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PubMed2001

A preliminary examination of adolescent girls' perceptions of the parental knowledge of their boyfriends.

STUDY OBJECTIVE: The purpose of this study was to describe adolescent girls' perceptions of their parents' contact with and knowledge of the girls' boyfriends. A second objective was to determine if knowledge was related to demographic characteristics of the girls or aspects of the relationship with their boyfriend. DESIGN: Cross-sectional analysis of data from an interview with adolescent girls enrolled in a longitudinal study. SETTING: Urban adolescent medicine clinic. PARTICIPANTS: Adolescent girls (n = 109) with a mean age of 17.6 (range 14.9-19.3 yr). Eighty percent were African-American and 20% were Caucasian. RESULTS: Most girls reported that their parents had some contact (either in person or on the phone) with their boyfriends. Thirteen girls reported that their parents did not know their boyfriends well, 40 reported that their parents knew their boyfriends somewhat, and 56 reported that their parents knew their boyfriends well. Age, race, and sexual experience were not related to how well the parents knew the boyfriend. Girls who had been involved with their boyfriends longer, believed that their relationship would last longer, were more satisfied, were more likely to tell their boyfriends private information and were more likely to describe their parents as knowing their boyfriends well. CONCLUSIONS: These results provide an initial description of girls' perceptions of their parents' relationships with their boyfriends. It would be important to understand how to utilize the information regarding these parental-boyfriend relationships to further adolescent girls' development of healthy (both psychologically and physically) relationships.

Adolescent↗
PubMed2003

Power imbalance between nurses and patients: a potential inhibitor of partnership in care.

The Patient's Charter identifies the need for nurses to respect patients' rights to influence their care, and contemporary nursing practice advocates that nurses work in partnership with patients. Hence nurses are encouraged to share their power and facilitate empowerment in their patients by giving them information and support. However, the literature indicates that nurses are not very successful in making patients feel empowered to make informed decisions. This study, conducted in 1998, provides some answers as to why this may be the case. The aim of the study was to explore and describe nurses' and patients' views regarding partnership in care in hospital. Using the grounded theory approach, participants were drawn from four hospitals in Western Australia. A purposive sample of 33 nurses and 32 patients were interviewed in-depth. Participant observation was also conducted and field notes were written. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings showed that nurses viewed involving patients in care as requiring them to give patients information and to share their decision-making powers with them. With the exception of a few, the majority of nurses were unwilling to share their decision-making powers. This created a situation of power imbalance with subsequent little patient input. Factors identified included nurses' beliefs that they "know best", the view that patients lacked medical knowledge and the perceived need for nurses to hold onto their power and maintain control. If nurses and patients are to work as partners, it is important that nurses make every effort to equalize the power imbalance. One way to do this is for nurses to share and give information to patients readily and to be open in their communication with them.

Attitude of Health Personnel↗
PubMed1977

Marital therapy in prison: one-partner 'couple therapy'.

The intent of this article is, first, to describe some currently available means of strengthening marital and family ties for the incarcerated offender, and to point out the inherent limitations of these processes. Second, we will describe common reactions of inmates to marital crises, especially impending divorce. Third, we will make some comments and recommendations about the conduct of 'marital therapy' when the therapist has access to only one spouse or partner. Inefficient and dysfunctional as such an approach may sound to the therapist accustomed to working with couples 'on the streets,' it is often the only alternative available to the correctional mental health professional when the imprisoned marital partner is in a state of acute pain, with both crisis intervention and follow-up treatment critical.

Communication↗
PubMed2004

How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors, interventions, and gaps in our accumulated knowledge.

