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PubMed1979

Bifurcation in non-negotiable games: a paradigm for self-organisation in cognitive systems.

The interaction between two self-organising systems, each possessing two hierarchical levels, is dealt with. The communication process is pursued as a bidirectional information transfer. The criterion for the selection of the intrasystem control algorithm(s) is based on the maximisation of the 'Joint Figure of Merit' related to the long-term average of an appropriately weighted sum of conflicting terms: Probabilities of homeostases versus adequate matching with the partner.

Behavior↗
PubMed2005

Conversational silence, coercion, equality: the role of language in influencing who gets identified as abused.

Various methods of ascertaining self-reported exposure to intimate partner violence (IPV) in health care and research settings have been evaluated to identify women who interpret themselves as abused for clinical and research intervention. However, few interpretive frameworks have been proposed to explain factors that may influence the success of this ascertainment process, including the contribution of language in facilitating women's interpretations of situations as abusive across social, cultural and historical contexts. This omission is substantial, given that IPV is context-specific, involving interaction between individuals of diverse linguistic and cultural backgrounds and their sociocultural environment. In the first part of this paper, we outline hermeneutics, one interpretive theoretical tradition to describe approaches to interpreting IPV. Hermeneutics is a linguistic philosophy that focuses on questions of how people understand spoken language, written text, and themselves through language across sociocultural environments. Hermeneutics acknowledges conditions and situations that facilitate opportunities for broad shared understanding and vocabularies about violence between communities, professionals and abused women, which in turn may reduce harm to women and negotiate action women may want to take in response to situations they interpret as abusive. In the second and third parts of the paper, we compare and contrast the strengths and limitations of three common approaches for asking women about IPV in health care and research settings, and outline a multi-dimensional IPV ascertainment tool that incorporates the three asking approaches to facilitate professionals bringing broad definitions of and vocabularies about abuse to encounters with women. This paper provides health care researchers, clinicians and policy makers with a framework for understanding the potential influence of language on women's interpretations of IPV, including the role of community and professional conversational silence, coercion and equality in influencing women's interpretations. We look at the influence of language about intimate partner violence in the United States on women's interpretations of abuse, although the basic constructs presented here could be applied in other countries and settings.

Coercion↗
PubMed2006

Factors that shape young people's sexual behaviour: a systematic review.

BACKGROUND: Since nearly half of new HIV infections worldwide occur among young people aged 15-24 years, changing sexual behaviour in this group will be crucial in tackling the pandemic. Qualitative research is starting to reveal how social and cultural forces shape young people's sexual behaviour and can help explain why information campaigns and condom distribution programmes alone are often not enough to change it. We undertook a systematic review to identify key themes emerging from such research, to help inform policymakers developing sexual health programmes, and guide future research. METHODS: We reviewed 268 qualitative studies of young people's sexual behaviour published between 1990 and 2004. We developed a method of comparative thematic analysis in which we coded each document according to themes they contained. We then identified relations between codes, grouping them accordingly into broader overall themes. Documents were classified as either primary or secondary depending on their quality and whether they contained empirical data. From the 5452 reports identified, we selected 246 journal articles and 22 books for analysis. FINDINGS: Seven key themes emerged: young people assess potential sexual partners as "clean" or "unclean"; sexual partners have an important influence on behaviour in general; condoms are stigmatising and associated with lack of trust; gender stereotypes are crucial in determining social expectations and, in turn, behaviour; there are penalties and rewards for sex from society; reputations and social displays of sexual activity or inactivity are important; and social expectations hamper communication about sex. The themes do not seem to be exclusive to any particular country or cultural background, and all themes were present, in varying degrees, in all countries assessed. INTERPRETATION: This study summarises key qualitative findings that help in understanding young people's sexual behaviour and why they might have unsafe sex; policymakers must take these into account when designing HIV programmes. Considerable overlap exists between current studies, which indicates the need to broaden the scope of future work.

Adolescent↗
PubMed2003

Managing threats to self: awareness in early stage Alzheimer's disease.

