How Computer Literacy and Socioeconomic Status Affect Attitudes Toward a Web-Based Cohort: Results From the NutriNet-Santé Study

Background

In spite of the growing literature in the field of e-epidemiology, clear evidence about computer literacy or attitudes toward respondent burden among e-cohort participants is largely lacking.

Objective

We assessed the computer and Internet skills of participants in the NutriNet-Santé Web-based cohort. We then explored attitudes toward the study demands/respondent burden according to levels of computer literacy and sociodemographic status.

Methods

Self-reported data from 43,028 e-cohort participants were collected in 2013 via a Web-based questionnaire. We employed unconditional logistic and linear regression analyses.

Results

Approximately one-quarter of participants (23.79%, 10,235/43,028) reported being inexperienced in terms of computer use. Regarding attitudes toward participant burden, women tended to be more favorable (eg, “The overall website use is easy”) than were men (OR 0.65, 95% CI 0.59-0.71, P<.001), whereas better educated participants (>12 years of schooling) were less likely to accept the demands associated with participation (eg, “I receive questionnaires too often”) compared to their less educated counterparts (OR 1.62, 95% CI 1.48-1.76, P<.001).

Conclusions

A substantial proportion of participants had low computer/Internet skills, suggesting that this does not represent a barrier to participation in Web-based cohorts. Our study also suggests that several subgroups of participants with lower computer skills (eg, women or those with lower educational level) might more readily accept the demands associated with participation in the Web cohort. These findings can help guide future Web-based research strategies.     

Impact of male circumcision on HIV risk compensation through the impediment of condom use in Botswana

Background

Male circumcision has been recommended as a method of reducing the risk of transmitting HIV. However, widespread uptake of male circumcision may lead to HIV risk compensation by impeding condom use.

Objective

To investigate the impact of male circumcision on condom use.

Methods

The study used cross-sectional data from the Botswana AIDS Impact Survey III on 1,257 men aged 15 years or older who were sexually active. Data were analyzed using Pearson''s chi-square statistic and binary logistic regression.

Results

The study found that 15% of circumcised men did not use condoms compared to 12% of uncircumcised men, and circumcision was not significantly associated with condom use. Non-use of condoms was significantly affected by religious beliefs, low level of education, marriage, drunkenness, and misconceptions regarding antiretroviral therapy (ART).

Conclusions

We conclude that male circumcision does not impede condom use. Condom use is impeded by low level of education, marriage, drunkenness, and misconceptions regarding ART. We recommend the emphasis of consistent condom use targeting people with low education, those in marriage, users of alcohol, and people receiving ART.     

Insomnia with Objective Short Sleep Duration is Associated with Deficits in Neuropsychological Performance: A General Population Study

Study Objectives:

To examine the joint effect of insomnia and objective short sleep duration on neuropsychological performance.

Design:

Representative cross-sectional study.

Setting:

Sleep laboratory.

Participants:

1,741 men and women randomly selected from central Pennsylvania.

Interventions:

None.

Measurements:

Insomnia (n = 116) was defined by a complaint of insomnia with a duration ≥ 1 year and the absence of sleep disordered breathing (SDB), while normal sleep (n = 562) was defined as the absence of insomnia, excessive daytime sleepiness, and SDB. Both groups were split according to polysomnographic sleep duration into 2 categories: ≥ 6 h of sleep (“normal sleep duration”) and < 6 h of sleep (“short sleep duration”). We compared the groups'' performance on a comprehensive neuropsychological battery that measured processing speed, attention, visual memory, and verbal fluency, while controlling for age, race, gender, education, body mass index, and physical and mental health.

Results:

No significant differences were detected between insomniacs and controls. However, the insomnia with short sleep duration group compared to the control with normal or short sleep duration groups showed poorer neuropsychological performance in variables such as processing speed, set-switching attention, and number of visual memory errors and omissions. In contrast, the insomnia with normal sleep duration group showed no significant deficits.

Conclusions:

Insomnia with objective short sleep duration is associated with deficits in set-switching attentional abilities, a key component of the “executive control of attention.” These findings suggest that objective sleep duration may predict the severity of chronic insomnia, including its effect on neurocognitive function.

Citation:

Fernandez-Mendoza J; Calhoun S; Bixler EO; Pejovic S; Karataraki M; Liao D; Vela-Bueno A; Ramos-Platon MJ; Sauder KA; Vgontzas AN. Insomnia with objective short sleep duration is associated with deficits in neuropsychological performance: a general population study. SLEEP 2010;33(4):459-465.     

Condom use at first and latest sexual events among young people: evidence from a rural and peri-urban setting in Uganda

Background

Condom use remains low among young people despite high prevalence of HIV, STIs, and unplanned pregnancy in Uganda.