UNLABELLED: Maintenance of abstinence from cigarettes during pregnancy yields important benefits for both women and children, yet only 20%-30% of pregnancy cessation lasts 1 year postpartum. This paper reviews accumulated knowledge about factors that influence restarting smoking and the effectiveness of interventions to decrease it. Evidence from six trials and six multivariate predictor studies is provided, supplemented by qualitative and more focused quantitative studies. Studies were international, with diverse candidate predictors, intensity and timing of interventions, theory, designs, and measures of quitting and of maintenance postpartum. RECOMMENDATIONS: (a). Partner smoking must be addressed in interventions with cessation messages. (b). Intervention studies should include women of lower socioeconomic status and Black women. (c). Program developers and researchers should adopt a consistent standard for cessation. (d). Communication laboratory methods should test ways to increase intrinsic reasons for abstinence and success attributions to stable, internal causes. (e). Staging for postpartum smoking should supplant relapse prevention alone. (f). Among those whose intention it is to maintain nonsmoking postpartum, standard relapse prevention treatment is insufficient to combat environmental cues that also have been suspended for the pregnancy and typical problems of sleeplessness, stress, depression, and weight concern. (g). Interventions ideally should begin in late pregnancy, when postpartum smoking goals can be revised and plans made to manage postpartum issues. (h). Innovative methods for reducing postpartum problems should be tested. (i). Study of incentives for pregnancy cessation should include varying patterns, carryover to early postpartum months, and focus on their impact on long-term change.

Adult↗
PubMed2002

Women and arthritis: burden, impact and prevention programs.

OBJECTIVES: To characterize the public health burden and impact of arthritis among women, document the growing interest in addressing arthritis as a public health problem, and review new national (Centers for Disease Control and Prevention [CDC]) and state arthritis programs. RESULTS: Arthritis and other rheumatic diseases are a major public health problem, affecting nearly 27 million women in 1997 and accounting for 23.9 million ambulatory medical care visits and 451,000 hospitalizations among women in that year. Arthritis is also the leading cause of disability and is associated with considerable functional limitations. The 1999 National Arthritis Action Plan: A Public Health Strategy prompted first-time congressional funding to the CDC to monitor the burden of arthritis and to establish state arthritis prevention programs through cooperative agreements. The CDC's Arthritis Program also used this funding to build the public health science base, develop national health communications campaigns, foster partnerships, and initiate health systems change. CONCLUSIONS: Arthritis in general and selected types, such as rheumatoid arthritis, systemic lupus erythmatosus (SLE), and fibromyalgia, disproportionately affect women. The CDC, state health departments, and their partners are working toward improving the quality of life for women affected by arthritis. Effective, evidence-based interventions, such as self-management education and physical activity programs, are currently available and can reduce pain, improve function, and delay disability, but they remain underused. Future research should focus on improving earlier diagnosis and increasing access to effective interventions.

Age Distribution↗
PubMed2004

Optimizing the alliance in couple therapy.

The complexity of the relation between alliance and outcome in couple therapy was investigated in a study of 47 couples in brief therapy. Self-rated alliance was measured after the first and third sessions using the couple version of the Working Alliance Inventory. The results indicated that the correlation between alliance and outcome was significantly stronger when the partners agreed about the strength of the alliance, when the male partner's alliance was stronger than the female's, and when the strength of both partners' alliance increased as therapy progressed. The authors suggest that a unique feature of couple therapy is that the partners have both a preexisting relationship with each other (allegiance) and an alliance with the therapist to balance.

Adult↗
PubMed1995

AIDS risk behaviours and correlates in teenagers attending sexually transmitted diseases clinics in Los Angeles.

OBJECTIVE: Of all age groups, teenagers have the highest rates of sexually transmitted diseases. Therefore, it is particularly important to target interventions at this group. Teenagers attending STD clinics are at particularly high risk since behaviours that lead to an STD can also result in the transmission of HIV. The goal of this study was to collect information concerning the prevalence and correlates of high-risk behaviours in this population as a first step in the design of an effective intervention programme. METHODOLOGY: Face-to-face interviews were conducted with patients attending five STD clinics operated by the Los Angeles County Department of Health Services. RESULTS: In the exclusively heterosexual teenage subgroup (N = 100, 55% Hispanic, 28% African-American, 10% White), males became sexually active at a younger age than females (14 years vs 14.9 years, p < 0.02), had more partners in the last 12 months (4.1 vs 2.0, p < 0.003), more "steady" partners (2.2 vs 1.4, p < 0.02) and more life time partners (14.1 vs. 4.1, p < 0.001). Only 10.0% of males and 3.8% of females reported consistent condom use with steady partners and 36% of both male and female respondents with non-steady partners. The decision to use condoms during vaginal sex was most likely made by the respondent, whereas the decision not to use condoms was most likely a joint decision. CONCLUSIONS: An intervention aimed at improving sexual communication regarding condom use could increase this behaviour among many adolescents, since only few teenagers in our sample perceived condom use as unpleasant.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Oxysterol binding proteins: in more than one place at one time?