Lack of awareness is described as a clinical feature of Alzheimer's disease that is observed in a significant proportion of those assigned this diagnosis. There is an extensive literature emphasising biological explanations in which unawareness is viewed essentially as a symptom, but possible psychosocial factors, together with the socially constructed nature of expressed awareness, are largely neglected. The onset of dementia may be viewed as a threat to self occasioning attempts to regain control through a range of psychological strategies, which are likely to affect the ways in which people communicate an account of their experience and hence the extent to which they may be considered 'aware'. In the present study, 12 participants with a medical diagnosis of early stage Alzheimer's disease, who were described in clinical records as ranging from 'very aware' to 'unaware' of their illness, were interviewed on two occasions. Partners were also interviewed separately on each occasion. Transcripts were analysed using Interpretative Phenomenological Analysis. In response to their memory difficulties, participants were seen as engaging in the processes of acknowledging, reacting, explaining, experiencing the emotional impact, and adjusting. All participants acknowledged memory problems, indicating a basic awareness of changes in their memory functioning, but made varying judgements about the meaning and impact of these. The resulting spectrum of responses formed a continuum running from 'self-maintaining' to 'self-adjusting'. A self-maintaining stance related to attempts to normalise the situation and minimise the difficulties, thus maintaining continuity with prior sense of self, while a self-adjusting stance related to attempts to confront the difficulties and adapt one's sense of self accordingly. A preliminary model of the construction of awareness in early stage Alzheimer's is presented that acknowledges biological mechanisms but places the main emphasis on psychosocial factors and self-concept.

Adaptation, Psychological↗
PubMedDate not supplied

Consideration of alternative accounts of gender-linked speech patterns in individuals with mental retardation.

Several preliminary reports have reported the existence of gender influences on the communication patterns of individuals with mental retardation. This study considers two alternative hypotheses to the conclusion that the reported effects were attributable to gender. Two studies extend a previous analysis by further exploration of the original transcripts (Study 1) and addition of participants (Study 2). In Study 1, the possibility of influences from adult partners is analyzed. In Study 2, the association of syntactic development and gender-linked effects is examined. Both alternatives are rejected on the basis of these extended analyses.

Adolescent↗
PubMed2000

Synthesis of oxepanes and trans-fused bisoxepanes via biomimetic, endo-regioselective tandem oxacyclizations of polyepoxides.

[reaction: see text] This communication describes the first examples of tandem endo-regioselective and stereospecific oxacyclizations of 1, 5-diepoxides to oxepane products and a similar tandem oxacyclization of 1,5,9-triepoxides to fused bisoxepane cyclic carbonates. A mechanism for these biomimetic oxacyclizations is proposed in which the epoxides act as both electrophilic and nucleophilic reaction partners.

Epoxy Compounds↗
PubMed1978

Effects of a marriage enrichment program: an outcome study.

This study investigated the impact of a marriage enrichment program. Fourteen couples were randomly assigned to one of two experimental groups or to a no-treatment control group. One experimental group received fair-fight training for 3 weeks followed by a sexual enhancement format for 3 additional weeks. The second experimental groups received the opposite treatment sequence. The same counselor team used the same exercises in both groups. The sequence of treatment did not differentially affect outcome. The immediate and longer term treatment effects that were found generally favored the treatment groups over the no-treatment control group on spouses' separate reports of marital and personal functioning. Using larger and more homogeneous samples, future studies should examine the relationship of individual partner changes to couple changes, conduct a follow-up evaluation of at least 3 months, and obtain behavioral assessments of couples' interactions before and after treatment.

Aggression↗
PubMedDate not supplied

Drug-scene roles and HIV risk among Puerto Rican injection drug users in East Harlem, New York and Bayamón, Puerto Rico.

This article describes and compares distributions of drug-scene roles, frequency of engaging in role behaviors, and relationships of role-holding to high-risk behaviors and sexual partnerships among Puerto Rican injection drug users in New York and Puerto Rico. For this study 561 street-recruited injection drug users in East Harlem, New York, and 312 in Bayamón, Puerto Rico were asked the number of days (in the last 30) in which they earned money or drugs in each of seven drug-scene roles; and about behaviors and egocentric risk partner characteristics in the last 30 days. East Harlem subjects were more likely to get resources by selling drugs and syringes, and buying drugs for someone else; Bayamón subjects were more likely to be "hit doctors," buy needles for others, operate a shooting gallery, or escort others to shooting galleries. All roles were part-time except shooting gallery management in East Harlem. About 27% of respondents at each site engaged in two or more roles. Many roles were associated with increased odds of injecting more than twice a day, receptive syringe sharing, distributive syringe sharing, receptive paraphernalia sharing, and having a drug-injecting sex partner. Drug-scene role structures vary between cities. Most roles are part-time pursuits. Role-holders have higher-risk behaviors and sexual partnerships than other drug injectors. Although further research is needed, drug-scene role-holders should be targeted for interventions to affect their own risk and their communications with others.

Adult↗
PubMedDate not supplied

General practitioners' perceptions of the illness behaviour and health needs of South Asian women with menorrhagia.

