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PubMed2005

The role of personality and coping style in relation to awareness of current functioning in early-stage dementia.

This study investigated the role of psychological factors in unawareness in early-stage dementia, focusing on personality and coping strategies. Forty-nine individuals with a 'non-frontal' dementia and their partners completed standardized self-report questionnaires. Multiple regression analyses indicated that personality factors, in particular negative attitudes towards emotional expression, were related to avoidant coping in managing the threat of dementia. Neither negative attitudes towards emotional expression nor avoidant behavioural coping related to unawareness after controlling for relevant disease-related and emotional variables. However, a relationship was found between conscientiousness and unawareness. The findings were interpreted with reference to literature on processes of denial and a distinction between conscious behavioural avoidance and unconscious defensive denial was made. Implications for clinical practice were considered.

Adaptation, Psychological↗
PubMed2004

Assessment of welfare of the child in HIV positive couples.

BACKGROUND: Demand for assisted conception amongst HIV-infected couples is rising in parallel with increased efficacy of antiretroviral medication which has improved life expectancy and reduced vertical transmission risk. There are no published data on welfare of the child assessment in HIV positive couples undergoing assisted conception. METHODS: We assessed welfare of the child in 131 (i.e. total number seen, not treated) couples, where one or both partners were infected with HIV and referred to the infertility clinic at Chelsea and Westminster Hospital since 1999. In total, 59 couples received sperm washing treatment (male partner infected) resulting in 17 healthy babies, and 14 couples were treated in the female positive programme (5 concordant and 9 discordant for HIV) resulting in three healthy babies. RESULTS: Issues surrounding welfare of the child were commonly encountered in this series and were significant enough to withhold treatment in five cases. Many were relationship issues surrounding acquisition of infection, fear of infection in the negative partner or child (n = 1), poor prognosis (multiple drug resistance) (n=3) or disability related to infection (n = 1). CONCLUSIONS: Welfare of the child in HIV infected couples must be carefully considered in specialist centres with experienced counsellors. Issues surrounding treatment are complex and require close liaison with HIV specialists and involvement of the couple.

Child Welfare↗
PubMed2006

Safety of sperm washing and ART outcome in 741 HIV-1-serodiscordant couples.

BACKGROUND: To evaluate the safety of sperm washing and assisted reproduction technique (ART) outcome offered to serodiscordant couples with a human immunodeficiency virus-1 (HIV-1)-positive male. METHODS: Sperm washing was performed and checked by RT-PCR on each semen sample before its fresh usage. Intrauterine insemination (IUI) or IFV/ICSI was offered according to fertility profile of each couple. Non-infected women underwent HIV testing 2 weeks before each procedure and for up to 6 months after. RESULTS: Seven hundred and forty-one couples entered the study of a possible 2011 serodiscordant couples counselled over 4 years. Superovulation and IUI were performed in 581 couples, where the pregnancy rate per cycle and pregnancy rate per couple were 19 and 78%, respectively, with multiple pregnancy rate being 4%. One hundred and sixty couples were treated by IVF/ICSI, where pregnancy rate per cycle and per couple were 22 and 41%, respectively, with multiple pregnancy rate being 10%. All female partners were still HIV-1 negative at follow-up. CONCLUSION: Sperm washing within a programme of reproductive counselling was proved to be safe in this large series of serodiscordant couples. The overall pregnancy rate (70.3%), independent of the procedure used (IUI or IVF/ICSI), justifies the effort of the medical team in setting up and implementing dedicated centres and of the individual patient in seeking a safe pregnancy.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Predicting cardiac rehabilitation enrollment: the role of automatic physician referral.

BACKGROUND: Despite the established benefits of cardiac rehabilitation, evidence suggests referral to, and subsequent enrollment in, cardiac rehabilitation following a coronary event remains low (10-25%). The aim of this study was to identify predictors of attendance to cardiac rehabilitation intake and subsequent enrollment in rehabilitation after coronary artery bypass graft surgery within the framework of an automatic referral system. DESIGN AND METHODS: We conducted a historic prospective study of patients who underwent coronary artery bypass graft surgery between 1 April 1996 and 31 March 2000 and lived within the geographic referral area of a multi-disciplinary cardiac rehabilitation center in central-south Ontario, Canada. Coronary artery bypass graft surgery patients are automatically referred to cardiac rehabilitation at the time of hospital discharge. Consecutive health records of eligible patients were reviewed for medical history, cardiac risk factor profiles, and evidence of cardiac rehabilitation intake attendance and enrolment. RESULTS: A total of 3536 patients met eligibility criteria. Patients were predominantly male (79.1%), approximately 64 years of age, living with a spouse or a partner, English-speaking, retired and had multiple cardiac risk factors. Of eligible patients, 2121 (60.0%) attended the cardiac rehabilitation intake appointment. Of patients who attended cardiac rehabilitation intake 1463 (69%) enrolled in at least one cardiac rehabilitation service, based on their risk factor profile. Selected cardiac rehabilitation services were exercise training (n=1287; 88%), nutrition counseling (n=571; 39.0%), nursing care (n=546; 37.3%), and psychological intervention (n=223; 15.2%). CONCLUSIONS: An institutionalized, physician-endorsed system of automatic referral to cardiac rehabilitation resulted in higher rates of cardiac rehabilitation intake and enrollment following coronary artery bypass graft surgery than previously reported and should be adopted for all cardiac populations.