Oxysterols are potent signalling lipids that directly bind liver X receptors (LXRs) and a subset of oxysterol binding protein (OSBP) related proteins (ORPs). It is relatively well established that the oxysterol-regulated function of LXRs is to control the expression of genes involved in reverse cholesterol transport, catabolism of cholesterol, and lipogenesis. In contrast, the mechanisms by which oxysterols and ORPs affect cellular lipid metabolism have remained poorly understood. In this review, we summarize the information available on function of the ORPs and compare the two families of proteins binding oxysterol to demonstrate the different responses that similar lipids can elicit within cells. The other focus is on the membrane targeting determinants and the protein interaction partners of ORPs, which provide interesting clues to the mode(s) of ORP action. Specifically, we suggest a model in which a general property of ORPs is to function at membrane contact sites, specialized zones of communication between two different organelles.

Cholesterol↗
PubMed2000

Women's responses to sexual violence by male intimates.

The purpose of this grounded theory study was to devise a theoretical framework that describes the problem of sexual violence by male intimates from the point of view of 23 women who have experienced such violence at some time in their adult lives. The core variable, forging ahead in a dangerous world, reflects the women's descriptions of life after violence as a struggle to get on with their lives in a social world they know through first-hand experience to be unsafe. The theoretical framework includes three variations of forging ahead (getting back on track, starting over again, and surviving the long, hard road) described by three subgroups of women who experienced different types of sexual violence. The framework also outlines three common processes used to forge ahead: telling others, making sense of the violence, and creating a safer life. The nature and meaning of these processes differ according to group.

Adaptation, Psychological↗
PubMed2002

Interdisciplinary telecommunication and expert teleconsultation in diagnostic pathology: present status and future prospects.

Telepathology can be performed in an active or a passive manner. There are two main types: interdisciplinary telepathology and expert teleconsultations. Interdisciplinary telepathology involves a pathologist and another specialist (e.g. a radiologist or endoscopist). It is mainly used in an active manner (i.e. online and in realtime) and has three purposes: to ensure correct tissue sampling, to provide additional diagnostic information to the pathologist, or to facilitate collaborative therapeutic or diagnostic decision making between the clinician and pathologist. Expert teleconsultations, typically between two pathologists, are mainly undertaken in passive mode (i.e. offline and using store-and-forward techniques). The Internet often serves as a platform for both types of telepathology application. Experience with interdisciplinary telepathology is rare at present and is usually limited to partners at a local institution. The efficiency and accuracy of expert teleconsultations in telepathology have been demonstrated in numerous studies. In future, the application of expert teleconsultation in pathology will expand, with the Internet as the communications medium. Interdisciplinary telepathology is a promising technique to improve diagnostic quality.

Diagnostic Services↗
PubMedDate not supplied

The Zen of physician initiatives.

Many physicians today feel ravaged by the brutal speed with which change has been occurring. They see the beliefs and practices of a lifetime being abandoned and replaced by the flavor of the month, management du jour. But if you are willing and able to take the brave step of approaching your physicians without an agenda, meeting with them to listen to their concerns, and can also avoid hanging a lightning-rod label on every bright new idea that comes out of the sessions, you'll be on the way to effective new management. This new style is a "Zen" approach (but don't give it that label) that lets real collaboration come into the place that is supposed to be all about healing--the health care organization. From "never call it anything" to "stay with them until they get it," ideas on how to be a Zen manager are presented, with the ultimate goal of truly partnering with physicians and infusing them with a desire to move beyond the frustration and disenchantment they are feeling.

