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The current paper describes the process and results of an effort to find a way to effectively manage and diffuse prevention knowledge. This study shows the role that today's communication technologies can play in ensuring collaboration and participation in both the design and use of a knowledge management system (KMS) for prevention research, practice and policy. In the context of this study, 'prevention research' includes primary through tertiary prevention efforts consistent with general applied public health research in the US. An online Delphi study was used to engage a set of prevention research constituencies in the design of a mechanism to enhance the potential for effective technology transfer. A three-round Delphi was conducted with 58 stakeholders and key informants involved in prevention: government-level policy makers, researchers and front-line practitioners. The study resulted in consensus on 34 functions and 32 output/content elements of a proposed web-based KMS called Prevention-Effects.net. The paper also describes the implications of both the processes of development and the benefits of the proposed system for those interested in prevention.

Assisted Reproductive Technology (ART) is a modern technological tool that provides otherwise infertile individuals and couples an opportunity to conceive. As a multimillion dollar business, ART faces challenges common to other highly profitable enterprises, such as how and when to measure success. This poses ethical challenges as well, though these are unlike the ethical challenges faced by businesses which trade in consumer goods. ART makes babies. Individuals and couples seeking ART may be both vulnerable and fragile, thus ART providers must gently balance smart business practices with ethical care delivery. Applying Laura Nash's integrated approach to business ethics may offer ART providers a suitable model that combines ethically sound care with economically sound business practice. Key to Nash's approach are value creation, economic and social benefit, and relationship building. Not a short-term approach to quick business decisions, Nash's approach requires a long-term commitment as a way of doing business. © Common Ground, Deborah Flynn, All Rights Reserved.

Since the advent of medical treatments for HIV, the promotion of adherence to these difficult treatment regimens has proven critical to disease management. Three Connecticut state-funded HIV medication adherence programs were evaluated.1 The purpose of this process evaluation was to explore and compare the goals and modality of each adherence program, assess client and staff satisfaction, and provide recommendations for the improvement of these programs. Focus group interviews with clients and individual interviews with staff were conducted at each of the programs. Interviews were transcribed, coded and analyzed with a code and retrieve method of theme identification. Focus group themes included the importance of social support on medication adherence and the "lifesaving" effect the program has had. The staff expressed that although complete adherence should be the long-term objective, more intermediate objectives should be considered (e.g., behavioral changes to increase clients' ability, self-esteem, and self-efficacy to take medications).

Objectives: To engage a community to critically examine local health disparities. Design: Concept mapping is a tool used to rapidly assess the variations in thinking of large stakeholder groups' about a particular topic. Setting: Jackson, Mississippi. Participants: Community members. Methods: Dialog groups and community meetings were held, and participants were asked to respond to the statement, "A specific thing that causes African Americans to get sicker and die sooner is⋯" Aggregate responses were rated for importance and feasibility and then sorted into related groups. Aggregate sorts and ratings were then processed by using multidimensional scaling and hierarchical cluster analysis. Results: There were 132 (unduplicated) reported contributors to health disparities. These responses fell into eight general clusters: economic issues, government, contextual factors, cultural factors, HIV, stress, environment, and motivation. Factors respondents felt were the most important contributors to disparities (economic factors, contextual factors, stress) did not correlate with those that they thought were most likely to be changed in society (contextual factors, government, motivation). Conclusions: Concept mapping provided a mechanism for rapidly documenting community thinking about health disparities. This mechanism stimulated community dialog and was used as a first step toward the long-term goal of creating equal community, academic, and medical partnerships for addressing disparities. The concept mapping process stimulated critical thinking about contributors to health inequities and uncovered contextual factors previously unknown to researchers and public health planners. The process allowed for active engagement and exchange of knowledge between the community and researchers and allowed a mechanism for identifying and rectifying disconnects in knowledge within and between stakeholder groups.

Women are often faced with the primary role of providing care for individuals with Alzheimer's disease (AD). This study explored women caregiver's perceptions of caregiving through the use of Cognitive Mapping (CM), a qualitative research method. Volunteers were recruited from caregiver support groups to construct maps of their experience of "caregiving for someone with AD." Maps were analyzed for commonly identified concepts and relationships. Twelve participants identified 280 concepts, 206 of which were unduplicated. Concepts were collapsed into 17 categories; the largest concepts being "friends and family," "sad," "frustration," and "time." The maps produced by the sample in this study were unique, providing evidence that the experience of AD caregiving varies significantly among caregivers. CM appears to be effective for identifying caregiver stressors and needed support services.

