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PubMed2002

Family influences on adolescent sexual and contraceptive behavior.

Studies of adolescent pregnancy risk are relevant to understanding responsible adolescent sexual behavior because most investigators have focused on the key proximal determinants of pregnancy--sexual intercourse and contraceptive use--rather than analyzing pregnancy status per se. Lesser pregnancy risk is associated with teens remaining sexually abstinent, postponing onset of intercourse, and having intercourse less often or with fewer partners, as well as by using contraception at first or most recent intercourse and by using contraception consistently over time. Living with a single parent, in a lower SES family, having older sexually active siblings or pregnant/parenting teenage sisters, being a victim of sexual abuse, and residing in disorganized/dangerous neighborhoods all place teens at elevated risk of adolescent pregnancy. Parent-child closeness or connectedness, and parental supervision or regulation of children, in combination with parents values against teen intercourse (or unprotected intercourse), decrease the risk of adolescent pregnancy. Studies about parent-child sexual communication and adolescent pregnancy risk are less conclusive, largely because of methodological complexities.

Adolescent↗
PubMed2003

Chlamydial infection: an accurate model for opportunistic screening in general practice.

OBJECTIVES: To estimate the prevalence of Chlamydia trachomatis in women in general practice and to assess risk factors associated with infection. METHODS: The study was carried out in 2001-2 in different general practices in Antwerp, Belgium. Sexually active women, visiting their general practitioner for routine gynaecological care (mostly pill prescription or PAP smear), were offered opportunistic screening for chlamydia. 787 participants aged 15-40 delivered a self taken vaginal sample and filled in a questionnaire which included questions on demographic variables, urogenital symptoms, sexual history, and sexual behaviour. Samples were tested for presence of chlamydial DNA by means of a ligase chain reaction (LCR) assay, and positives were confirmed by two other amplification assays (PCR and SDA). RESULTS: Overall prevalence was 5.0% (95% CI: 3.5 to 6.5). Determinants of infection in logistic regression analysis were age 18-27 years, >1 partner in the past year, no use of contraceptives, frequent postcoital bleeding, having a symptomatic partner, painful micturition, and living in the inner city. The area under the ROC curve in the full model was 0.88. Selective screening based on a combination of the five first determinants detects 92.3% of infections in this sample; 37.5% of the population would need to be screened. CONCLUSION: Targeted screening for chlamydial infection is possible, even in a heterogeneous group of general practice attendants. Implementing this model would require considerable communication skills from healthcare providers.

Adolescent↗
PubMedDate not supplied

Designing and building new local public health agencies in Nebraska.

Prior to 2001, the local public health system in Nebraska was weak, fragmented, and severely under funded. Local public health departments covered only 22 of the state's 93 counties. The Turning Point project provided the impetus for change by allowing a diverse group of public health stakeholders to develop a strategic plan for strengthening and transforming the public health system. The plan acted as a catalyst to use some of the Nebraska Tobacco Settlement Funds to provide dedicated state funding to build the local public health system. By June 2002, 16 new local public health departments had been organized, ultimately covering all of the 93 counties in the state. Some of the keys to long-term sustainability are creating a network of community health partners that support collaborative decision making, continually seeking input from the community, developing and implementing an education and training plan for public health professionals and local board of health members, and demonstrating accountability by documenting results and communicating them to policy makers and the general public.

Community Health Planning↗
PubMed2006

Multiple effects of joint attention intervention for children with autism.

Joint attention refers to an early developing set of behaviors that plays a critical role in both social and language development and is specifically impaired in children with autism. In a series of three studies, preschool teachers demonstrated the effectiveness of discrete trial instruction and pivotal response training strategies to teach joint attention to 5 children with autism (Study 1). Parents of 2 of the 5 children also taught joint attention at home and in the community (Study 2). Several additional dependent measures demonstrated collateral improvements in expressive language and social-communicative characteristics that were socially validated by parent raters (Study 3). Results are discussed with respect to the importance of addressing different forms of joint attention, the necessity to extend intervention to naturalistic contexts and joint attention partners, the pivotal nature of joint attention, and whether intervention adequately addresses both the form and social function of joint attention.

