Low-dose computerized tomography of the jaw bone in pre-implantation diagnosis. Limits of dose reduction and accuracy of distance measurements

This commentary on the issues and challenges related to the provision of sex education in US schools opens by using a 1997 action of the Franklin County, North Carolina, school board as an example of the controversy. In this case, the school board ordered the removal of chapters on sex behavior, contraception, AIDS, and sexually transmitted diseases from its 9th grade health text book to comply with a new state law requiring public schools to teach sexual abstinence until marriage. While most US adults approve of sex education in schools, the abstinence-only movement has orchestrated a highly organized, successful campaign to remove information from schools and has garnered a $250 million commitment from the federal government to promote abstinence until marriage as part of welfare reform efforts. The commentary continues with a review of efforts to undermine sexuality education starting in the 1960s and sketches the current state of sex education efforts. The next section looks at the new strategy used by sex education opponents, which led them to refocus efforts on local school boards and state legislatures instead of national policies. Remaining topics include the other tactics used by sex education opponents, the heightened fear of teachers to discuss controversial subjects, the lack of teacher training to discuss sexuality, and the consequences of this situation in the classroom. Recommendations to redress this situation include improving professional training, forming local advisory committees, encouraging parental involvement, and promoting the benefits of comprehensive programs.     

Sexual expression and dementia. Views of caregivers: A pilot study

OBJECTIVE: To measure the attitudes of health professionals in nursing homes towards sexuality and sexual expression in cognitively impaired and cognitively intact residents. DESIGN: Postal survey. PARTICIPANTS: The staff (administrators, clinicians, social workers and others) of 300 randomly selected nursing homes located in three states. Of these, 114 representatives responded. MAIN OUTCOME MEASURE: A measure of attitudes towards resident sexuality developed during a prior study. RESULTS: Results suggest that respondents held a generally positive orientation towards residents' sexual expression which was expressed with respect to cognitively impaired residents as well as to those who were cognitively intact. Possibly because of the small sample size and resulting low statistical power, statistical analyses failed to demonstrate any significant differences among the groups of residents: administrators, clinicians, social workers, and undifferentiated 'others'. However, while non-significant, there was a consistent tendency for administrators to be relatively more conservative than were the other groups. Almost all respondents agreed that additional staff training should focus specifically on dealing with resident sexual expression. CONCLUSIONS: Overall, the sample reported generally positive attitudes towards resident sexuality and sexual expression.     

Motivational forces affecting participation in post-registration degree courses and effects on home and work life: a qualitative study

Over the past decade, pre- and post-registration education for nurses and midwives in the United Kingdom has undergone major change, creating an atmosphere where continuing professional development is a matter of priority for individual health care staff. Against this context of change, and as part of a larger study of continuing education and training in the National Health Service, a cohort of participants in a part-time health studies degree course were interviewed using a semi-structured schedule. Twenty-nine nurses, midwives and allied professional staff described their motives for participation in the course and its effects on their professional and personal lives. Data collected in interviews were analysed using qualitative methods and revealed that participation was encouraged by both professional and personal factors. For many staff participation was prompted by negative feelings about themselves and their professional status. Participation in the course was associated with (largely negative) changes in home and family life and most participants faced additional financial burdens. The findings of the study have implications for policy relating to the funding of continual professional education for nurses and other health care staff. Health care staff are receiving mixed messages about continuing education from policy makers and employers. Dependence on willingness and ability to pay for post-registration degree-level studies is unlikely to be an efficient or equitable means of ensuring lifelong learning for healthcare staff.     

Sexual attitudes and self-reported behavior of congenitally disabled adults.

A 1–3 hr personal interview was conducted and a questionnaire was administered to 45 18–35 yr old physically disabled Ss. The questionnaire dealt with (a) attitudes towards pornography, masturbation, and other aspects of sexuality; (b) degree of personal interest in sex; and (c) the extent and form of Ss' intimate sexual behavior. Results indicate that while Ss tended to express liberal attitudes toward sexuality, they did not indicate a high degree of personal interest in sex. Nearly all of the Ss were unmarried, and over half had never had a serious relationship with the opposite sex or any intimate sexual experience. There were indications that many Ss were uninformed about sexual matters. Ss' negative attitudes toward sex could be attributed to restrictive living conditions and insufficient sex education and guidance. As a group, females expressed more conservative attitudes toward sexuality than did males. Findings suggest the need for reorientation on the part of parents, educators, and society toward recognizing and accepting the emotional and sexual needs of disabled persons. (French summary) (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The integration of nursing and midwifery education within higher education: implications for teachers--a qualitative research study