Adaptation, Psychological↗
PubMed1999

The NCI All Ireland Cancer Conference.

The National Cancer Institute (NCI) has recently decided to embark on an international partnership with the developing cancer programs on the Island of Ireland (Northern Ireland and the Republic of Ireland) in an attempt to further improve the quality and range of cancer services available for patients. This Transatlantic Partnership called the All Ireland-NCI Cancer Consortium offers exciting opportunities in cancer treatment, education and research as the cancer-caring communities from both the Republic of Ireland and Northern Ireland prepare to join with the U.S. NCI in this major endeavor. The inaugural event of the partnership will be the NCI All Ireland Cancer Conference to be held in Belfast, October 3-6, 1999. (See www.allirelandcancer.com, for information on the conference.) Cancer is a significant cause of mortality and morbidity on the Island of Ireland. There are approximately 28,000 new cases and approximately 11,000 deaths from cancer each year. Therefore, Northern Ireland and the Republic of Ireland have among the highest cancer incidence and mortality rates in the Western World. In recent years there has been a major restructuring of cancer services in both parts of the Island. This is the result of several government reports such as the Campbell Report in Northern Ireland and the National Strategy Document for Cancer in the Republic of Ireland. The National Strategy Document proposes that cancer treatment services should be centered around primary care services, regional services, supra-regional centers and a national coordinating structure whereby the supra-regional centers deliver specialist surgery, medical and radiation oncology, rehabilitation and specialist palliative care. Three supra-regional cancer centers are being established in the cities of Dublin, Cork and Galway and a National Cancer Forum, which has served as a multidisciplinary advisory board to the Government, has pushed the development and implementation of this plan. This has already resulted in a major expansion in the number of medical oncologists practicing in Ireland but further development is required to facilitate multidisciplinary care, to establish programs of education and training and to harness the scientific talent available to engage in the international effort against cancer. In Northern Ireland the Chief Medical Officer commissioned a report entitled "Cancer Services-Investing for the Future" whose key recommendations were that Northern Ireland should have one cancer center in Belfast and four smaller cancer units. This report also recommended the implementation of a multidisciplinary approach to cancer diagnosis, treatment and palliative care. As in the Republic, all the recommendations of the Report have been accepted and the planning and implementation of this plan are now well under way. Therefore, development of services for cancer patients is a top priority for both governments on the Island and, given the process of cancer service development, it is timely to bring international expertise such as the NCI on board as partners in this effort. The decision by the NCI to develop an agreement for cancer research and service development in Ireland is a major boost for those involved in cancer care and research and will, no doubt, help speed the process of redevelopment. There have already been several visits from senior NCI personnel to Ireland including Dr. Klausner, the Director of the NCI, to determine the potential impact of this agreement and to identify the most productive areas of interaction between the NCI and the Irish Cancer Community. As a result of these visits, the NCI has decided to focus on several areas of strategic importance whose objectives will be to enhance clinical services, improve patient care, promote North South collaboration and cement strategic Ireland-U.S. collaboration in cancer research and development. The agreement will build on existing informal links in U.S.-Irish scientific, medical education and training and also promote clinical trials and cancer epidemiology programs. Major components of the NCI Ireland Agreement will include some of the following: EDUCATION AND EXCHANGE OF SCHOLARS: Education will form one of the major platforms of this agreement through the support of educational programs for medical, nursing and scientific staff. These will include the exchange of scholars, including Ph.D., M.D. and nursing students. Particular emphasis will be given to the exchange of medical and nursing trainees focused on clinical research. This will have an immediate clinical impact and will naturally extend the support that has already been given to the training of medical and scientific trainees from the Island of Ireland. Further exchanges would include Ph.D. students, laboratory-based M.D.s in training, clinical visiting professors and investigators from the U.S. wishing to