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PubMed2005

Unraveling smoking ties: how tobacco use is embedded in couple interactions.

The purpose of this research was to explore couple interactions related to tobacco use prior to pregnancy, as part of a larger grounded theory project focused on couple interactions related to tobacco use. Interviews with 28 women who quit or reduced smoking for pregnancy and their partners were conducted. Analysis of retrospective accounts of pre-index pregnancy interactions resulted in the identification of tobacco-related routines related to: (a) regulation of smoking; (b) practices related to the acquisition, use and handling of tobacco; (c) communication about tobacco use; and (d) responding to slips and lapses. Variations in the enactment of routines were captured in three tobacco-related interaction patterns: (a) disengaged; (b) conflictual; and (c) accommodating. Findings provide insights into the role tobacco plays in relationships and resistance to behavior change.

Adult↗
PubMed2001

Gap junction protein connexin-43 interacts directly with microtubules.

Gap junctions are specialized cell-cell junctions that mediate intercellular communication. They are composed of connexin proteins, which form transmembrane channels for small molecules [1, 2]. The C-terminal tail of connexin-43 (Cx43), the most widely expressed connexin member, has been implicated in the regulation of Cx43 channel gating by growth factors [3-5]. The Cx43 tail contains various protein interaction sites, but little is known about binding partners. To identify Cx43-interacting proteins, we performed pull-down experiments using the C-terminal tail of Cx43 fused to glutathione-S-transferase. We find that the Cx43 tail binds directly to tubulin and, like full-length Cx43, sediments with microtubules. Tubulin binding to Cx43 is specific in that it is not observed with three other connexins. We established that a 35-amino acid juxtamembrane region in the Cx43 tail, which contains a presumptive tubulin binding motif, is necessary and sufficient for microtubule binding. Immunofluorescence and immunoelectron microscopy studies reveal that microtubules extend to Cx43-based gap junctions in contacted cells. However, intact microtubules are dispensable for the regulation of Cx43 gap-junctional communication. Our findings suggest that, in addition to its well-established role as a channel-forming protein, Cx43 can anchor microtubule distal ends to gap junctions and thereby might influence the properties of microtubules in contacted cells.

Amino Acid Sequence↗
PubMed2007

An analysis of the stressors and coping strategies of Chinese adults with a partner admitted to an intensive care unit in Hong Kong: an exploratory study.

AIMS: The aim of this study was to identify the major stressors affecting Chinese adults whose partner had been admitted to an intensive care unit and to understand the major coping strategies employed to manage such stressors. BACKGROUND: Recently a greater number of patients of higher acuity have been admitted to intensive care units and survive lengthy illnesses of an unpredictable course. Such critical illnesses have been identified as a major life event to family members of these patients. Little is known, however, about the stressors and coping mechanisms of Chinese adults whose critically ill partner is admitted to an intensive care unit. METHODS: An exploratory qualitative design was selected to achieve the aims of the study. A purposive sample of 10 Chinese adults with a partner in an intensive care unit of a regional general hospital in Hong Kong participated in tape-recorded semi-structured interviews. Content analysis was employed to analyse the translated interviews. FINDINGS: Categories of stressors included uncertainty, difficulties in communication, changes in roles and responsibilities, difficulties in decision making, financial strain as well as changes in relationships. Analysis identified a range of coping strategies which included seeking information, seeking support, reliance on cultural beliefs and practices, turning to religious beliefs, maintaining hope and acceptance of illness. CONCLUSIONS: The findings demonstrate the importance of cultural beliefs and practices in determining the coping mechanisms employed to manage the stressors identified by this sample of Chinese adults. Such findings indicate the use of both internal and external coping strategies in order to maintain equilibrium in the family. RELEVANCE TO CLINICAL PRACTICE: Implications for nursing practice highlight the significance of seeking information throughout the critical period and also culturally appropriate support from healthcare professionals.

Adaptation, Psychological↗
PubMedDate not supplied

Explaining demographic trends in teenage fertility, 1980-1995.

CONTEXT: The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live. METHODS: Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time. RESULTS: Factors associated with the increase in the teenage birthrate in the 1980s include negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort. CONCLUSIONS: Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce the proportion of adolescents having sex at an early age and to improve contraceptive use. The increasing risk levels among sexually experienced teenagers suggest that current programs may be reducing sexual activity among adolescents already at a low risk of a teenage birth, without addressing the needs of those at highest risk.

Adolescent↗
PubMed1988

A role for the hamster's flank gland in heterosexual communication.