This study was a qualitative narrative that reviewed the historical developments that led to the integration of nursing and midwifery education with higher education in the United Kingdom (UK). A sample of teachers was investigated with particular reference to role conflicts they may have experienced as a result of integration. In addition to this the views of established academic university staff were assessed. The methodology adopted for the research was an eclectic qualitative one, drawing on several approaches, and sought to inquire into individuals personal perception of these events. In this paper the progression of events, nationally and locally, that led to the educational reforms in nursing and midwifery in the 1990s are examined. This narration includes a brief history of the creation of a new university department. Following this there is detail of how data were collected and analysed from a teacher population within this new department. The findings, whilst difficult to generalize to the wider population of nurse and midwife teachers, demonstrate that the sample of teachers examined, all of whom have been involved in the process of integration, have been exposed to stress that has resulted in role conflict. Established university staff, however, were more objective, expressing some broad anxieties regarding the resource demands and research capability of the new department.     

Sexuality and aging--usual and successful

BACKGROUND: As aging research increasingly reflects an effort to dissociate true time-driven changes from those that can be improved, sexuality in later life remains largely unexplored. Several problems are evident. There is a lack of normative data, a lack of a conceptual framework relating to the biology, psychology, and sociology of sex, and an attitudinal resistance that obscures the entire topic. METHODS: We conducted a three-part instructional series on major topics involved with sexuality and aging. We surveyed our group of attendees (n 158, average age 68 for males, 65 for females) before and after the series. RESULTS: A remarkably robust sex life was evidenced by both the men and the women, even until advanced old age. Yet, a substantially decreased involvement was reported from 10 years earlier. Despite current activities, people of both sexes wished they were participating even more than they currently were. Impotency was identified as the major negative feature for the men; relationship problems were for the women. A questionnaire 6 months after the series reported improved sexual attitudes, but no change in sexual activities from the earlier survey. CONCLUSION: Sexuality is a major quality-of-life issue which persists into old age. Our study showed that the usual sexual practices reported by our group were not considered by them to be ideal. The intervention of this instructional series provided improved sexual attitudes but not performance. Additional studies are encouraged.     

The birds and the bees: an analysis of advice given to parents through the popular press

There is a growing need for parents to communicate with their adolescents about sexuality, as teenage pregnancies and sexually transmitted diseases are on the rise. Many parents indicate that they lack information and feel uncomfortable communicating with their children about sex. The popular press regularly publishes articles on parenting issues, including how to discuss sex. In this study, 26 articles from 1984 to 1993 were reviewed, and the tone, quality of information, and advice given to parents on how to communicate were analyzed. The articles reflected current research regarding parent-child sexual communication and provided much more detailed advice about how best to approach the topic with an adolescent. However, readership seemed to be primarily white and mothers in traditional families, and little advice was offered on how to handle more difficult issues, such as contraception and AIDS. The findings suggest that the popular press could serve as an informational vehicle for educating both youth and parents about sexuality and how to have productive discussions regarding this issue.     

Sexual behaviour in young people

A review of the literature from the United Kingdom reveals a progressive reduction in recent decades in the age at first intercourse, an increase in the prevalence of premarital sex to the point of near universality, and a convergence of the sexual behavior of males and females. Over the past 30 years, the median age at first intercourse in the UK has dropped from 16 to 14 years for females and from 15 to 13 years for males. Fewer than 1% of women 16-24 years of age had their first sexual experience within marriage compared with 40% of women 45-59 years old. These trends reflect biologic factors, including earlier age at menarche, and social factors such as liberalization of norms governing sex behavior and peer pressure. Age at first intercourse increases with educational level and social class status. Curiosity is the factor most commonly cited by males as motivating first intercourse, while females identify romantic reasons. Nearly half of young women and over half of young men who have intercourse before the age of 16 years have unprotected sex. Contraceptive use is more likely with casual than steady sex partners. The condom is the most widely used contraceptive method in the early stages of sexual experience, and its use is increasing as a result of awareness of acquired immunodeficiency syndrome. More than two-thirds of young people consider themselves inadequately prepared at first intercourse in terms of information on sexual matters. Although the majority gain their information about sexuality from friends, schools are cited as a preferred source. The importance of sex education is confirmed by the positive association of predominantly school-based information and contraceptive use at first intercourse. There is no evidence that sex education hastens the onset of sexual activity.     

