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PubMed1998

New insights into erectile dysfunction: a practical approach.

Erectile dysfunction (ED) is the most common sexual problem in men, after premature ejaculation, affecting up to 30 million in the United States. In a society in which sexuality is widely promoted, ED impacts on feelings of self-worth and self-confidence and may impair the quality of life of affected men and their partners. Damage to personal relationships can ensue; and the anger, depression, and anxiety engendered spill over into all aspects of life. Patients are often embarrassed or reluctant to discuss the matter with their primary care practitioners. Unfortunately, many physicians fail to take the opportunity to promote open discussion of sexual dysfunction. They too, may avoid the topic through personal embarrassment. Since the National Institutes of Health (NIH) Consensus Conference on Impotence in 1992, the inadequate level of public and professional understanding of ED has begun to be addressed. As a first step in breaking down the communication barriers between patients and practitioners, it is important that physicians have a thorough understanding of the wide variety of conditions associated with ED and how the different risk factors for ED may be readily identified. This review addresses the diagnosis of ED and identifies diagnostic tests that can be used by primary care physicians to determine the patients most at risk and the treatments most suited to meet the patients' and their partners' goal for therapy.

Erectile Dysfunction↗
PubMed1999

Communication during gynecological out-patient encounters.

The intimate nature of women's health problems presented during gynecological encounters places great demands on gynecologists' communicative behavior. The present study examined what patients expect from their gynecologist, how gynecologists and patients actually communicate during out-patient encounters, and what factors shape the structure and process of the encounter. Twenty-one gynecologists (13 consultants and eight residents) videotaped 303 consecutive out-patient encounters. Multilevel analysis was used to take into account the similarity among encounters with the same gynecologist. The results showed that gynecological patients expected foremost to receive clear and understandable information. One-third of the patients expected support and understanding. Psychosocial issues were hardly ever the topic of conversation. The length of the out-patient visits increased in the presence of patients' partner, with the type of problem presented, and with the frequency with which the patient disagreed with the gynecologist. The visit was also longer when gynecologists provided more medical information and asked more psychosocial questions. Although gynecological encounters focus almost exclusively on medical issues, talking about non-somatic aspects does not seem to prolong the visit as much as the presence of the patient's partner or whether or not the gynecologist and patient had met before. In view of patients' affective needs, it would be worthwhile to examine whether gynecologists can be taught to handle patients' psychosocial needs as well.

Adult↗
PubMed1998

Black Sea TeleDiab: diabetes computer system with communication technology for Black Sea region.

BlackSea TeleDiab (BSTD) is a multidisciplinary research project whose aim is to promote the exchange of healthcare information between clinicians and scientists in countries of the Black Sea area to provide a means by which the care of patients with diabetes may be enhanced. The project is built on an existing organizational framework provided by the WHO Diabcare Quality Network (Q-Net) and the Black Sea Diab Action Project. The aim is to develop a standardized software package (in the national languages of the CCE/NIS Black Sea partners) for the storage and transfer of medical information and healthcare data between participating institutions. It will utilize a standard format for medical records based on the Good European Health Record (GEHR), a project within the Advanced Informatics in Medicine (AIM) program, which aims to develop and propagate a common architecture for computerized health records across Europe that can be used across clinical domains, countries, and computer systems.

Computer Communication Networks↗
PubMed1991

Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students.

The main purpose of this study was to evaluate the role of multiple psychosocial and knowledge-related antecedent factors that may predict sexual and alcohol and drug use behaviors that are associated with the transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus infection. Five hundred forty-four ninth-grade urban high school students were surveyed regarding knowledge, attitudes, and behaviors related to STDs and acquired immunodeficiency syndrome (AIDS). Results of multiple regression analyses indicate that higher levels of STD and AIDS knowledge were associated with lower levels of STD and AIDS anxiety (R2 delta = 0.09; p less than 0.001), fewer negative attitudes toward people with AIDS (R2 delta = 0.09; p less than 0.001), stronger perceptions of self-efficacy (R2 delta = 0.03; p less than 0.01), and stronger peer affiliation (R2 delta = 0.02; p less than 0.05). Negative attitudes toward people with AIDS were inversely related to knowledge (R2 delta = 0.08; p less than 0.001), social support (R2 delta = 0.02; p less than 0.01), and perceived self-efficacy (R2 delta = 0.01; p less than 0.05). Predictors of alcohol and drug use included perceived peer norms (R2 delta = 0.08; p less than 0.001) and strong peer affiliation (R2 delta = 0.05; p less than 0.001). The best predictor of sexual risk behavior was alcohol and drug use (R2 delta = 0.07; p less than 0.001). Lower levels of knowledge (R2 delta = 0.14; p less than 0.01) and perceived peer norms (R2 delta = 0.05; p less than 0.05) predicted nonuse of condoms. Our results indicate that several factors relate to adolescent risk for STDs: the connection between peer influence and adolescent risk behaviors, the link between alcohol and drug use and sexual risk behavior, and the role of knowledge in determining nonuse of condoms.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Enhancing relationships: understanding the feminine mystique of pretending orgasm.