It is commonly assumed that the male hamsters' flank glands subserve an agonistic role with other males as the intended recipients of the olfactory message. Because of little evidence to support such a relationship, two studies investigated whether females might selectively respond to male flank odors. In a free choice situation females spent more time in proximity with glandular rubbings obtained from intact males than those obtained from castrates or a clean control. Moreover, these sexually receptive females remained longer near odors from familiar as opposed to novel males. The second experiment demonstrated that receptive females spent more time in proximity with flank odors of dominant males as opposed to their subordinate partners or to a clean control. Females can use flank gland odors to discriminate among males as a function of their hormonal state, familiarity and dominance. If this occurs in the wild, such odors could provide cues which would facilitate intersexual selection.

Animal Communication↗
PubMed1992

Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual risk behavior.

Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.

Adolescent↗
PubMed1994

Towards authentic conversations. Authenticity in the patient-professional relationship.

The purpose of this paper is to evaluate the significance of the existential notion of authenticity for medical ethics. This is done by analyzing authenticity and examining its implications for the patient-professional relationship and for ethical decision-making in medical situations. It is argued that while authenticity implies important demand for individual responsibility, which has therapeutic significance, it perpetuates ideas which are antithetical both to authentic interaction between patients and professionals and to fruitful deliberation of moral dilemmas. In order to counteract these consequences, an alternative idea of authenticity is introduced. According to this idea, authenticity is not regarded primarily as individual sovereignty, but as an ability to participate in a dialogue in which the subjectivity of both partners is respected. Such practice, based on mutual trust and responsibility, would enhance common decision-making and overcome the alienation between patients and professionals.

Communication↗
PubMed2004

A phenomenology of problematic sexual behavior occurring in sleep.

First-person reports of individuals' experiences of problematic "sleep sex" were collected in an Internet-based study. Qualitative analysis of 121 reports yielded 6 distinct themes: (1) fear and a lack of emotional intimacy; (2) guilt and confusion; (3) a sense of repulsion and feelings of sexual abandonment; (4) shame, disappointment, and frustration; (5) annoyance and suspicion; (6) embarrassment and a sense of "self-incrimination." Results suggest that sleep sex can elicit negative emotions and cognitions that may become a source of personal and relational distress. Clinician familiarity with problematic sleep sex may foster more effective communication with individuals presenting with such complaints.

Adult↗
PubMed1997

Using existing health care systems to respond to the AIDS epidemic: research and recommendations for Chile.

Chile is a country with a relatively low prevalence of HIV infection, where successful prevention has the potential to change the future course of the epidemic. A controversial national prevention strategy based upon public education has emerged in response to characterizations of the epidemic as well-dispersed with a growing involvement of heterosexuals. This characterization is not consistent with the observed facts. There is a comparatively well-organized health care system in Santiago that is doing a good job of detecting HIV infection and already has in place the elements of a targeted intervention scheme. Chile should place priority on the use of the existing health care infrastructure for implementing both the traditional public health interventions for sexually transmitted diseases (contact tracing and partner notification) and the AIDS-necessitated strategy of focused counseling and education.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Internet policy and procedures for health care organizations: the approach of Partners Healthcare System, Inc.

The internet, and in particular the World Wide Web, are becoming significant elements of health care organization's strategic information technology plans. The Internet, although having great potential, also poses risks to the organization, and its use must be managed. The article discusses the Internet policies and procedures developed by Partners Healthcare System, with emphasis on the philosophies behind and the major components of the policies and procedures.

Authorship↗
PubMed1999

Public evaluation of an announcement of public interests communicated by an AIDS patient.

Announcements of public interests (APIs) on television (TV) have been an important means of AIDS prevention. Recently in Hong Kong, the first API on TV which was communicated by a male AIDS patient, named J.J., was displayed on the screen from April to December, 1995. The objective of this study is to examine the effectiveness of this API, as compared with other APIs previously shown in Hong Kong. Collecting data from a random sample of 1,275 residential respondents in Hong Kong through a telephone survey, this study demonstrated that the public gave very favorable evaluation on J.J.'s API, when compared with other APIs. Remarkable impacts of J.J.'s API on the public included increasing concern for AIDS, condom use, and testing blood for HIV infection, and reducing the number of sex partners. The impacts tended to be more salient on male than female viewers. Some of these impacts also appeared to vary by different levels of education and family income.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Content analysis of verbal communication between spinal cord injured and nondisabled male college students.

