Women's views about intimate examinations and sexually inappropriate practices by their general practitioners

Abstract

The aim of this survey of 472 adult women was to assess women patients' feelings about intimate examinations and their perceptions and experiences of sexually inappropriate medical practice. Two-thirds of women preferred a women doctor for intimate examinations. Slightly more than two-thirds found intimate examinations embarrassing and stressful, and strongly expressed the need for information and on-task, health-related comments during these examinations. General personal comments or non-medical touching were not particularly welcomed, even for the purpose of comforting the patient. There was a range of views about patients' personal relationships with doctors, with the lines between acceptable and unacceptable behaviour somewhat ambiguous. A small but significant number of women perceived that they had been sexually harassed (5%) or abused (3%) by a doctor, with this experience more common for non-English speaking women. Results were discussed in terms of implications for improved doctor practice, particularly during intimate examinations and with vulnerable patients.     

Predicting short and long-term exercise intentions and behaviour in patients with coronary artery disease: A test of protection motivation theory

The purpose of this study was to examine the utility of protection motivation theory (PMT) in the prediction of exercise intentions and behaviour in the year following hospitalisation for coronary artery disease (CAD). Patients with documented CAD (n?=?787), recruited at hospital discharge, completed questionnaires measuring PMT's threat (i.e. perceived severity and vulnerability) and coping (i.e. self-efficacy, response efficacy) appraisal constructs at baseline, 2 and 6 months, and exercise behaviour at baseline, 6 and 12 months post-hospitalisation. Structural equation modelling showed that the PMT model of exercise at 6 months had a good fit with the empirical data. Self-efficacy, response efficacy, and perceived severity predicted exercise intentions, which, in turn predicted exercise behaviour. Overall, the PMT variables accounted for a moderate amount of variance in exercise intentions (23%) and behaviour (20%). In contrast, the PMT model was not reliable for predicting exercise behaviour at 12 months post-hospitalisation. The data provided support for PMT applied to short-term, but not long-term, exercise behaviour among patients with CAD. Health education should concentrate on providing positive coping messages to enhance patients’ confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity.     

The Contribution of Executive Skills to Reading Comprehension

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9–15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD.     

Anxiety Sensitivity and Interoceptive Exposure: A Transdiagnostic Construct and Change Strategy

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.     

Examining the Intertextuality of Fictional Political Comedy and Real-World Political News

This study examines the intertextuality of a fictional political comedy and a political news article. In an experiment, participants watched the political comedy Man of the Year or a control film, read a politically relevant news article on electronic voting, and were asked their discussion intention about the political issue featured in the news article. Beyond direct effects, the mediating influence of elaboration about the politically relevant news article on discussion intent was analyzed. Results revealed no main effect of political comedy viewing on discussion intent, and no mediating effect of elaboration either. However, viewing the fictional political comedy was associated with higher levels of elaboration about the related news article, which shows evidence of intertextuality among media texts. Moreover, perceived external realism of the fictional political comedy was a significant positive predictor of discussion intent about the news article. Results also showed perceived external realism about the fictional political comedy to be a nearly significant moderator of the elaboration and discussion intent relationship. A broader discussion regarding the theoretical and practical implications of the findings is included.     

Genetic Counselors’ Current Use of Personal Health Records-Based Family Histories in Genetic Clinics and Considerations for Their Future Adoption

Given the widespread adoption of electronic medical records and recent emergence of electronic family history tools, we examined genetic counselors’ perspectives on the emerging technology of the personal health record (PHR)-based family history tool that links to an electronic medical record (EMR). Two-hundred thirty-three genetic counselors responded to an on-line survey eliciting current use of electronic family history (EFH) tools and familiarity with PHR-based family history tools. Additionally, after being shown a series of screen shots of a newly developed PHR-based family history tool based on the U.S. Surgeon General’s My Family Health Portrait (United States Department of Health and Human Services 2009), participants were surveyed about the perceived usefulness, ease of use, and impact on current workflow that this kind of tool would have in their practices. Eighty-three percent reported that their institution has an EMR, yet only 35 % have a dedicated space for family history. Eighty-two percent reported that less than 5 % of their patients have a PHR, and only 16 % have worked with patients who have a PHR. Seventy-two percent or more agreed that a PHR-based family history tool would facilitate communication, increase accuracy of information, ensure consistency in recording information, increase focus on actual counseling, reduce repetitive questions, improve efficiency, and increase the legibility and clarity. Our findings suggest that participants were familiar with existing EFH tools, but that the majority did not use them in practice. Genetic counselors’ adoption of such tools is limited due to non-existence of this kind of technology or inability to integrate it into their clinics. They are also strongly in favor of adopting a PHR-based family history tool in genetics clinics, but have practical concerns that must be addressed before the tool can be implemented.     

Thinking Levels of Questions in Christian Reading Textbooks

If Christian schools desire students to achieve higher-level thinking, then the textbooks that teachers use should reflect such thinking. Using Risner's (1987 Risner, G. P. (1987). Cognitive levels of questioning demonstrated by test items that accompany selected fifth-grade science textbooks (Doctoral dissertation). Vanderbilt University, Nashville, TN. [Google Scholar]) methodology, raters classified questions from two Christian publishers’ fifth grade reading textbooks based on the revised Bloom's taxonomy (Anderson et al., 2001 Anderson, L. W., Krathwohl, D. R., Airasian, P. W., Cruikshank, K. A., Mayer, R. E., Pintrick, P. R., … Wittrock, M. C. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. New York, NY: Addison Wesley Longman. [Google Scholar]). The questions in the A Beka Book textbook contained 57.6% lower-level and 42.4% higher-level thinking; the questions in the Bob Jones University Press textbook contained 45.8% lower-level and 54.2% higher-level thinking. Analysis revealed a statistically significant difference between the percentages of thinking in the two publishers (p < .05).     

Males' Reactions to Participating in Research on Dating Violence Victimization and Childhood Abuse

Childhood abuse and dating violence victimization are prevalent and devastating problems. Although there has been an abundance of research on these topics in recent years, researchers and institutional review boards often struggle with determining whether asking respondents questions on previous violence will result in increased emotional distress or other negative research outcomes. Empirical data are therefore needed that examine the research reactions of individuals who participate in research on childhood abuse and dating violence. This study examined this topic among a sample of male college students (N?=?193). Results showed that victims of childhood sexual abuse had more negative emotional reactions and victims of physical dating violence had more negative perceived drawbacks to research participation than nonvictims. However, victims and nonvictims did not differ on positive research reactions. These findings suggest that there are few differences between victims and nonvictims on research reactions.     

Aggression in the Laboratory: Problems with the Validity of the Modified Taylor Competitive Reaction Time Test as a Measure of Aggression in Media Violence Studies

Many laboratory studies of aggression use a measure known as the modified Taylor Competitive Reaction Time Test (TCRTT), for which validation studies are lacking. Using sound blasts administered by the participant against a fictional human opponent, the TCRTT also allows for multiple methods of measuring aggression. The validity of the TCRTT was tested in 53 college student participants. Participants took a self-report measure of aggressiveness as well as neuropsychological measures of frontal lobe functioning predictive of aggression. Results were not supportive of the TCRTT's validity and indicated concerns regarding the use of the TCRTT as a measure of aggression. Results suggest that labaratory studies of media violence using the TCRTT are of questionable validity.