Surveys estimate that 3-6% of the patients seen by physicians are gay or lesbian. There are unique health risks of gays and lesbians that are important to the clinician in determining an accurate diagnosis, providing patient education, and arriving at an appropriate treatment plan. One of the most significant medical risks of these populations includes avoidance of routine health care and dissatisfaction with healthcare. Many of these healthcare risks are not addressed because of lack of communication based on a number of common assumptions including the assumption that the patient is heterosexual. This article includes a summary of the medical literature through computerized searches to March 2002 in MEDLINE, PsychInfo, HEALTHSTAR, and bibliographies in articles on health care with gay and lesbian patients. The search strategy included health care of gays and lesbians and clinician-patient communication, partner and family issues. Secondly, it will examine common communication barriers and provide strategies for enhancing communication with patients in a gender-neutral, non-judgmental manner including suggestions for enlisting the inclusion of patients' families. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

Understanding the barriers to antiretroviral adherence is a critical step in improving the effectiveness of HIV treatment and saving lives. We sought to assess, qualitatively, the experiences of HIV-positive persons taking antiretroviral therapy (ART) in North Carolina. Twenty-four people participated in one of six focus groups. A structured interview script included three questions (two open-ended) and eight probes. Each discussion was taped, transcribed, and content-analyzed. Three distinct themes emerged. First, many participants believed that taking ART was lifesaving but missed doses because they feared that taking them in public would reveal their HIV status. Second, as a result, participants often found it difficult to integrate their regimens into the most basic daily activities. Finally, participants stressed the importance of having open, ongoing dialogues about their treatment plans and privacy needs with a wide range of health care workers. Multidimensional, tailored interventions may help persons living with HIV overcome the stigma and other complex barriers they face in taking antiretroviral therapy.

OBJECTIVE: The purpose of the study was to determine if sexual behaviors, orgasm, tampon use, and douching during menstruation modify the risk of endometriosis., METHODS: A case-control study was conducted. Subjects (n = 2,012) consisted of members of the Endometriosis Association and friends not affiliated with the organization who completed mailed surveys. Data were analyzed using chi(2), Fisher's exact test, t test, and regression analyses., RESULTS: There was no difference between study groups concerning douching practices. However, cases were less likely than controls to report sometimes or often engaging in sexual behaviors during menstruation (p = 0.002, OR = 1.5), and sexual behaviors during menstruation that included orgasm (p = 0.001, OR = 1.5). Cases were also less likely than controls to report using only tampons (p < 0.0001, OR = 2.6)., CONCLUSION: Sexual activity, orgasm, and tampon use during menstruation may confer protection against endometriosis. Copyright 2002 S. Karger AG, Basel

The Enhancing Data Utilization Skills through Information Technology (EDUSIT) project trained Maternal and Child Health professionals to collect, analyze and interpret data via a year-long web-based course. The overall goal of the project was to strengthen the technology and analytic skills of the public health workforce. This article describes and analyzes a web-based module for training public health professionals to use qualitative research and evaluation methods that was one of six offered within the EDUSIT project. The qualitative module consisted of six units: overview of qualitative methods, planning qualitative studies, conducting field observations, qualitative interviewing, analyzing qualitative data and presenting qualitative findings. Evaluation results found no statistically significant changes in specific knowledge or beliefs about qualitative methods. However, the change in participants' self-efficacy was statistically significant. Participants' self-reports also showed significant changes in perceived skill levels in `collecting qualitative data through an interview' and `analyzing and interpreting qualitative data'. Most participants rated each lesson within the qualitative methods module as valuable, and most found the teaching methods used satisfactory, emphasizing the value of both the didactic teaching and the practical exercises and team project. The most common difficulty reported was finding the time to complete the module requirements while also working full-time. Implications of these findings for web-based teaching of public health professionals are discussed.

Correlates of sexual satisfaction were identified in a sample of older married women. A 70-item questionnaire was mailed to an age-stratified sample of 5,000 married persons, including 1,000 married women over the age of 50. Usable questionnaires were received from 148 participants (14.8% return rate). Hierarchical multiple regression analysis, using sexual satisfaction as the dependent variable, yield ed five predictor variables that accounted for a significant portion of the variation in sexual satisfaction (Cumulative R-2 = .73). These results serve as a reminder that sexual interactions cannot be compartmentalized but must be considered within the context of the overall marriage relationship. Given the low return rate, interpretations should be limited until replication with an adequate sample has been completed.

Occupational segregation by race and gender, though less common now than in the past, continues to be the norm rather than the exception in the sport industry. The purpose of this study was twofold. First, occupational segregation on the baseball playing field, often referred to as stacking, was discussed in light of human capital and social closure theories. Second, an attempt was made to replicate and extend a multivariate analysis of stacking by Margolis and Piliavin (1999) that challenges the dominant social science paradigm for explaining stacking. The present study uses more recent data than the Margolis and Piliavin study, as well as multinomial logistic regression analysis. The results reveal that stacking persists in Major League Baseball. They also reveal that the effect of race/ethnicity on assignments to playing positions is reduced when one controls for skills and physical characteristics such as speed and power hitting. The implications of this finding for sport management are examined.

Objective: To examine whether an educational intervention that focused on physician communication training influenced physician ernpathic expression during patient interactions. Methods: This study used a quantitative research method to investigate the influence of communication training on physician-expressed empathy using two measures (global and hierarchical) of physician empathic behavior. Results: The differences in global empathy scores in the physician training group from baseline to follow-up improved by 37%, and hierarchical scores of physician empathic expression improved by up to 51% from baseline scores for the same group. Conclusions: The results strongly supported the hypotheses that training made a significant difference in physician empathic expression during patient interactions demonstrated by both outside observer measures of global ratings and hierarchical ratings of physician empathic behavior. Practice implications: These findings have significant implications for program design and development in medical education and professional training with the potential to improve patient outcomes. (C) 2008 Elsevier Ireland Ltd. All rights reserved.