Objectives

This paper presents patterns of condom use at first and latest sexual events and associated factors.

Methods

The data were obtained from 445 sexually active unmarried people aged 15–24 from one peri-urban and another rural district. Stratified multi-stage cluster sampling technique was applied. Logistic regression was used to identify factors associated with condom use at each of the two sexual events, while multinomial logistic regression was used to establish factors correlated with condom use at both first and last sex.

Results

Factors associated with condom use at each event were residence in the peri-urban district and higher education attainment. Factors correlated with condom use at both first and last sex were residence in peri-urban district (p<0.001) and being in school (p<0.01). Alcohol consumption and age at first sex were only significant at one event.

Conclusions

Some factors that influence condom use at first sex are different from those that affect condom use at latest sexual event. Prevention programmes against STIs, HIV and unplanned pregnancies among young people focus more on rural areas and those with minimal or no education.     

Insomnia with Short Sleep Duration and Mortality: The Penn State Cohort

Study Objectives:

Because insomnia with objective short sleep duration is associated with increased morbidity, we examined the effects of this insomnia subtype on all-cause mortality.

Design:

Longitudinal.

Setting:

Sleep laboratory.

Participants:

1,741 men and women randomly selected from Central Pennsylvania.

Measurements:

Participants were studied in the sleep laboratory and were followed-up for 14 years (men) and 10 years (women). “Insomnia” was defined by a complaint of insomnia with duration ≥ 1 year. “Normal sleeping” was defined as absence of insomnia. Polysomnographic sleep duration was classified into two categories: the “normal sleep duration group” subjects who slept ≥ 6 h and the “short sleep duration group” subjects who slept < 6 h. We adjusted for age, race, education, body mass index, smoking, alcohol, depression, sleep disordered breathing, and sampling weight.

Results:

The mortality rate was 21% for men and 5% for women. In men, mortality risk was significantly increased in insomniacs who slept less than 6 hours compared to the “normal sleep duration, no insomnia” group, (OR = 4.00, CI 1.14-13.99) after adjusting for diabetes, hypertension, and other confounders. Furthermore, there was a marginally significant trend (P = 0.15) towards higher mortality risk from insomnia and short sleep in patients with diabetes or hypertension (OR = 7.17, 95% CI 1.41-36.62) than in those without these comorbid conditions (OR = 1.45, 95% CI 0.13-16.14). In women, mortality was not associated with insomnia and short sleep duration.

Conclusions:

Insomnia with objective short sleep duration in men is associated with increased mortality, a risk that has been underestimated.

Citation:

Vgontzas AN; Liao D; Pejovic S; Calhoun S; Karataraki M; Basta M; Fernández-Mendoza J; Bixler EO. Insomnia with short sleep duration and mortality: the Penn State Cohort. SLEEP 2010;33(9):1159-1164.     

An Evaluation of an Educational Intervention in Psychology of Injury for Athletic Training Students

Context:

”Psychosocial Intervention and Referral„ is 1 of the 12 content areas in athletic training education programs, but knowledge gained and skill usage after an educational intervention in this area have never been evaluated.

Objective:

To evaluate the effectiveness of an educational intervention in increasing psychology-of-injury knowledge and skill usage in athletic training students (ATSs).

Design:

Observational study.

Setting:

An accredited athletic training education program at a large Midwestern university.

Patients or Other Participants:

Participants included 26 ATSs divided into 2 groups: intervention group (4 men, 7 women; age  =  21.4 ± 0.67 years, grade point average  =  3.37) and control group (7 men, 8 women; age  =  21.5 ± 3.8 years, grade point average  =  3.27).

Data Collection and Analysis:

All participants completed the Applied Sport Psychology for Athletic Trainers educational intervention. Psychology-of-injury knowledge tests and skill usage surveys were administered to all participants at the following intervals: baseline, intervention week 3, and intervention week 6. Retention tests were administered to intervention-group participants at 7 and 14 weeks after intervention. Analysis techniques included mixed-model analysis of variance (ANOVA) and repeated-measures ANOVA.

Results:

The Applied Sport Psychology for Athletic Trainers educational intervention effectively increased psychology-of-injury knowledge (29-point increase from baseline to intervention week 6; F_2,23  =  29.358, P < .001, η_p²  =  0.719) and skill usage (50-point increase from baseline to intervention week 6; F_2,23  =  5.999, P  =  .008, η_p²  =  0.343) in undergraduate ATSs. These increases were maintained at the 7-week and 14-week retention testing (P < .001 for both).

Conclusions:

This first attempt at evaluating an educational intervention designed to improve ATSs'' knowledge and skill usage revealed that the intervention was effective. Although both knowledge and skill usage scores decreased by the end of the retention period, the scores were still higher than baseline scores, indicating that the intervention was effective.     