OBJECTIVES: A study of general practitioners' (GPs) perceptions of the health needs of women of South Asian descent who suffer from menorrhagia. METHOD: A qualitative study using semi-structured interviews with 50 GPs in two British towns. FINDINGS: This study suggest that some women of South Asian descent may not consult their GPs even though suffering severe menorrhagia. Moreover, some GPs perceive that women may suffer from anaemia as the result of such illness behaviour. One reason for this reluctance to consult for menorrhagia may be the fact that some women of South Asian descent prefer to be examined by female doctors, yet may attend practices that lack a female partner. The study also shows that South Asian women, who consult male GPs for menorrhagia, are sometimes referred to hospital outpatients without internal examinations, and that women may be reluctant to keep their hospital appointments because of the lack of female gynaecologists. The study also indicates that a shortage of female interpreters may make communication difficult between some health care professionals and their patients, particularly when a complex and sensitive subject such as menorrhagia needs to be discussed. CONCLUSION: Women of South Asian descent may suffer serious problems such as iron deficiency anaemia, partly due to untreated menorrhagia. Since this was a study of GPs' perceptions of the health needs of South Asian women, it is now important to interview women themselves, to learn more about their perceptions of menorrhagia, and their perceptions of any subsequent contact with health care professionals.

Anemia, Iron-Deficiency↗
PubMedDate not supplied

Improving collaboration between researchers and communities.

Active collaboration between communities and researchers is critical to developing appropriate public health research strategies that address community concerns. To capture the perspectives of inner-city Seattle communities about issues in community-researcher partnerships, Seattle Partners for Healthy Communities conducted interviews with community members from the ethnically diverse neighborhoods of Central and Southeast Seattle. The results suggest that effective community-researcher collaborations require a paradigm shift from traditional practices to an approach that involves: acknowledging community contributions, recruiting and training minority people to participate in research teams, improving communication, sharing power, and valuing respect and diversity.

Community Health Planning↗
PubMed2001

Cleaner fish Labroides dimidiatus manipulate client reef fish by providing tactile stimulation.

The cleaner wrasse Labroides dimidiatus often touches 'client' reef fish dorsal fin areas with its pelvic and pectoral fins. The relative spatial positions of cleaner and client remain constant and the cleaner's head points away from the client's body. Therefore, this behaviour is not compatible with foraging and the removal of client ectoparasites. As clients seek such 'tactile stimulation', it can be classified as an interspecific socio-positive behaviour. Our field observations on 12 cleaners (observation time of 112h) suggest that cleaners use tactile stimulation in order to successfully (i) alter client decisions over how long to stay for an inspection, and (ii) stop clients from fleeing or aggressive chasing of the cleaner in response to a cleaner fish bite that made them jolt. Finally, predatory clients receive tactile stimulation more often than non-predatory clients, which might be interpreted as an extra service that cleaners give to specific partners as pre-conflict management, as these partners would be particularly dangerous if they started a conflict. We therefore propose that cleaner fish use interspecific social strategies, which have so far been reported only from mammals, particularly primates.

Animal Communication↗
PubMed1992

Local and global aspects of temporal patterning in the conversations of adults.

A randomization procedure was used to examine local and global aspects of patterning in the conversations of 25 pairs of students. This procedure involved reorganizing the binary events constituting the partners' individual records, and then combining these events to produce randomized dyadic records of each conversation. Comparisons between the observed and randomized records indicated an overall tendency in all dyads to avoid covocalization (simultaneous talk). Notwithstanding this overall tendency, there were gender-related differences between groups; dyads containing female participants tended to covocalize more frequently, and for longer durations, than male-male dyads. There was also a tendency for participants to respond promptly to the talk of their partners. We interpret these results as indicating that systematic variation in the use of covocalization may occur at local levels within the constraints set by information-processing requirements at global levels.

Communication↗
PubMed2004

Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challenges.

Sexually transmitted infections (STIs) constitute a huge health and economic burden for developing countries: 75-85% of the estimated 340 million annual new cases of curable STIs occur in these countries, and STIs account for 17% economic losses because of ill health. The importance of STIs has been more widely recognised since the advent of the HIV/AIDS epidemic, and there is good evidence that the control of STIs can reduce HIV transmission. The main interventions which could reduce the incidence and prevalence of STIs include primary prevention (information, education and communication campaigns, condom promotion, use of safe microbicides, and vaccines), screening and case finding among vulnerable groups (for example, pregnant women), STI case management using the syndromic approach, targeted interventions for populations at high risk (for example, sex workers), and in some circumstances (targeted) periodic mass treatment. The challenge is not just to develop new interventions, but to identify barriers to the implementation of existing tools, and to devise strategies for ensuring that effective STI control programmes are implemented in the future.

Adolescent↗
PubMed1991

Human immunodeficiency virus and migrant labor in South Africa.

