The social context of the emergence of HIV in Thailand.
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Acquired Immunodeficiency Syndrome↗
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[From research to users: the Worksafe European Project and the IST-Gaslini Prevention and Safety Project].
OBJECTIVE: The Worksafe Project aims at increasing access to and use of the large amount of data related to the broad sector of health protection of workers and workplace safety recognising the key role of the communication and dissemination of the research results with particular reference to cancer. PARTICIPANTS: Four scientific institutes: National Institute for Research on Cancer, Genoa (IST); Finnish Institute of Occupational Health (FIOH), Helsinki; Karolinska Institutet (KI), Stockholm; International Agency for Research on Cancer (IARC), Lyon, and two technological partners (Softeco Sismat, Genoa; Fundacion Robotiker, Bilbao). RESULTS: The creation of the Worksafe portal, a web based infrastructure that allows knowledge sharing on top of a distributed digital data collection and provides web accessed services addressing a broad interested audience including biomedicine companies universities, research institutions, local and national public organisations and private users.
Environmental Illness↗
Balancing research and service: the experience of the cancer information service.
BACKGROUND: The National Cancer Institute's Cancer Information Service (CIS), the nation's foremost resource for cancer information, has supported cancer control research throughout its 22-year history. The Cancer Information Service Research Consortium (CISRC) is a consortium established to fully involve the CIS in theory-based cancer control research. METHODS: This paper focuses on the experiences of the CIS Project Directors in the development and implementation of three research projects within the CIS program. Conclusions are drawn from discussions that have taken place over time in such venues as conference calls, CISRC Members Council meetings, and project advisory meetings. RESULTS: Overall, the CISRC/CIS collaboration has been successful. A number of factors have contributed to this success, including the perceived value of the research within the CIS and the mechanisms and structures established to foster collaboration. The lessons learned, based on the challenges and opportunities of implementing these intervention research projects within the operations of the regional CIS offices, are discussed. CONCLUSIONS: Integration of research within a service program requires careful planning and preparation. Mutual benefit, shared ownership, consistency with current practice, staff training, and the value of research to each partner were essential ingredients to the success of this collaboration.
Communication↗
The hospital-supplier partnership: take care of the relationship first, and individual rewards will follow.
Partnerships and consolidation will continue to occur with increasing frequency within the supplier and health care provider communities as the health care industry strives to lower costs without diminishing quality and service. This article examines what constitutes the ideal hospital-supplier relationship. It asks the question: What does each partner need to do to make the relationship work effectively? It outlines the keys to a win-win proposition and ways to prevent the relationship from breaking down.
Commerce↗
Advantages and limitations of medical dispatching: the French view.
One of the main features of the French emergency medical services (EMS) system as it has been developed during the last 40 years is the participation of a physician in each stage of the EMS organization. Thus, in the 100 French emergency medical dispatch centres, all calls received on 15, the national medical emergency phone number, are medically dispatched. The main advantages are: (i) better security for the caller; (ii) proper adaptation of the response to the emergency; (iii) a quicker and more efficient intervention time; (iv) the hospital is informed of the arrival of an emergency; (v) the respect of medical secrecy; (vi) a good cost-efficiency ratio in the use of intervention means. The main limitations are connected with: (i) the inaccuracy of certain calls and problems of dialogue with the caller; (ii) the poor acceptance of the system's obligations by some of the callers, patients, physicians or any other partners of the EMS organization. In the future the implementation of the multi-purpose European emergency number 112 will probably require the system's adaptation to it.
Emergency Medical Service Communication Systems↗
Sexual protective strategies of late adolescent females: more than just condoms.