Attention↗
PubMed2006

Novel function of beta-arrestin2 in the nucleus of mature spermatozoa.

A growing number of proteins originally found in endocytic structures of the plasma membrane appear to be able to traffic into the nucleus, but the cellular function of this translocation remains unclear. We have found that beta-arrestin2, which typically shows a cytoplasmic localization owing to constitutive nuclear export, appears in the nucleus after stimulation of the G-protein-coupled odorant receptor hOR17-4. In the nucleus, beta-arrestin2 was involved in transcriptional regulation as shown by a Gal4-based transactivation assay. Moreover, we discovered that beta-arrestin2 and hOR17-4, a receptor known to have a role in sperm-egg communication, colocalize in the midpiece of mature human spermatozoa. Stimulation of hOR17-4 in spermatozoa induced PKA-dependent translocation of beta-arrestin2 to the nucleus and nuclear accumulation of phosphorylated MAPKs. Analysis of the interaction partners of beta-arrestin2 indicates that odorant receptor signaling in spermatozoa may be important for the regulation of gene expression during the early processes of fertilization.

Aldehydes↗
PubMed1995

The Georgia Information Network for Public Health Officials (INPHO): a demonstration of the CDC INPHO concept.

The Georgia Division of Public Health is serving as the first demonstration model of a statewide implementation of the Centers for Disease Control and Prevention Information Network for Public Health Officials. The goals of the project are to make communication easy, to make information accessible, and to make data exchange as swift and as smooth as technology will allow. By having a state-of-the-art telecommunications network, public health officials will be able to rapidly collect health data and transform them into meaningful health status information that can be used to inform health policy decisions. The Georgia Information Network for Public Health Officials is a unique consortium of private and public sector partners funded with a grant from the Robert W. Woodruff Foundation. The project will install the telecommunications infrastructure and the supporting software to position Georgia public health as the health information leader of the state.

Centers for Disease Control and Prevention, U.S.↗
PubMed1999

Prevalence of communicable disease among restaurant workers along a highway in Assam, India.

105 workers of 29 roadside restaurants along a highway in Assam were interviewed for their habits, educational status and were examined for their hygienic status and presence of communicable diseases (STDs,TB etc). Most of them were young, males with 40% literacy; more than half were unmarried. About 30% of them were alcoholic and smokers and 2.9% were addicted to cannabis. The hygienic conditions of the workers were poor. More than one third had sexual contact with multiple sex partners or commercial sex workers and 2% were engaged in homosexual activity. Most of them did not use condom. 25.7% of them had genital lesions suggestive of sexually transmitted disease, 11.8% showed gram negative diplococci in urethral smears and 5.1% were VDRL reactive. Skin infections followed by gastrointestinal disorders and respiratory tract infections were other prevalent problems. 70.6% were positive for intestinal parasites and 22.2% were sputum positive for acid fast bacilli. However all the collected blood samples were negative for HIV.

Adult↗
PubMed2000

A qualitative study of women's views about how health professionals communicate about infant feeding.

OBJECTIVE: To look at how communication by health professionals about infant feeding is perceived by first time mothers. DESIGN: Qualitative semi-structured interviews early in pregnancy and 6-10 weeks after birth. SUBJECTS AND SETTING: Twenty-one white, low income women expecting their first baby were interviewed mostly at home, often with their partner or a relative. RESULTS: The personal and practical aspects of infant feeding which were important to women were seldom discussed in detail in ante-natal interviews. In post-natal interviews women described how words alone encouraging them to breastfeed were insufficient. Apprenticeship style learning of practical skills was valued, particularly time patiently spent watching them feed their baby. Women preferred to be shown skills rather than be told how to do them. Some felt pressure to breastfeed and bottle feeding mothers on post-natal wards felt neglected in comparison. Women preferred their own decision-making to be facilitated rather than being advised what to do. Some women experienced distress exposing their breasts and being touched by health professionals. Continuity of care and forming a personal relationship with a health professional who could reassure them were key factors associated with satisfaction with infant feeding communication. CONCLUSIONS: The infant feeding goal for many women is a contented, thriving baby. In contrast, women perceive that the goal for health professionals is the continuation of breastfeeding. These differing goals can give rise to dissatisfaction with communication which is often seen as 'breastfeeding centred' rather than 'woman centred.' Words alone offering support for breastfeeding were often inadequate and women valued practical demonstrations and being shown how to feed their baby. Spending time with a caring midwife with whom the woman had developed a personal, continuing relationship was highly valued. Women were keen to maintain ownership, control and responsibility for their own decision-making about infant feeding.