Veterans Administration psychology: A professional challenge for the 1980s.

Discusses the role that psychology has played in the Veterans Administration (VA) since the 1940's, a role that has increased in prominence over the years. Psychologists in the VA's Department of Medicine and Surgery have been involved in the delivery of health and mental health care services, research efforts, and training programs for psychology interns. It is noted that despite psychology's long-standing involvement in the VA, concerns have arisen recently regarding the status of psychology within the VA. Events contributing to these concerns involve decreased administrative visibility, attempts to exclude psychologists from medical staff membership, threats of psychology staff reductions, and proposals to place psychologist practitioners under the direction of physicians. Psychology's legislative and regulatory efforts to address these concerns are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Battered women: Sex roles and clinical issues.

Examines how sex role biases contribute to the origins of spousal violence, compound its psychological effects, and interfere with effective treatment for battered women. Issues that commonly arise during psychotherapy with battered women and their batterers are discussed, such as self-esteem, denial, manipulation, body integration and sexuality, and familial relationships. Clinical impressions are supported with preliminary results of data collected from 400 battered women. Suggestions are made for implementing effective, nonsexist treatment programs with preventive, secondary, and tertiary strategies. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School nurses' perceptions of parental involvement in school health. Results of a statewide study

The purpose of this study was to determine how school nurses attempt to involve parents of seventh graders in school health programs, identify nurses' perceptions of barriers to parental involvement, and identify related staff development needs. A questionnaire was sent to the school nurse in each school in Indiana that had a seventh grade (n = 447); 279 questionnaires were returned, a response rate of 63%. Most respondents worked in situations without written policies for parental involvement. A minority of school nurses reported receiving input from parents through advisory committees or parent surveys. The most common involvement activities were related to providing parents with information about the school health program. Less than half of the respondents reported offering health education through activities such as parent health education classes, health fairs, health education resource centers, or health newsletters. Lack of time was identified as the major barrier faced by school nurses. Several staff development needs were identified.     

Transgender HIV prevention: a qualitative needs assessment

Although clinical experience and preliminary research suggest that some transgender people are at significant risk for HIV, this stigmatized group has so far been largely ignored in HIV prevention. As part of the development of HIV prevention education targeting the transgender population, focus groups of selected transgender individuals assessed their HIV risks and prevention needs. Data were gathered in the following four areas: (1) the impact of HIV/AIDS on transgender persons; (2) risk factors; (3) information and services needed; and (4) recruitment strategies. Findings indicated that HIV/AIDS compounds stigmatization related to transgender identity, interferes with sexual experimentation during the transgender 'coming out' process, and may interfere with obtaining sex reassignment. Identified transgender-specific risk factors include: sexual identity conflict, shame and isolation, secrecy, search for affirmation, compulsive sexual behaviour, prostitution, and sharing needles while injecting hormones. Community involvement, peer education and affirmation of transgender identity were stressed as integral components of a successful intervention. Education of health professionals about transgender identity and sexuality and support groups for transgender people with HIV/AIDS are urgently needed.     

Psychologists’ sexual education and training in graduate school.

The current study explored the sex education and training that clinical and counselling psychologists receive during graduate school, practicum placements and internship. There were 162 psychologists who completed an Internet survey. Although nearly all participants had received some form of education related to sexuality during their graduate training, the depth and breadth of training was limited and was not related to how long clinicians had been practising. Modelling and feedback appeared to be underutilized as training methods. Participants reported more training related to sexual problems (e.g., sexual violence, sexual disorders) than healthy sexuality (e.g., contraception, STIs/STDs). Sexuality-specific training experiences but not participant characteristics (e.g., gender, religiosity) or cognitive-affective factors predicted the amount of sex therapy experience gained during graduate school. This suggests that training programs may be largely responsible for the (limited) amount of sex education and training received by students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Volunteer bias in sexuality research

Biases associated with volunteering for studies in human sexuality were studied. Beginning with a sample of over 1000 introductory psychology students, subjects participated in a two-phase study in which those willing and unwilling to volunteer for a variety of sexuality studies were compared. In both phases of this study, volunteers were significantly different from nonvolunteers on some, but not all, dimensions assessed. Specifically, compared to nonvolunteers, volunteers reported a more positive attitude towards sexuality, less sexual guilt, and more sexual experience. These differences were independent of subject gender. Sobering implications of these findings for the generalizability of sexuality research results are discussed.     