OBJECTIVE: To identify the sexual protective strategies of late adolescent heterosexual women. DESIGN: Open-ended questioning regarding sexual protective strategies was included in a larger cross-sectional survey on sexual risk. Participants' responses were recorded verbatim and analyzed using content analysis. PARTICIPANTS: 234 African American, Hispanic/ Latina, and non-Hispanic white 19- to 21-year-old females were recruited from the driver's license records of a mid-Atlantic state. MAIN OUTCOME MEASURES: Participants responded to the open-ended question, "How or what do you do to reduce your risk for sexually transmitted diseases and HIV?" RESULTS: Seven primary sexual protective strategies were identified from participants' responses: using condoms, abstaining or postponing sexual intercourse, getting tested for human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs), selecting safe partners, negotiating condom use, talking about sexual risk histories, and limiting the number of sexual partners. CONCLUSIONS: Some of the sexual protective strategies identified by study participants were less than effective and left young women vulnerable to infection with HIV and STDs. In addition, the use of these alternative strategies may leave young women feeling less at risk and thus less likely to use other more effective strategies such as condoms. The implications for nursing practice and the assessment of the sexual protective strategies of young heterosexual women are discussed.
AIDS Serodiagnosis↗
The role of hormonal contraception in adolescents.
Most pregnancies in women under age 20 years, as well as more than half of the pregnancies in the United States, are unintended. Contraceptive use is especially poor in adolescents, for whom the socioeconomic and educational consequences are great. A 1988 study indicated that more than 8% of sexually active adolescents had two or more sexual partners within the previous 3 months, higher than any other age group. The reasons why adolescents do not use contraception effectively fall into two categories: lack of access to contraceptive information and noncompliance with contraceptive recommendations. Studies have demonstrated that educational programs incorporating decision-making and communication skills, self-esteem enhancement, and peer influence can result in a decrease in the rate of adolescent sexual activity and pregnancy. Knowledge-based programs alone do not correlate with postponement of sexual activity or the use of contraceptives. In a survey of more than 4000 sex education teachers, 80% replied that they are in need of "factual information, materials, and strategies. In a true/false examination given to educators on contraception, few correct answers were recorded regarding potential side effects of oral contraceptives. Effective counseling and communication with adolescents require an understanding of adolescent development.
Adolescent↗
Everyday lies in close and casual relationships.
In 2 diary studies, 77 undergraduates and 70 community members recorded their social interactions and lies for a week. Because lying violates the openness and authenticity that people value in their close relationships, we predicted (and found) that participants would tell fewer lies per social interaction to the people to whom they felt closer and would feel more uncomfortable when they did lie to those people. Because altruistic lies can communicate caring, we also predicted (and found) that relatively more of the lies told to best friends and friends would be altruistic than self-serving, whereas the reverse would be true of lies told to acquaintances and strangers. Also consistent with predictions, lies told to closer partners were more often discovered.
Adolescent↗
[A certificate of proficiency in community health methods adapted to a tropical milieu].
The authors report on their 4 years of experience and research in education and training of medical doctors, nurses and male nurses, in the field of community health methodology in developing countries. They start from the fact, widely recognized by national and international organizations (W.H.O.), that improvement of health status of a population demands some other activities than curative ones, i.e. comprehensive knowledge of its social and cultural environment, evaluation of its health status, organization and management of the health services, clearly defined and fully observed collaboration between various partners, population, professionals, politicians. Neither medical doctors nor nurses and male nurses have been taught and trained in these fields. The authors suggest a part-time course of three months, built round the learning of methods and techniques of socioethnology, economics, epidemiology, management of services, and communication. Taking into account the pecularities of the audiences (foreigners, or nationals), the authors propose a pedagogical pattern based on the experience of the participants, both in simulated situation (case studies) or in actual situation (survey and setting-up of a program in a community).
Community Health Nursing↗
The Information Commons: a model for (physical) digital resource centers.