As individuals become increasingly aware of their sexuality and orgasmic responsiveness, concomitantly, the phenomenon of pretending orgasm is becoming a greater part of the sexual relationship for many couples. However, few studies exist concerning this phenomenon despite the fact that nearly two-thirds of all females have reported pretending orgasm. Therefore, the purpose of this study was to profile those females who have pretended orgasm by examining the dimensions of their sexual and orgasmic behaviors, the factors that inhibit their orgasm, the dynamics of partner interaction, and any desired changes in their sexual lives. A survey research design was employed utilizing the responses of 805 professional nurses who participated in a study concerning self-perceptions of the female sexual response. The findings indicate that those females who have ever pretended orgasm became sexually active at a younger age and have been more sexually explorative than those females who have not pretended orgasm. Furthermore, the role of their sex partners was a significant dimension in their orgasmic pretense. The resultant impact on coupled relationships has many critical implications for therapists.

Adult↗
PubMedDate not supplied

Age and gender differences in sexual behavior preferences: a follow-up report.

This study extends prior research on gender differences in sexual behavior preferences. The authors administered the 6-factors Inventory of Dyadic Heterosexual Preferences (IDHP)1 to 76 married or cohabiting couples (mean age = 35 years). Their preference patterns were compared to similar data obtained previously from younger (mean age = 21 years), single respondents. Gender differences that were replicated included women's stronger preferences for romantic foreplay and men's greater erotophilia and preferences for using erotica and combining alcohol and drug use with sex. Women's stronger conventionality was not replicated among older partners, both of whom were less conventional than their younger counterparts. Older men and women were also more inclined toward the use of erotica. Unlike younger men, older men were more negative toward the use of contraception. Implications for sexual safety, adjustment, communication, and therapy are discussed.

Adult↗
PubMedDate not supplied

A comparative analysis of communication about sex, health and sexual health in India and South Africa: Implications for HIV prevention.

This paper provides a comparative analysis of modes of dialogue, non-verbal communication and embodied action relating to sex and health in two contrasting countries-India and South Africa-which have the world's two most heavily HIV-affected populations (in terms of numbers of people living with HIV). Drawing on material derived from multiple studies, including ethnographic and other forms of qualitative and multi-disciplinary research, the paper identifies commonalities as well as differences in communication relating to sex and sexual health in these diverse settings. The paper considers: first, how and by whom sex is and is not talked about, in public discourse and private conversation; second, how sexual intention and desire are communicated through indirect, non-verbal means in everyday life; and third, how references to sexuality and the sexual body re-enter within a more explicit set of indigenous discourses about health (rather than 'sexual health' per se), such as semen loss in India and womb 'dirtiness' in South Africa. The concluding section reflects on the implications of a comparative analysis such as this for current policy emphases on the importance of promoting verbal communication skills as part of 'life skills' for HIV prevention.

Cultural Characteristics↗
PubMed2005

Establishing an Internet-based tobacco-control network for Czech health professionals.

This article describes the background, implementation, and evaluation of an Internet-based health promotion network in the Czech Republic. The network was intended to build the indigenous capacity of Czech health professionals in the use of the Internet for tobacco control to organize and coordinate public health campaigns, heighten public awareness, and catalyze policy change. Multiple methods of evaluation included three needs assessment surveys, three training workshop evaluations, an Internet survey of participating member organizations, and quarterly reports from the project partners. The evaluation showed that an Internet-based network was established with 40 health professionals from 30 organizations. A grassroots heart disease prevention and tobacco-control advocacy group was formed. Network participants utilized and continue to utilize the Internet to communicate, research, coordinate outreach, and advocate tobacco-control issues.

Computer-Assisted Instruction↗
PubMed1986

Marital adjustment, intimacy and needs in female agoraphobics and their partners: a controlled study.

Female agoraphobics and their partners were compared with three groups of control couples (non-phobic female psychiatric patients and their husbands, maritally distressed couples, and happily married couples) on measures relating to marital adjustment, intimacy, and needs. Neither agoraphobics nor their partners rated their marriages as more maladjusted or unpleasant than non-phobic psychiatric patients or their partner controls. Instead, agoraphobics and their spouses were found to be more comparable to happily-married couples than to maritally-distressed controls. Non-phobic psychiatric patients and their partners were generally found to rate their marriages as being as distressing and unpleasant as those of maritally distressed controls.

Adult↗
PubMed2003

Community reaction to bioterrorism: prospective study of simulated outbreak.

To assess community needs for public information during a bioterrorism-related crisis, we simulated an intentional Rift Valley fever outbreak in a community in the southern part of the United States. We videotaped a series of simulated print and television "news reports" over a fictional 9-day crisis period and invited various groups (e.g., first-responders and their spouses or partners, journalists) within the selected community to view the videotape and respond to questions about their reactions. All responses were given anonymously. First-responders and their spouses or partners varied in their reactions about how the crisis affected family harmony and job performance. Local journalists exhibited considerable personal fear and confusion. All groups demanded, and put more trust in, information from local sources. These findings may have implications for risk communication during bioterrorism-related outbreaks.

