The display has to adapted to the user. For pathologists this means using a microscope to view the images that have been sent [11]. For radiologists this means a dynamic user-interface adapted to the radiologists needs and wishes and which provides the best possible working environment [5]. 3) Integration with the HIS. The purchase and installation of telemedicine equipment should be integrated in a whole informatisation strategy and not be considered as a standalone act.

Computer Communication Networks↗
PubMedDate not supplied

Evaluating the program effects of a radio drama about AIDS in Zambia.

This study describes an approach to the analysis of data that is designed to isolate program effects for evaluations and applies that approach to a program in Zambia designed to disseminate AIDS information. Evidence is considered that a radio drama broadcast for nine months had an impact on knowledge and behavior related to AIDS among Bemba speakers in northern Zambia. Using results from large sample surveys (1,600 men and women), conducted before and after the drama was broadcast, the analyses compare changes in knowledge and behavior in those most likely and least likely to have listened to the broadcast. While the population as a whole had improved its knowledge substantially, and some people reported having reduced risky behavior, attributing these changes to the program itself was not possible.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Diabetes care management: a managed care approach.

A Diabetes Care Management program was developed by PrimeCare, a network model HMO, to improve quality of life health outcomes and reduce the costs of medical care for its members with diabetes. The HMO used a systems-based approach to communicate information about appropriate self-management and standards of care to members and physicians. The focus of the program was to educate and encourage patients to self-manage their illness, and to partner with physicians, other health care providers and community organizations to achieve improved quality of life, clinical and financial results. Clinical process indicators were used to measure results of interventions. Significant increases in the percentage of participants receiving glycosylated hemoglobin (HbA1c) tests, retinal eye exams and lipid panel tests were achieved.

Diabetes Mellitus↗
PubMed2006

Rethinking the benefits of an adapted version of 'Alzheimer Café' for individuals with Alzheimer's and their partners.

This article reviews dementia care in the context of an adapted version of an Alzheimer's Cafe focusing on eight couples newly diagnosed with dementia. It is primarily a reflective account. The adapted version of an Alzheimer Café focused on providing an informal café with more emphasis on communication, education and support for couples. It also seeks to provide a critical platform to evaluate the impact of developing such approaches like, (Alzheimer Café) in contrast to other approaches like, couple therapy, relationship and person centred approaches.

Adaptation, Psychological↗
PubMed2003

Gender inequalities, intimate partner violence and HIV preventive practices: findings of a South African cross-sectional study.

The aim of the paper is to investigate associations between a range of markers of gender inequity, including financial, psychological and physical violence, and two proximal practices in HIV prevention, namely discussion of HIV between partners and the woman suggesting condom use. The paper presents an analysis of data from a cross-sectional study of a representative sample of women from three South African Provinces which was primarily undertaken as an epidemiological study of gender-based violence. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households. Households were randomly selected from within clusters. One randomly selected woman aged 18-49 years was interviewed in each selected home. One thousand three hundred and six women were interviewed (90.3% of eligible women). One thousand one hundred sixty four women had a partner in the previous year and were asked questions related to HIV prevention and gender inequalities in the relationship. The results indicate that discussion of HIV was significantly positively associated with education, living in Mpumalanga Province, the man being a migrant, the woman having multiple partners in the past year and having no confidante. It was significantly negatively associated with living in the Northern Province, the relationship being poor and there being a substantial age difference between partners. The woman suggesting condom use was significantly positively associated with her education, her having multiple partners, domestic violence prior to the past year and financial abuse. It was negatively associated with the relationship being poor. We conclude that this suggests that some indicators of gender inequalities are significantly associated with discussion of HIV and condom use but the direction of association found was both positive and negative. This highlights the need for a more nuanced understanding of gender inequalities and their relationship to HIV risk. Suggestions for key research questions are made.

Adolescent↗
PubMedDate not supplied

Challenges of managing child behavior in the 21st century dental setting.