Since its planning, construction, and opening in 1996, the Information Commons, located in The University of Iowa's Hardin Library for the Health Sciences, has served as a common ground for self-directed learning, information research, hands-on class sessions, and multimedia development. Initiatives launched from the Information Commons not only have helped increase the visibility of Hardin Library as an environment well equipped to support traditional research and education needs, but have promoted the library as a campus leader and viable partner in planning and delivering digital technologies effectively. Ongoing initiatives have focused on better integrating the library's services and resources with the curricula and research needs of the university's health sciences units. This paper describes the facility, its programmatic elements, and its impact on education, communication, and technology trends in an academic health sciences setting. Particular attention is paid to initiatives launched during the first two years of operation. This paper also discusses plans for expansion of the facility.
Budgets↗
Timing in mother-infant communications: a comment on Murray & Trevarthen (1986)
Murray & Trevarthen (1986) experimentally manipulated the behaviours of mothers and infants in an attempt to determine who is responsible for the fine temporal patterning during vocal engagements. In the present note it is argued that the measures of content and style of maternal talk used by Murray and Trevarthen do not directly indicate the ways in which the behaviours of the partners are combined on a moment-to-moment basis.
Female↗
MALS is a binding partner of IRSp53 at cell-cell contacts.
Insulin receptor substrate p53 (IRSp53) is a key player in cytoskeletal dynamics, interacting with the actin modulators WAVE2 and Mena. Here, we identified a PDZ protein, MALS, as an IRSp53-interacting protein using a yeast two-hybrid screen. A pull-down assay showed that IRSp53 and MALS interact through the PDZ domain of MALS and the C-terminal PDZ-binding sequence of IRSp53. Their interaction in MDCK cells was also demonstrated by co-immunoprecipitation. Immunocytochemistry showed the colocalization of IRSp53 and MALS at cell-cell contacts. Cytochalasin D induced the redistribution of both proteins to the cytosol. Thus, MALS is a partner of IRSp53 anchoring the actin-based membrane cytoskeleton at cell-cell contacts.
Amino Acid Sequence↗
The timing is never right: Mexican views of condom use.
Unprotected sex is a critical issue in the Hispanic community, with the incidence of new Hispanic acquired immune deficiency syndrome (AIDS) cases three times that of non-Hispanic Whites. The researchers used focus groups to examine: (a) whether newly immigrated Mexican men and women in the Southeast United States discussed human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention with each other, and (b) how condom use was discussed. For the women, communication was safe sex, and for the men, trust was safe sex. Both communication and trust were dependent on timing in the relationship. Participants could not discuss condoms in a new or established relationship because of issues of trust. This study highlights the complexity of HIV/STD prevention and suggests that trust and timing should be considered within the cultural context of condom introduction.
Adult↗
Power communication and condom use: patterns of HIV-relevant sexual risk management in heterosexual relationships.
Combining relationship-based theories with quantitative methods is a relatively new approach in HIV prevention research. In this paper--focusing on relationship power, communication on HIV protection measures and condom use--clusters are identified which contribute to the understanding of HIV-relevant sexual risk management in heterosexual contacts. Data on 508 heterosexual contacts were collected in the German-speaking part of Switzerland using computer-assisted telephone interviews. Condom use is practised regularly among young and middle-aged couples but not among older couples. Cluster analyses show that in sexual contacts with equal or female power, communication appears to be decisive as to whether a condom is used. Male relationship power, however, is accompanied by relatively frequent condom use, regardless of whether the couple communicated about HIV protection measures. Implications for HIV prevention research and strategies, with an emphasis on aspects of relationship, gender and age, are suggested.
Adult↗
Intimacy and sexual risk behaviour in serodiscordant male couples.
Several studies have demonstrated individual-level determinants of HIV sexual risk behaviour. Very little research has been conducted to identify couple-level factors associated with unsafe sexual behaviour. As part of a three-year study of more than 100 serodiscordant male couples, we conducted an in-depth qualitative study of 15 Latino and non-Latino male couples via focus groups and a follow-up telephone survey. We identified the sexual risk behaviour that occurs in these male couples, their perceptions of susceptibility for HIV transmission, and numerous couple-level and intrapsychic factors associated with their risk behaviour. We also describe the challenges confronted by these couples and barriers to emotional intimacy and couple satisfaction. Finally, we provide suggestions for ways of intervening to facilitate improved couple functioning, pleasure, satisfaction, and communication, and ways of reducing sexual risk behaviour without loss of emotional intimacy.