Adolescent↗
PubMed2006

Uganda's successful Guinea Worm Eradication Program.

Having begun its national Guinea Worm Eradication Program (UGWEP) in 1991 (1991 population, 16.6 million) with the third-highest number of cases reported by any endemic country, and ranked as the second-highest endemic country in the world in 1993, by 2004, Uganda celebrated its first full calendar year with no indigenous cases of the disease. Systematic interventions began in 1992 and were gradually intensified until the final indigenous case occurred in July 2003. The favorable concentration of most cases in relatively few northern districts of the country was partly offset by chronic insecurity in much of the endemic area and by repeated importations of cases from neighboring Sudan. Strong support and dedicated leadership by government officials and external partners were keys to this program's dramatic success. This program cost approximately US dollar 5.6 million.

Animals↗
PubMed1994

[The personal computer as a rehabilitation aid for severely handicapped patients].

The case example presented outlines the efforts of a quadriplegic young man who has succeeded in finding himself an occupational basis through training as an expert in electronic desktop publishing (DTP). Due to his severe mobility handicaps, computerized workstations for DTP training had been put up both in the training company and in his own home. These Desktop Publishing systems enable even very severely disabled persons to perform at a par with non-disabled persons. If this adapted workplace is connected to a communication network, the work results need not be delivered materially to the place where they are needed or further worked on, but can be dispatched electronically to the addressee. Communication networks enable the disabled person to easily exchange data with other workstations, or, through the use of modems to access the public telephone system, to send messages from his private environment (e.g., for sending fax messages or placing information in his partners' electronic mailboxes).

Adult↗
PubMed2006

Making sense of syphilis: beliefs, behaviours and disclosure among gay men recently diagnosed with infectious syphilis and the implications for prevention.

BACKGROUND: The resurgence of syphilis in men who have sex with men (MSM) has proved remarkably resilient in the face of innovative control and prevention interventions. Understanding the determinants of the current outbreaks has been restricted by the available data. Qualitative work is needed to understand individual and community experiences of syphilis and to help guide new prevention and control efforts. METHODS: An exploratory study using semi-structured interviews with a convenience sample of MSM (n = 15), recently diagnosed with infectious syphilis, attending sexual health and HIV-outpatient services in Brighton, England. RESULTS: Analysis focussed on men's beliefs about syphilis, their experience of testing and being given a syphilis diagnosis, mediators of 'risky' sexual behaviour and disclosure to social and sexual contacts. Two beliefs--'syphilis is rare' and 'syphilis is dirty'--dominated respondents' accounts. These beliefs coloured every aspect of respondents' clinical and social experience of syphilis, and impeded disclosure and partner notification. They also contributed to misconceptions about behaviours with increased syphilis transmission risk, the mechanics of disease acquisition, health-seeking behaviours and risk-reduction strategies. CONCLUSIONS: The apparent failure of syphilis control measures so far may be due to our limited understanding of MSM's views and experience of STIs other than HIV Syphilis prevention needs to tackle MSM's widely held beliefs about sexual communication, risk behaviour and other STIs. The most useful health education interventions are likely to be those that build on MSM's significant knowledge base and address both the current syphilis crisis and wider sexual health promotion goals.

Adult↗
PubMed1999

Noverbal communication and alliance in therapy: the body formation coding system.

Body formations of therapist and couple during therapy sessions mainly function to signal their degree of readiness to interact or their degree of engagement in the therapeutic process, which is one contextual display of their affective communication. For this study, we developed the Body Formation Coding System (BFCS), a 4-category instrument to assess engagement at the triadic level. This article presents the BFSC method as well as a first validation on a sample of 14 triads. The results show that (a) triads vary according to their degree of triadic engagement; (b) engagement is related to the degree of therapeutic alliance; and (c) when the alliance is sufficient, a triadic invariant of engagement emerges. This means that partners regulate and coordinate their behaviors to maintain a stable level of engagement, whatever changes in their conversational organization. Finally, it discusses the potential of this method for describing the interactive aspects of the therapeutic alliance.

Female↗
PubMed1992

Symbol vocabulary and the focus of conversations: augmenting language development for youth with mental retardation.

Communication devices designed to augment the language development of individuals with severe cognitive disabilities and little or no functional speech typically contain primarily nouns because they seem easiest to acquire and evaluate. In this study, the effect of a more diverse vocabulary was assessed. Systematic observations of the use of computerized speech-output devices by 12 youth with moderate or severe mental retardation and severe spoken language disability and by their partners were made over a 2-year period. Social-regulative symbols (e.g., "please," "I'm finished") were used as soon as they were introduced, and their availability expanded the focus of conversations both at home and at school. Implications for conceptualizing variation in early language use and for the design of language intervention programs are discussed.

Child↗