Journal Article↗
PubMed2001

What parents are told after prenatal diagnosis of a sex chromosome abnormality: interview and questionnaire study.

OBJECTIVE: To investigate how the prenatal diagnosis of a sex chromosome anomaly is first communicated to parents. DESIGN: Health professionals were interviewed by telephone and the conversation was taped; parents were sent questionnaires at 1 month after diagnosis and those who responded were sent another at 6 months. PARTICIPANTS: 29 health professionals who had recently informed parents that a sex chromosome anomaly had been identified in an apparently anatomically normal, viable fetus. 23 mothers and partners who had been informed of such a diagnosis. MAIN OUTCOME MEASURES: Health professionals' knowledge about sex chromosome anomalies and parents' responses to information provided by health professionals. RESULTS: Analysis of the telephone interviews identified great variation in what different healthcare professionals know, think, and say about the same sex chromosome anomaly. The small numbers and the low response rate for the questionnaire (39% for women and 30% for men) meant that statistical analysis was not appropriate. CONCLUSIONS: It is essential for obstetric units to have an established protocol for giving results and for all staff who communicate results to parents to have accurate, up to date information about the condition identified.

Adult↗
PubMed2005

Effects of information and group structure on evolution of altruism: analysis of two-score model by covariance and contextual analyses.

An altruistic individual has to gamble on cooperation to a stranger because it does not know whether the stranger is trustworthy before direct interaction. Nowak and Sigmund (Nature 393 (1998a) 573; J. Theor. Biol. 194 (1998b) 561) presented a new theoretical framework of indirect reciprocal altruism by image scoring game where all individuals are informed about a partner's behavior from its image score without direct interaction. Interestingly, in a simplified version of the image scoring game, the evolutionarily stability condition for altruism became a similar form of Hamilton's rule, i.e. inequality that the probability of getting correct information is more than the ratio of cost to benefit. Since the Hamilton's rule was derived by evolutionarily stable analysis, the evolutionary meaning of the probability of getting correct information has not been clearly examined in terms of kin and group selection. In this study, we applied covariance analysis to the two-score model for deriving the Hamilton's rule. We confirmed that the probability of getting correct information was proportional to the bias of altruistic interactions caused by using information about a partner's image score. The Hamilton's rule was dependent on the number of game bouts even though the information reduced the risk of cooperation to selfish one at the first encounter. In addition, we incorporated group structure to the two-score model to examine whether the probability of getting correct information affect selection for altruism by group selection. We calculated a Hamilton's rule of group selection by contextual analysis. Group selection is very effective when either the probability of getting correct information or that of future interaction, or both are low. The two Hamilton's rules derived by covariance and contextual analyses demonstrated the effects of information and group structure on the evolution of altruism. We inferred that information about a partner's behavior and group structure can produce flexible pathways for the evolution of altruism.

Altruism↗
PubMed2005

Confronting the obstacles to screening and interventions for alcohol problems in trauma centers.

Despite the demonstrated clinical benefits and decreased risks of injury recurrence, brief alcohol interventions are still not routine practice in trauma centers. Although alcohol and drugs play a significant role in trauma, few trauma specialists are aware of the potential benefits of interventions because alcohol treatment specialists have not widely disseminated their findings to other specialties. This article addresses some key obstacles that must be overcome to facilitate brief interventions as routine trauma practice. Included are discussions on training, cost and reimbursement factors, responsibility of the trauma surgeon, patient privacy and confidentiality issues, insurance laws and regulations, needed collaboration with partners, and research priorities and funding.