Does the interaction between a disabled person and a nondisabled person differ in content and climate from the interaction between two nondisabled persons? The purpose of this study was to compare dyadic interaction behavior of traumatically disabled and nondisabled men paired in homogeneous or mixed dyads. Forty-five disabled and 45 nondisabled men, assigned to dyads consisting either of two disabled students, two nondisabled students, or one disabled and one nondisabled student, discussed a low, medium and high intimacy topic. A group of trials analysis of variance was used to assess the effects of dyad composition and topic intimacy on self-disclosure. Dyads consisting of two nondisabled partners exhibited the least self-disclosure at all levels of topic intimacy. Dyads in which both partners were disabled exhibited the most self-disclosure on low and medium intimacy topics and had the greatest frequency of disability related responses. The mixed dyads exhibited the most self-disclosure on the high intimacy topic. Disabled subjects in homogeneous dyads exhibited greater depth of self-disclosure than nondisabled subjects in homogeneous dyads. The implications of the results are discussed in terms of facilitating the acquisition of interaction skills for traumatically disabled persons, evaluating patient-staff communication and the role of peer counseling in rehabilitation settings.

Adolescent↗
PubMed2007

Does the UK government's teenage pregnancy strategy deal with the correct risk factors? Findings from a secondary analysis of data from a randomised trial of sex education and their implications for policy.

BACKGROUND: Much of the UK government's 1999 report on teenage pregnancy was by necessity based on rather old or non-longitudinal research. AIM: To examine the associations between risk factors identified in the report and pregnancy at or before age 16 years among young women and partners of young men using the more recent data. RESULTS: Socioeconomic disadvantage, being born to a teenage mother, expectation of being a teenage parent, low educational expectations and various other behaviours are potential risk factors for teenage pregnancy, as suggested by unadjusted analyses. Those who cited school as providing information on sex had a reduced risk of pregnancy at or before age 16 years, as did girls reporting easy communication with parent or guardian at baseline. Various measures of low sexual health knowledge were not associated, in either adjusted or unadjusted analyses, with increased risk of pregnancy at or before age 16 years among boys or girls. CONCLUSIONS: A focus on many of the risk factors identified in the 1999 report is supported herein. It is suggested that knowledge may not be an important determinant, but that relationships with parents and school, as well as expectations for the future, may have important influences on teenage pregnancy. The analysis also provides new insights into risk factors for pregnancies among the partners of young men.

Adolescent↗
PubMed2005

The role of docking interactions in mediating signaling input, output, and discrimination in the yeast MAPK network.

Cells use a network of mitogen-activated protein kinases (MAPKs) to coordinate responses to diverse extracellular signals. Here, we examine the role of docking interactions in determining connectivity of the yeast MAPKs Fus3 and Kss1. These closely related kinases are activated by the common upstream MAPK kinase Ste7 yet generate distinct output responses, mating and filamentous growth, respectively. We find that docking interactions are necessary for communication with the kinases and that they can encode subtle differences in pathway-specific input and output. The cell cycle arrest mediator Far1, a mating-specific substrate, has a docking motif that selectively binds Fus3. In contrast, the shared partner Ste7 has a promiscuous motif that binds both Fus3 and Kss1. Structural analysis reveals that Fus3 interacts with specific and promiscuous peptides in conformationally distinct modes. Induced fit recognition may allow docking peptides to achieve discrimination by exploiting subtle differences in kinase flexibility.

Amino Acid Sequence↗
PubMed1982

Influence of olfactory signals on the reproductive behaviour of social groups of rhesus monkeys (Macaca mulatta).

Olfactory influences are important in the control of reproductive function in many mammalian species including primates. Previous studies have shown that a mixture of volatile aliphatic acids (copulins), normally present in the vaginal secretions of rhesus monkeys, can exert a stimulatory effect on the sexual behaviour of males when pairs are tested in small cages. The present study deals with the role of these substances when tested in social groups of rhesus monkeys housed in a large testing arena, the purpose being to assess the effectiveness of olfactory signals under more nearly naturalistic conditions. Each group consisted of one male with four long-term ovariectomized females from which the male could choose. A counter-balanced experimental design was used in which each female of a testosterone-treated pair was given applications to the sexual skin of either copulins or control ether immediately before each 1-h behaviour test. After 16 tests, the procedure was repeated with the previously untreated pair in each group, and nine groups were separately studied. Testosterone was used here simply to enhance female proceptivity. The results showed that females received significantly more ejaculations (P less than 0.05), mounting attempts (P less than 0.01) and mounts (P less than 0.05) when bearing copulins than when bearing control ether. There were positive responses to copulins in 12 of the 36 males-females pairs, involving all males, and positive responses to ether in five of 36 pairs, involving four males. Copulins resulted in a change in the choice of sexual partner in five males, but there were no changes in the choice of partner with ether. Social factors, such as dominance, could override the responses to olfactory signals, and there was a significant treatment order effect, but this was eliminated by the counter-balanced design. These findings indicate a significant role for olfactory communication in mate selection in a socially living higher primate.