Aged↗
PubMed2006

CARF regulates p19ARF-p53-p21WAF1 senescence pathway by multiple checkpoints.

CARF was first cloned as a novel binding partner of ARF from a yeast-interactive screen. CARF and ARF colocalize in the perinucleolar region and have a collaborative function. In the nucleoplasm, CARF interacts with p53 and enhances its function. We demonstrate that p53 downregulates CARF in a negative feedback regulatory loop and may also involve p53 antagonist HDM2.

Animals↗
PubMed2006

Kermit 2/XGIPC, an IGF1 receptor interacting protein, is required for IGF signaling in Xenopus eye development.

GIPC is a PDZ-domain-containing protein identified in vertebrate and invertebrate organisms through its interaction with a variety of binding partners including many membrane proteins. Despite the multiple reports identifying GIPC, its endogenous function and the physiological significance of these interactions are much less studied. We have previously identified the Xenopus GIPC homolog kermit as a frizzled 3 interacting protein that is required for frizzled 3 induction of neural crest in ectodermal explants. We identified a second Xenopus GIPC homolog, named kermit 2 (also recently described as an IGF receptor interacting protein and named XGIPC). Despite its high amino acid similarity with kermit, kermit 2/XGIPC has a distinct function in Xenopus embryos. Loss-of-function analysis indicates that kermit 2/XGIPC is specifically required for Xenopus eye development. Kermit 2/XGIPC functions downstream of IGF in eye formation and is required for maintaining IGF-induced AKT activation. A constitutively active PI3 kinase partially rescues the Kermit 2/XGIPC loss-of-function phenotype. Our results provide the first in vivo loss of function analysis of GIPC in embryonic development and also indicate that kermit 2/XGIPC is a novel component of the IGF pathway, potentially functioning through modulation of the IGF1 receptor.

Adaptor Proteins, Signal Transducing↗
PubMed1999

How adult beliefs shape the speech communities of a child who has multiple disabilities.

Ethnographic and micro-ethnographic techniques were used to investigate how the strategies employed by two adults (a mother and a physical therapist) to initiate and maintain interactions with a 2-year-old child with multiple disabilities were reflective of the adult partner's beliefs and values about communication in general and about this child in particular. Results indicate that the physical therapist believed in using the child's existing abilities as the primary reference point for establishing a speech community with the child. The mother used the demands of the larger, mostly nondisabled speech community as her primary reference point. How these differences affect the nature of the child's membership and level of independence in these speech communities is discussed.

Adult↗
PubMed2001

Evolution of women's oral health.

The current focus on women's oral health emerged from emphasis on the women's health movement. Provision of high quality oral health care throughout a woman's life span requires the enhancement of multiple factors. Future progress will depend on partnering among various constituencies; education at the predoctoral, postdoctoral, and continuing education levels; expansion of the scope of gender-specific research; and development of innovative modalities for the diagnosis, prevention, treatment, and utilization of clinical dental services for women.

Dental Health Services↗
PubMedDate not supplied

Consistency of condom use for disease prevention among adolescent users of oral contraceptives.

A six-month prospective study examined consistency of condom use for disease prevention among 308 adolescent women who had received a prescription for oral contraceptives at a family planning clinic. Only 16 percent used condoms consistently over a six-month period, yet 30 percent were considered at high risk for sexually transmitted diseases (STDs) because of multiple, sequential or concurrent relationships with male partners. The type of relationship in which the adolescents were involved did not predict consistency of condom use. Consistent condom use was associated with having asked a partner to use a condom, perceiving partner support for condom use, having less frequent sexual intercourse and using oral contraceptives inconsistently. The findings suggest that family planning providers need to more strongly emphasize to adolescents the importance of consistent condom use to protect against STD infection.