The authors investigate the impact of the migrant labor system on heterosexual relationships on South African mines and assess the implications for the future transmission of human immunodeficiency virus (HIV) infection. The migrant labor system has created a market for prostitution in mining towns and geographic networks of relationships within and between urban and rural communities. A section of the migrant workforce and a group of women dependent on prostitution for economic support appear especially vulnerable to contracting HIV infection since they are involved in multiple sexual encounters with different, changing partners, usually without condom protection. Furthermore, sexually transmitted disease morbidity is extensive in the general and mineworker populations. Historically, migration facilitated the transmission of sexually transmitted diseases and may act similarly for HIV. Problems of combating the HIV epidemic in South Africa are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Early second language acquisition: a comparison of the linguistic output of a pre-school child acquiring English as a second language with that of a monolingual peer.

Two pre-school children were recorded at regular intervals over a 9-month period while playing freely together. One child was acquiring English as a second language, whilst the other was a monolingual English speaker. The sociolinguistic domain was such that the children were likely to be motivated to communicate with each other in English. A variety of quantitative measures were taken from the transcribed data, including measures of utterance type, length, type-token ratios, use of auxiliaries and morphology. The child for whom English was a second language was found to be well able to interact on equal terms with his partner, despite being somewhat less advanced in some aspects of English language development by the end of the sampling period. Whilst he appeared to be consolidating his language skills during this time, his monolingual partner appeared to be developing rapidly. It is hoped that normative longitudinal data of this kind will be of use in the accurate assessment of children from dual language backgrounds, who may be referred for speech and language therapy.

Child Language↗
PubMed2002

Extending the IOI to significant others and to non-hearing-aid-based interventions.

Two extensions of the International Outcome Inventory for Hearing Aids are described: the first is designed for the significant other (SO) (IOI-HA-SO), and the second for alternative interventions for hearing difficulties (IOI-AI). A feature of the IOI-HA-SO is that several items are modified to inquire about effects of the partner's hearing loss on the SO. The IOI-AI is designed to cover effects of use of listening aids other than personally worn hearing aids, use of hearing tactics, and aural surgery.

Communication↗
PubMed2006

Male infertility: the element of disguise.

The purpose of this descriptive study was to explore the element of disguise in the infertility experience of men. I conducted a secondary analysis of data from a previous study of 10 men experiencing infertility. Three categories of disguise were identmifed: disguise to protect themselves, disgise to protect their partner, and disguise to protect both themselves and their partner. This study's results indicate that health care professionals need to increase their awareness of the element of disguise and provide interventions for men experiencing infertility.

Adaptation, Psychological↗
PubMed1998

Systematic analysis of STD control: an operational model.

BACKGROUND: Sexually transmitted diseases (STDs) enhance HIV transmission, and improved management of STD in primary health care decreases HIV incidence. In resource poor countries, those responsible for planning and managing STD control programmes need to be able to analyse the STD situation in their setting and the interventions which are therefore likely to be most cost effective. However, the data required for such decision making are often not available in developing countries. This paper presents an operational model, developed as a practical tool to support planning, monitoring, and evaluation of STD intervention strategies in settings where data are unavailable or inadequate. METHOD: The operational model is based on the approach developed for estimating the effectiveness of control measures in tuberculosis programmes. Using available data, the model takes a step by step approach. It begins with analysis of the total male and female population, the proportion of men and women aged 15-49 years, and the proportion of these who are sexually active. Subsequent steps analyse numbers with STDs, and loss of cases to the health system at each stage between infection and cure. The model was tested in Nairobi, Kenya using available demographic, epidemiological, and public health data; no original data were collected. Data for the total population of Nairobi were not available to illustrate all the steps in the model. For these steps, relevant information was taken where available from a specific study population using a large STD referral centre. RESULTS: Despite the lack of precise data for Nairobi, the model highlighted sex imbalances in population, which has potential implications for STDs. It also showed significant disparities in terms of public health policy--for example, between the number of people infected with STDs and the number who have symptoms, and between the number with symptoms and those who seek treatment from public health facilities. It also showed differences between the numbers who attend a health facility, and those that are correctly diagnosed and treated, and, of these, the proportion that are cured. CONCLUSION: Even where data are incomplete or not available, the model can be a useful tool for analysis. Application of the model, as the Nairobi example illustrates, provides a useful starting point in terms of determining both general and specific determinants of STDs, identifying problems, highlighting significant sex differences, and indicating where it might be appropriate to focus interventions. The model showed that, in Nairobi, only a small proportion of STD cases are removed from the reservoir of infection in the community through curative services, that cases are lost to the health services at every step, and therefore that interventions are required at every step to achieve comprehensive STD control. It highlights the need for strategies to prevent infections, to identify and treat those with and without symptoms, to motivate those who are aware of their infection to seek treatment, and to improve the effectiveness of partner notification and treatment. Finally, the model points to areas where data are inadequate and where STD control programmes need to concentrate information collection efforts.

Adolescent↗