Rural sex education: assessment of programs and interagency collaboration

The purposes of this study were to assess the sex education programs offered in three rural Ohio counties, the agencies involved, and the extent to which agencies collaborated, and to compare interagency collaboration across counties. This cross-sectional study occurred in two phases. Using key-informant interviews (n = 85), Phase 1 identified current programs. Phase 2 assessed interagency collaboration via a mailed survey (n = 116). Results indicated that there were five to nine sex education programs per county, each involving five to eight agencies. Sex education was offered inside and outside of schools; programs were available to keep pregnant/parenting youth in school, enhance self-esteem, provide parenting education to teens, and advocate for abstinence. Sex education also occurred via a newsletter and an adolescent health conference, and in various clinics. Minimal collaboration was noted among agencies providing these programs. Public health nurses are ideally situated to identify current programs and agencies involved and form an interagency group to plan and implement comprehensive, collaborative sex education programs for youth. Further research is needed to longitudinally assess the impact of such program development on interagency collaboration, teen sexual activity, and pregnancy rates.     

Developing a research unit within a hospital social work department

This article describes the establishment of a research unit as an integral part of a hospital social work department on the basis of the authors' experience in a cancer center over a 13-year period. Methods are described for building support within the institution, for the process of initiating the unit, for deciding on study topics, and finally for bridging the gap between clinical and research staff. The evolution of the relationship between clinical and research staff was characterized by four different phases: curiosity, competitiveness, cooperation, and collaboration. A childhood bereavement project is used to exemplify the developmental processes and the ongoing interaction of research and clinical staff. The professional practice of all staff benefited from the increased academic rigor and productivity, although some staff remained unconvinced of the value of such a major research effort. The benefits and costs of the unit are also discussed.     

Management of sexuality in a mental health setting

Clients with long term mental health problems can be particularly vulnerable to sexually transmitted diseases, but nurses and other staff find it difficult to address the issues of sex and sexuality. More training courses would help to address this, but the attitudes of health professionals to these issues also need to be examined.     

The patient from receiver of information to informed decision-maker

In this article the change of paradigm currently taking place within the field of patient education is indicated. In this change of paradigm the patient is increasingly being seen as responsible for his own health and as someone who makes independent choices in this respect. This has consequences for the role the patient is given in decisions on individuals care. The consequences of current developments within the Dutch society and in medical techniques as these relate to the need for patient education are enlightened. Some of the main topics for patient education are mentioned and the effects of patient education as established through meta-analyses are summarised. A planning model for a systematic development of patient education interventions is recommended. Relevant topics for research on patient education in the Netherlands are indicated.     

Gender differences in erotic plasticity: The female sex drive as socially flexible and responsive.

Responding to controversies about the balance between nature and culture in determining human sexuality, the author proposes that the female sex drive is more malleable than the male in response to sociocultural and situational factors. A large assortment of evidence supports 3 predictions based on the hypothesis of female erotic plasticity: (a) Individual women will exhibit more variation across time than men in sexual behavior, (b) female sexuality will exhibit larger effects than male in response to most specific sociocultural variables, and (c) sexual attitude-behavior consistency will be lower for women than men. Several possible explanations for female erotic plasticity are reviewed, including adaptation to superior male political and physical power, the centrality of female change (from no to yes) as a prerequisite for intercourse, and the idea that women have a milder sex drive than men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use with care: possibilities and constraints offered by computers in nursing clinical education

Funding constraints, demands for improved efficiency, low staff to student ratios and improved computer software (D. Wright, The use of multimedia computers and software in nurse education, Health Inf. 1 (3) (1995) 101-107.) all combine to produce a situation where a dramatic increase in the use of CBE for tertiary nurse education appears inevitable. In particular there is a very strong movement towards the development of nurse education materials able to be delivered via the World Wide Web (WWW). Given the speed and the extent of these developments it is essential that CBE developments are subject to adequate review and critique. In particular it is important that the pedagogical concepts under pinning the CBE are congruent with the technological innovation being implemented. This paper provides such a review and critique through the discussion of a project concerned with the integration of a computerised hospital nursing care planning database into the undergraduate nursing curriculum. The evaluation of the project not only raises many issues and concerns relevant to CBE in general, but also provides examples of the ways in which CBE can be used to link theory to practice. It also highlights the need for congruency between pedagogy, technology and student learning. Implications arising from the project are discussed at length, including the possibility for clinicians and academics to work collaboratively on database development.