Adaptation, Psychological↗
The Interdisciplinary Generalist Curriculum Project at the University of Wisconsin Medical School: the Generalist Partners Program.
The Generalist Partners Program (GPP) provides all University of Wisconsin Medical School students with a comprehensive generalist core curriculum through early clinical experiences, interactive faculty presentations, and small-group discussions during the first two years of medical school. The GPP is the first component of a comprehensive, longitudinal generalist curriculum offered during all four years of medical education. Faculty members from family medicine, general internal medicine, and general pediatrics work together to develop the learning goals and provide the curriculum for the GPP courses. Each of the 145 entering first-year medical students is matched with a community-based physician, the generalist practice partner, and the students participate in early clinical experiences at this site throughout their first two years of medical education. Students' clinical experiences are presented and discussed in case-based small-group sessions led by the school's generalist faculty. A core lecture series on professionalism, communication skills, evidence-based medicine, and the organization of the health care system supplements the early clinical experiences.
Curriculum↗
Understanding HIV-related risk among persons with a severe and persistent mental illness: insights from qualitative inquiry.
We conducted focus groups with 36 men and women who were receiving treatment for a severe and persistent mental illness (SPMI) to learn more about the social context of their intimate relationships and the psychological antecedents of their sexual decision-making. Qualitative analysis of focus group transcripts indicated that a) sexual activity tended to be unplanned and occurred in social networks where HIV risk may be elevated, b) HIV-related knowledge was superficial and insufficient to guide safer sexual behavior, c) participants' HIV risk perception was often based upon factors unrelated to their sexual behaviors, and d) communication skills for HIV risk reduction were poor. We discuss how qualitative methods yielded insights not readily available through quantitative approaches and offer recommendations for HIV risk assessment and prevention among persons with an SPMI.
Adult↗
Distinct structural domains within C19ORF5 support association with stabilized microtubules and mitochondrial aggregation and genome destruction.
C19ORF5 is a sequence homologue of microtubule-associated proteins MAP1A/MAP1B of unknown function, except for its association with mitochondria-associated proteins and the paclitaxel-like microtubule stabilizer and candidate tumor suppressor RASSF1A. Here, we show that when overexpressed in mammalian cells the recombinant 393-amino acid residue COOH terminus of C19ORF5 (C19ORF5C) exhibited four types of distribution patterns proportional to expression level. Although normally distributed throughout the cytosol without microtubular association, C19ORF5C specifically accumulated on stabilized microtubules in paclitaxel-treated cells and interacted directly with paclitaxel-stabilized microtubules in vitro. The native 113-kDa full-length C19ORF5 and a shorter 56-kDa form similarly associated with stabilized microtubules in liver cells and stabilized microtubules from their lysates. As C19ORF5 accumulated, it appeared on mitochondria and progressively induced distinct perinuclear aggregates of mitochondria. C19ORF5 overlapped with cytochrome c-deficient mitochondria with reduced membrane potential. Mitochondrial aggregation resulted in gross degradation of DNA, a cell death-related process we refer to as mitochondrial aggregation and genome destruction (MAGD). Deletion mutagenesis revealed that the C19ORF5 hyperstabilized microtubule-binding domain resides in a highly basic sequence of <100 residues, whereas the MAGD activity resides further downstream in a distinct 25-residue sequence (F967-A991). Our results suggest that C19ORF5 mediates communication between the microtubular cytoskeleton and mitochondria in control of cell death and defective genome destruction through distinct bifunctional structural domains. The accumulation of C19ORF5 and resultant MAGD signaled by hyperstabilized microtubules may be involved in the tumor suppression activity of RASSF1A, a natural microtubule stabilizer and interaction partner with C19ORF5, and the taxoid drug family.
Amino Acid Sequence↗