This paper discussed factors influencing behavior management of the child dental patient. Pediatric dentists are affected by changes in: (1) society; (2) marketing and media; (3) communications and technology; and (4) parenting practices. Behavior of pediatric patients reflects fewer boundaries, less discipline and self-control, and lowered behavioral expectations by parents and contemporary culture. The insurance industry, regulatory bodies, legal system, dental staff, and pediatric dentist education are other influences on behavior management. Responses of the American Academy of Pediatric Dentistry (AAPD), which could support the pediatric dentist in the changing environment, include: (1) research; (2) continuing education for staff and dentists; (3) development of Internet accessible materials for the public; (4) legislative activity; (5) partnering with pediatric medicine to develop new behavior management strategies; (6) establishment of an AAPD Council on Child Behavior; and (7) ongoing critical reassessment of behavior issues by the AAPD.

Behavior Control↗
PubMed1990

The ontogeny of antiphonal calling in European starlings.

The ontogeny of antiphonal calling was studied in free-living European starlings. Nestlings participate in three types of vocal exchanges: (1) Broodmates exchange calls while the parents are away; (2) parents and nestlings exchange calls during feeding; (3) nestlings exchange calls with parents approaching from a distance. Analysis of the temporal patterning of vocal interactions revealed call alternation and avoidance of acoustic overlap in exchanges of the first and third types. The antiphonal exchanges between parents and young develop shortly before fledgling and appear to help family groups maintain contact after the young have left the nest. Early antiphonal exchanges between broodmates are as smooth as later ones between parents and chicks, suggesting that chicks quickly attain proficiency at antiphonal interactions and do not rely on an adult partner to maintain the pattern. There are parallels with the development of vocal turn-taking in human infants.

Aging↗
PubMed2002

Domestic violence: how to ask and how to listen.

Significant numbers of women experience physical, sexual, and psychological abuse by their partners or family members and come to the emergency department for care. The nurse has a unique opportunity to make a difference in these women's lives by simply asking about the abuse in a caring and confidential manner. Listening and thinking in terms of a stage-based approach to behavioral change with battered women may guide the emergency nurse toward more effective intervention strategies. The goal is not to "fix it" but rather to partner with her and offer options that may help shift her trajectory toward more safety and less isolation.

Adolescent↗
PubMed2002

Credible threats and promises.

We consider various implications of information about the other player in two-player evolutionary games. A simple model of desertion shows that information about the partner's behaviour can be disadvantageous, and highlights the idea of credible threats. We then discuss the general issue of whether the partner can convince the focal player that it will behave in a specific way, i.e. whether the focal player can make credible threats or promises. We show that when desertion decisions depend on reserves, a player can manipulate its reserves so as to create a credible threat of desertion. We then extend previous work on the evolution of trust and commitment, discussing conditions under which it is advantageous to assume that a partner will behave in a certain way even though it is not in its best interest.

Animal Communication↗
PubMed2006

Interpersonal and noninterpersonal interactions, interpersonal motives, and the effect of frustrated motives.

A new circumplex model of interpersonal interaction emphasizes the motives that drive interpersonal behaviors and the negative affect (such as anger) that occurs when a strongly activated motive is frustrated. This study examined the model experimentally by varying conditions designed to activate and frustrate interpersonal motives. One hundred twenty-nine students engaged in text-based discussions using a computer. Three factors were varied: (a) activation of interpersonal motives--participants believed the interaction was interpersonal (with a human) or noninterpersonal (with a computer); (b) individual differences in motive activation--assertive and nonassertive participants were compared (strong vs. weak motive to influence others); and (c) level of frustration of activated motives--the "partner's" messages contained dominating or nondominating language. Participants who believed their interaction was interpersonal produced more interpersonal behaviors of various types. Assertive participants who interacted with a dominating and apparently human partner produced a disproportionate amount of hostility, indicating anger ascribed to frustrated motives.

Adult↗
PubMedDate not supplied

Making the choice. A close look at the joint venture option. Part I.

The rapidly changing, highly challenging present and future marketplace facing group practices raises many questions for administrators. One answer to this new marketplace is to form an alliance with a financial partner who can provide capital and management expertise. Author Keith Korenchuk, J.D., M.P.H., describes the concept of acquiring such a partner and how to handle the process.

Commerce↗