Animals↗
PubMed1992

Establishing the role of the clinical nurse specialist in postanesthesia care.

The postanesthesia clinical nurse specialist (CNS) is a relatively new and developed role, one that is needed and that can be justified in the specialty of postanesthesia care nursing. This article describes a model with components of expert practitioner, educator, researcher, consultant, and liaison. The sub-role of change agent pervades all other roles of the postanesthesia CNS. Establishment of the role is examined using change theory. Fitting this specialty CNS into the organization is briefly examined through systems theory. Integrating the role into the system requires role making, role taking, and steps to reduce the stress associated with establishing a new role. Communication with involved subsystems, such as postanesthesia staff nurses, management, anesthesia staff, and physicians, is vital to the success of the role. Through education and interaction, significance of the role can be demonstrated to establish the postanesthesia CNS as a vital partner in postanesthesia nursing practice.

Consultants↗
PubMed2006

State diabetes prevention and control program participation in the Health Disparities Collaborative: evaluating the first 5 years.

BACKGROUND: Approximately 20.8 million people in the United States, or 7% of the population, have diabetes mellitus. Treatment for this disease costs Americans more than 130 billion dollars yearly, and it is the sixth leading cause of death. The prevalence of diabetes has grown substantially in recent decades and is expected to continue to rise. CONTEXT: The medically underserved and poor are at greater risk of developing diabetes and its complications than are other members of the U.S. population. The Health Resources and Services Administration makes health care resources and services available to economically disadvantaged populations through the Health Disparities Collaborative (HDC), a consortium formed to pool resources and services from state- and community-level donors. Since 1999, many of the Centers for Disease Control and Prevention's Division of Diabetes Translation State Diabetes Prevention and Control Programs (DPCPs) have joined the HDC to leverage resources and services. METHODS: The purpose of a 2004 evaluation was to examine the impact that DPCP involvement with the Collaborative had on aspects of diabetes care at Federally Qualified Health Centers (FQHCs). An electronic survey was administered to DPCP coordinators. They were asked about 1) their roles and experience as participants in the Collaborative; 2) the skills and expertise most useful in developing and maintaining an effective collaboration for improved health care for diabetes; 3) which DPCP contributions were viewed as being routine and which were perceived to be essential; 4) the effects of DPCP contributions on the use of the chronic care model under which FQHCs operate; and 5) which health systems improvements played the greatest role in enhancing components of the chronic care model. CONSEQUENCES: Most respondents identified themselves as DPCP coordinators with 3 years of experience in that position. Organizational skills, such as communication, leadership, conflict resolution, negotiation, and meeting management, were cited as necessary to develop and maintain collaborative partnerships. DPCP contributions to FQHCs were perceived to be training, technical assistance with clinical care and patient education, financial resources, linkages to other diabetes partners, educational materials, and improved linkages with community resources. INTERPRETATION: DPCPs contribute resources, skills, knowledge, and varied perspectives to the Collaborative that FQHCs may not have otherwise.

Centers for Disease Control and Prevention, U.S.↗
PubMed1966

Conjoint psychotherapy of marital pairs.

Many traditional concepts are being challenged in contemporary psychiatric practice, including the classical "one-to-one" relationship of individual psychotherapy. Where the patient's presenting difficulties include significant inability to function or feel happy in the marital role, the technique of conjoint psychotherapy (having both partners treated simultaneously by the same doctor) may be indicated. Conjoint therapy is envisaged as a continuum, embracing a considerable range of situations where it is sound practice to see husband and wife together. The treatment plan has three stages: complaint, clarification, and compromise, each of which presents specific features and pitfalls. Emphasis is placed on dealing with individual psychopathology of each partner, both per se and in relation to the marital situation. Results to date suggest that conjoint treatment represents a promising therapeutic modality. Even in cases where individual psychopathology cannot fully be resolved, certain plateaus of satisfaction may be attained as communication improves.

Adult↗