Alcohol-Related Disorders↗
PubMedDate not supplied

The life and afterlife of AT&T's HealthSite.

What was going to be the richest, most potent healthcare web site died only 30 days after it debuted. Its strategic partners, surprised and feeling a little abandoned, say they learned a critical lesson in the new field of marketing on the Internet.

Computer Communication Networks↗
PubMedDate not supplied

[Crisis intervention in child sexual abuse].

The impact of sexual abuse on children's development of attachment behaviour is especially disastrous when the abuse happens early in childhood, and when it lasts over a long period of time, and in case the abuser is closely related to the child. These early traumatic experiences regularly result in damages to the mental, physical and emotional development of a child. The main task of youth welfare is to protect children against maltreatment. For being able to do so it is significant to emphasize a scientific approach to the hypothesis-based risk evaluation and the conceptualization of intervention. In order to come to a sound conclusion the agencies and professionals involved in a case of child abuse have to collaborate professionally. Potential misunderstandings between the collaborating partners in this procedure will be discussed, as well as the way out of the labyrinth.

Adolescent↗
PubMed2002

A survey of STI policies and programmes in Europe: preliminary results.

OBJECTIVES: A survey was conducted to assess the adequacy of sexually transmitted infections (STI) prevention and control policies and programmes in the European region (including the central Asian republics). METHODS: An adapted World Health Organization (WHO) model questionnaire was sent to ministry of health officials in all 45 countries of Europe and central Asia. The questionnaire included questions on STI programme structure; STI case management; the different types and levels of services, including public and private service providers; partner notification and screening policies; services for vulnerable populations; monitoring and supervision; surveillance and research. RESULTS: Western European countries largely leave STI prevention and care to individual practitioners. Licensed providers exist at all levels of care, and access to consultations and treatment is usually free of charge. In the newly independent states (NIS), by contrast, programme efforts emphasise state guidance and supervision of local providers rather than individual practitioners. Access to services is limited in that in several NIS, only public sector specialists are licensed to treat STI. Formerly free of charge policies have been severely eroded. While in western Europe access to condoms appears to be good, in the NIS there are many fewer condom outlets. Regionwide, in 40% of countries the distribution of condoms is part of STI consultations. CONCLUSIONS: Non-availability of affordable high quality STI services, including STI treatment and condoms, may be one of the causes for the much higher STI prevalence in parts of eastern Europe and NIS than in western Europe.

Communicable Disease Control↗
PubMed2006

Protein-protein interaction through beta-strand addition.

Protein-protein interactions have essential roles at almost every level of organization and communication in living cells. During complex formation, proteins can interact via covalent, surface-surface or peptide-surface contacts. Many protein complexes are now known to involve the binding of linear motifs in one of the binding partners. An emerging mechanism of such non-covalent peptide-surface interaction involves the donation or addition of a beta strand in the ligand to a beta sheet or a beta strand in the receptor. Such 'beta-strand addition' contacts can dictate or modulate binding specificity and affinity, or can be used in more promiscuous protein-protein contacts. Three main classes of beta-strand addition can be distinguished: beta-sheet augmentation; beta-strand insertion and fold complementation; and beta-strand zippering. A survey of protein-protein complexes in the protein data bank identifies beta-strand additions in many important metabolic pathways. Targeting these interactions might, thus, provide novel routes for rational drug design.

Animals↗
PubMed2002

Psychiatric issues related to infertility, reproductive technologies, and abortion.

Infertility, treatment with reproductive technologies, and abortion are among the most emotionally weighty and philosophically contentious experiences in most patients' lives. They involve the most intimate body parts and behaviors and the most heartfelt hopes and profound disappointments. They can strain relationships with partners, relatives, and friends. The primary care practitioner who is informed about the psychological impact of these experiences can play an essential role in interpreting medical information; helping patients think through their own values, resources, and options; facilitating communication between members of a couple and with their friends and family; providing emotional support; and identifying and treating psychiatric disorders that sometimes occur before, during, or after these experiences.

Abortion, Induced↗