extend their studies in Ireland. CLINICAL TRIALS: Another major area for partnership will be the enhancement of a clinical trials infrastructure and clinical trial development. Modernization of cancer care requires that delivery of care should be in the context of evidence-based medicine. This requires a vigorous and contemporary clinical trials infrastructure which would center around the clinical trials infrastructure already established at the Northern Ireland Cancer Centre and the Irish Clinical Oncology Research Group (ICORG) in the Republic of Ireland. The NCI has already commissioned the development of a new Clinical Trials Information System (CTIS) which seeks as its goal to set international standards in the clinical trials process, and it has already committed significant resources to its implementation. The outcome of this element of partnership will be that clinical trials performed in Irish institutions will immediately be compatible for collation, analysis and presentation with studies performed in the U.S. Moreover, this system will allow participating centers to immediately conform to international standards. This proposal therefore permits participating institutions in Northern Ireland and the Republic of Ireland to quickly achieve data management standards of the highest quality. TELECONFERENCING: Teleconferencing capabilities are already established in both the NCI and in Ireland and indeed limited teleconferencing linkages have already been established between the partners. Further investment in this infrastructure will be vital to the success of major elements of this partnership. It will facilitate clinical trial development, education programs, patient services development and exchange of clinical and scientific ideas. Communication between sites will be essential to the success of this partnership. TUMOR REGISTRIES: Another area for major collaboration and partnership will be in the use of the Cancer Tumor Registries in both Northern Ireland and the Republic of Ireland. The monitoring of improvements in cancer care can only be undertaken with a reliable tumor registry that tracks population-based cancer incidence and mortality. These data are now available in both Northern Ireland and the Republic of Ireland, and both Governments recognize their importance. The NCI proposes to assist both Tumor Registries by developing a common database that can assist in consultation, informatic tools and quality control. Consolidation of the Registries, North and South, will improve the overall quality of data collection and provide information on a genetically stable population. This therefore will act as a major tool for epidemiological investigations and programs focused on screening and prevention. DEVELOPMENTS IN CANCER CLINICAL SERVICES: The NCI Ireland partnership also proposes to assist the further development of clinical service programs on the Island of Ireland. These will include the improvement and standardization of Radiation Oncology practice and the development of a consolidated Radiation Oncology program for research. There are a limited number of radiation facilities on the Island of Ireland and there are significant needs in terms of linking practice elements and the implementation of uniform standards of practice. Assistance in standardizing and driving the development of clinical services will also extend to elements of medical and surgical oncology practice as well as palliative care. The development of palliative care services is already at an advanced stage on the Island of Ireland and is one that the NCI will carefully evaluate in terms of its own developing programs. THE NCI ALL IRELAND CANCER CONFERENCE: An important event to highlight the commencement of this special relationship will be the NCI All Ireland Cancer Conference to be held in Belfast October 3-6, 1999. This Conference will address clinical, laboratory, epidemiological and political issues that are pertinent to the care of cancer patients. It will highlight important work by Irish, American and European scientists with further input from well-known international academic and biotechnology investigators from across the world. These international experts will not only be asked to speak on their areas of expertise but also to comment on clinical and scientific programs that may help improve North and South interaction and Transatlantic collaboration. Finally, it is hoped that the Conference will be a marker of a very special interaction on the Island of Ireland focused on the overall development of cancer services for patients. It will also signal the start of an important partnership between the NCI and those involved in cancer care and research in Ireland. This tripartite cooperative agreement is a most exciting venture and it will hopefully be an example of how an effort focused on a human problem common to all societies can generate a spirit of cooperation and help to eliminate strife.