Adolescent↗
PubMed1994

Are bi-directionally violent couples mutually victimized? A gender-sensitive comparison.

Mutual victimization in marriage was studied in a sample of clinic couples (N = 57) where both spouses reported partner aggression on an adapted version of the Conflict Tactics Scale (Straus, 1979). As predicted, wives sustained more injuries and were more negatively affected by their partner's physical aggression than did husbands. Multiple dimensions of aggression were used to identify subgroups of mutually victimized couples (e.g., frequency, severity of aggressive act[s], psychological impact, and severity of injury). The largest subgroup consisted of spouses who reported low levels of victimization on all dimensions. Subgroup 2 included couples in which wives reported higher overall levels of victimization than did their husbands. A third small subgroup was also identified where husbands reported higher levels of victimization than did their wives. Contrary to prediction, both highly victimized wives and highly victimized husbands in the asymmetrical victimization subgroups reported greater levels of relationship and individual distress than did spouses in the mutual/low victimization and nonaggression control groups. However, the marriages of the two highly victimized subgroups did differ in important ways. The findings were interpreted to suggest an integration of feminist and dyadic theories of marital aggression.

Adult↗
PubMed2004

Domestic violence in women with PTSD and substance abuse.

This study reports rates of domestic violence for women with posttraumatic stress disorder (PTSD) and substance dependence. The Conflict Tactics Scale-Revised (CTS2) was used to assess the rates of both physical and psychological aggression, lifetime and current, by self and partner. Results showed substantial rates, both lifetime and current by both partner and self and, for a substantial number in the sample, for multiple events within the past year. Consistent with prior studies, analyses indicated that the correlation between self and partner negative relationship behaviors was high. A significant association was found between past-month substance use and increased self and partner negative relationship behaviors. The complex dynamics of women as both recipients and enactors of negative relationship behaviors are discussed.

Adult↗
PubMedDate not supplied

Assessing intimate partner violence in health care settings leads to women's receipt of interventions and improved health.

OBJECTIVE: This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to women's exit from an abusive relationship and to their improved health. METHODS: A volunteer sample of 132 women outpatients who described intimate partner violence during the preceding year were recruited from multiple hospital departments and community agencies in suburban and urban metropolitan Boston. Through in-person interviews, women provided information on demographics, past year exposure to violence, past year receipt of interventions, and whether they disclosed partner violence to their health care provider. They also described their past month health status with the 12-Item Short-Form Health Survey and further questions. RESULTS: Of the 132 women, 44% had exited the abusive relationship. Among those who were no longer with their partner, 55% received a domestic violence intervention (e.g. advocacy, shelter, restraining order), compared with 37% of those who remained with their partner. Talking to their health care provider about the abuse increased women's likelihood of using an intervention (odds ratio [OR]=3.9). Those who received interventions were more likely to subsequently exit (OR=2.6) and women no longer with the abuser reported better physical health based on SF-12 summary scores (p=0.05) than women who stayed. CONCLUSIONS: Health care providers may make positive contributions to women's access to intimate partner violence services. Intimate partner violence interventions relate to women's reduced exposure to violence and better health.

Adult↗
PubMed2003

Prevalence of illicit drug use in young Australian women, patterns of use and associated risk factors.

OBJECTIVES: To estimate the prevalence of illicit drug use in young Australian women, determine their patterns of drug use and identify associated risk factors. METHODS: Data were collected in 2000 as part of the second survey of the youngest cohort in the Australian Longitudinal Study on Women's Health (n = 9512). RESULTS: Among women aged 22-27 years, 58% reported having used an illicit drug at some time with most (57%) having used cannabis. Amphetamines (16%), ecstasy/designer drugs (15%) and LSD (14%) were the next three most commonly used drugs. Four different patterns of drug use were identified: past users of cannabis only (39%); current users of cannabis only (17%); past multiple drug users (13%) and current multiple drug users (31%). Living in a de-facto relationship or never being married, living with non-family members, a history of physical abuse, sexual intercourse, smoking and binge drinking were associated significantly with exclusive use of cannabis and with use of multiple drugs compared to never using illicit drugs. Living with a partner, experience of sexual or emotional abuse, pregnancy, diagnosis of depression and taking sleeping medication were associated significantly with being a multiple drug user, but not for exclusive cannabis use. Multiple drug users had, on average, used cannabis 2-3 years before using any other drug. CONCLUSIONS: Given the strong association found between smoking, heavy drinking and drug use of varied patterns, public health initiatives targeted at preventing young women from smoking and drinking should additionally target illicit drug use.

Adolescent↗
PubMed1989

Reproductive and sexual risk factors and human papilloma virus infection in cervical cancer among Hong Kong Chinese.

In this case-control study of cervical neoplasia in Hong Kong, 48 dysplasia and 68 cancer patients were matched with 116 surgical in-patient controls. The cases had an earlier age at first intercourse and more sex partners than the controls. The cases' husbands also had more sex partners and were less likely to use condoms regularly. In a multiple regression model the odds ratio were 6.0 (95% Confidence Interval 2.5-14.6) for the husband having more than one sex partner, 4.0 (1.5-10.7) for the woman having more than one sex partner, and 1.15 (1.05-1.28) per year younger for the woman's age at first intercourse. The odds ratio of 5.4 for women whose partners did not habitually use condoms was not significantly different from 1.0. In a sub-sample, 37% of cancer patients and 18% of dysplasia patients, but only 6% of gynaecological controls, showed a positive DNA hybridization to Human Papilloma Virus (Type 16). These findings suggest that cervical cancer and dysplasia are sexually transmitted in our population, with a possible viral aetiology.

Adult↗
PubMed1998

Relationships building. Measure service quality across health care encounters.

The relationships between service quality and satisfaction is a function of multiple service encounters across a wide variety of exchange partners within a health care organization. Studying the patient provider relationship leads to improved service quality. The authors report their findings from a study that tests a relationship-building framework that integrates service quality issues across multiple internal health care publics. Strategies for developing a strong patient-provider relationship bond are also discussed.

Economic Competition↗
PubMed1993

Sexual behaviour in the general population of Sweden.

The AIDS issue was a focus of interest in Sweden during the latter part of the 1980s. To assess changes in sexual behaviour we carried out annual mail surveys in random samples of the general population during this period. Each sample comprised 4000 individuals in the age range 16-44 years. The response rate was 71%. Throughout the study, 32% of the males and 20% of the females reported being single, with no regular partner. The corresponding figures for male and female teenagers were 78% and 54%, respectively. A multiple logistic regression analysis indicated that the odds ratios for having several sequential sexual partners were 29.9 for singles with no regular partner, 8.8 for singles with one regular partner (married/cohabiting = 1.0), 1.7 in the 16-17-year group, 1.6 in the 20-24-year group (34-44-year-group = 1.0) and 2.5 for big-city-dwellers (rural areas = 1.0). These differences were statistically significant. Of all respondents, 2% reported having had five sexual partners or more during the past year. Most of the respondents with a large number of sexual partners had not used a condom during the past month. The use of condoms increased during the study period, but still by the end of the period most of the casual sexual contacts took place without the use of a condom.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Exposure to partner violence and child behavior problems: a prospective study controlling for child physical abuse and neglect, child cognitive ability, socioeconomic status, and life stress.

Previous research suggests an association between partner violence and child behavior problems. However, methodological shortcomings have precluded the formation of directional conclusions. These limitations include failure to control for the effects of child physical abuse and general life stress, employment of nonrepresentative samples from battered women's shelters, and reliance on a single contemporaneous reporter, usually the mother, for information on both independent and dependent measures. This study used prospective, longitudinal data (N = 155) and multiple informants to examine the relation between maternal reports of partner violence in the homeand teacher- and youth-report ratings of concurrent and prospective child behavior problems. Hierarchical multiple regression analyses were used to control for the effects of child physical abuse, child physical neglect, socioeconomic status, child cognitive ability, and life stress. The contribution of partner violence to child behavior problems was confirmed for boys' (n = 81) externalizing problems and girls' (n = 74) internalizing problems. Child developmental status at the time of exposure further influenced these relations. For boys, behavior problems in middle childhood were most strongly related to contemporaneous partner violence, whereas behavior problems among both boys and girls at age 16 were most strongly related to partner violence exposure during the preschool years.

Child↗
PubMed1999

Partners' ratings of combat veterans' PTSD symptomatology.

The current study examined the concordance of combat veterans' scores on the Mississippi Scale for Combat-Related PTSD, with scores on a parallel version of that instrument completed by partners to assess veterans' symptoms. Further, the study examined the impact of quality of the marital relationship on score concordance. Bivariate and multiple regression were used with a sample of 466 veteran-partner dyads obtained from the National Vietnam Veterans Readjustment Study. There was moderate agreement in symptom reporting between veterans and their partners and little evidence to suggest that the quality of the relationship impacted upon the association between partner and veteran scores.

Combat Disorders↗