Journal Article↗
PubMed2001

Geriatric oral health issues in Germany.

A review of the oral health issues for the elderly in Germany is presented. The percentage of aged and very old people in the total population of Germany is increasing rapidly, as is the percentage of the dentate population due to the high standard of dental care. The percentage of the edentulous population has therefore decreased. It has become necessary for all who care for the elderly, to adjust to caring for the dentate patient and to begin to work together and communicate about the patient's needs. Physicians in particular need to be given training in the detection of caries, periodontal diseases and denture problems. They should feel comfortable working with the dentist and dental team as partners in rehabilitation treatment. The dental treatment needs of the German population aged 70 years and older are not yet adequately met although the social insurance of the elderly includes dental treatment. Provision of oral health care for the dependent elderly, especially those who are homebound or in nursing homes, is not effectively organised and has to be completely reconsidered. The social health insurance and the social long-term care insurance must adjust their insurance coverage to the dental needs of the frail elderly. The development and further improvement of age-adjusted dental care is of crucial importance with respect to future demographic changes.

Aged↗
PubMedDate not supplied

[Role of elderly and aged callers in the total clientele of a telephone counseling service].

Data from a study of the clientele of the telephone counselling service concerning people aged 45 to 65 and over 65 years are presented. It can be shown that elderly people often use telephone counselling as a permanent partner for social contacts. It is critically discussed whether a telephone counselling service should be established exclusively for older people.

Adult↗
PubMed1984

Suppression of the mixed lymphocyte reaction by alloantigen-primed and -stimulated human spleen lymphocytes.

This communication examines the ability of T cell-enriched preparations from human spleen to suppress lymphocyte proliferation following activation in the mixed lymphocyte reaction (MLR). To enable the generation of a subsequent responding MLR between identical partners to those employed in the initial (stimulating) MLR, spleen T cells were frozen at the time of the first culture. Spleen T cells, stimulated in this way, showed a marked ability to suppress human MLR responses, but HLA-D identity was required for the full expression of suppressor activity. The characteristics of the spleen MLR-induced suppressor T cell resemble closely those described for MLR-generated suppressor T cells in human peripheral blood.

Adult↗
PubMed1994

Reducing AIDS and other STDs among inner-city Hispanics: the use of qualitative research in the development of video-based patient education.

We report on the use of qualitative research in the design of video-based interventions aimed at reducing AIDS and other sexually transmitted diseases (STDs) among inner-city Hispanics. Focus groups, personal interviews, and clinic observations were conducted in the South Bronx and Queens, New York, to inform the development of culturally sensitive video-based materials for improving prevention education provided at inner-city STD clinics. Findings elucidate culturally defined gender roles and responsibilities regarding the introduction of condom use into primary and nonprimary relationships, as well as other norms, attitudes, and behaviors reducing the effectiveness of current AIDS and other STD prevention efforts. Too often, educational materials--including an increasing number of videos--are based on untested assumptions about what information should be provided rather than adequate formative research. One reason may be that the literature contains few accounts of how the empirical evidence obtained through such research can be translated into theoretically sound interventions. This paper explicates such a process.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Parish nursing: a system approach. Suggestions for planning and implementing parish partnerships.

The Parish Nurse Program at Chicago-based Resurrection Health Care Corporation (RHCC) sponsors partnerships between the corporation and parishes in the Chicago area to provide holistic, preventive healthcare services; access to appropriate resources; and witness to Jesus' healing mission. In RHCC's program, a parish nurse's role includes acting as a personal health counselor, discussing health concerns with parishioners and visiting them at home, in hospitals, and in nursing homes. The parish nurse also serves as a health educator, referral source for community resources, and facilitator for volunteer and support groups. The first step in introducing a parish nurse program is alerting staff within the organization and the surrounding community about the program. One way the parish nurse program director can do this is by developing a communications plan with the system's marketing and public relations staff. Members of a parish nurse program steering committee, the system's vice president for mission effectiveness, and professional peers should then work together to create supporting documents (e.g., job descriptions and pay grades) and an implementation plan. After the program basics are in place, partners can be sought and assessed. When a partnership is established, recruitment and orientation of the parish nurse begins. Once hired, the parish nurse should participate in the system's and the parish's orientation and continuing education sessions. A parish nurse with no previous experience as such should meet with an experienced parish nurse to get advice on interacting with parishioners and hospital and parish staff.

Catholicism↗