The Time Course of the Probability of Transition Into and Out of REM Sleep

Study Objectives:

A model of rapid eye movement (REM) sleep expression is proposed that assumes underlying regulatory mechanisms operating as inhomogenous Poisson processes, the overt results of which are the transitions into and out of REM sleep.

Design:

Based on spontaneously occurring REM sleep episodes (“Episode”) and intervals without REM sleep (“Interval”), 3 variables are defined and evaluated over discrete 15-second epochs using a nonlinear logistic regression method: “Propensity” is the instantaneous rate of into-REM transition occurrence throughout an Interval, “Volatility” is the instantaneous rate of out-of-REM transition occurrence throughout an Episode, and “Opportunity” is the probability of being in non-REM (NREM) sleep at a given time throughout an Interval, a requisite for transition.

Setting:

12:12 light:dark cycle, isolated boxes.

Participants:

Sixteen male Sprague-Dawley rats

Interventions:

None. Spontaneous sleep cycles.

Measurements and Results:

The highest levels of volatility and propensity occur, respectively, at the very beginning of Episodes and Intervals. The new condition stabilizes rapidly, and variables reach nadirs at minute 1.25 and 2.50, respectively. Afterward, volatility increases markedly, reaching values close to the initial level. Propensity increases moderately, the increment being stronger through NREM sleep bouts occurring at the end of long Intervals. Short-term homeostasis is evidenced by longer REM sleep episodes lowering propensity in the following Interval.

Conclusions:

The stabilization after transitions into Episodes or Intervals and the destabilization after remaining for some time in either condition may be described as resulting from continuous processes building up during Episodes and Intervals. These processes underlie the overt occurrence of transitions.

Citation:

Bassi A; Vivaldi EA; Ocampo-Garcées A. The time course of the probability of transition into and out of REM sleep. SLEEP 2009;32(5):655-669     

Knowledge and perception of microbicides among healthcare providers in Calabar,Nigeria

Background

With the worldwide spread of HIV/AIDS, the absence of a known cure and the challenges associated with existing prevention methodologies, there is need for new prevention technologies. The successful uptake of healthcare products and services depend, to a large extent, on healthcare providers'' knowledge, perception and attitude regarding them.

Objectives

To determine the knowledge and perception of healthcare providers regarding microbicides.

Methods

A semi-structured questionnaire was administered on 400 randomly selected health care providers in Calabar, Cross River State of Nigeria. Data obtained from the 350 returned questionnaire were analyzed using EPI -Info software version 3.5.1

Results

One hundred and sixty-four (46.9%) respondents were medical doctors while 157 (44.9%) were nurses, 7 (2%) were Pharmacists and 22 (6.2%) belonged to “other” categories. Thirty- two percent knew the advantages of microbicides over condoms. Sixty-eight percent indicated that microbicides would benefit only women while to 27%, it would benefit both men and women. Seventy-five percent of respondents would be willing to act as community advocates for microbicides while 21% would not be willing and 4% were not decided. There was a statistically significant association between professional group and willingness to act as community advocates for microbicides. Medical doctors were more likely to act as advocates than other professional groups (p<0.05). Female respondents were more likely to have correct knowledge regarding microbicides than males (p<0.05)

Conclusion

There are gaps in knowledge regarding microbicides among the health care providers. Capacity building would be successful since the majority are willing to act as community advocates.     

Evidence-based practice: beliefs,attitudes, knowledge,and skills among Colombian physical therapists

Objective:

The main purpose of this study was to describe a group of Colombian physical therapists'' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice.

Methods:

This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al.

Results:

The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice.

Conclusion:

The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.     

Athletic Training Approved Clinical Instructors' Reports of Real-Time Opportunities for Evaluating Clinical Proficiencies

Context:

Appropriate methods for evaluating clinical proficiencies are essential to ensuring entry-level competence in athletic training.

Objective:

To identify the methods Approved Clinical Instructors (ACIs) use to evaluate student performance of clinical proficiencies.

Design:

Cross-sectional design.

Setting:

Public and private institutions in National Athletic Trainers'' Association (NATA) District 4.

Patients or Other Participants:

Approved Clinical Instructors from accredited athletic training education programs in the Great Lakes Athletic Trainers'' Association, which is NATA District 4 (N  =  135).

Data Collection and Analysis:

Participants completed a previously validated survey instrument, Methods of Clinical Proficiency Evaluation in Athletic Training, that consisted of 15 items, including demographic characteristics of the respondents and Likert-scale items (1  =  strongly disagree to 5  =  strongly agree) regarding methods of clinical proficiency evaluation, barriers, educational content areas, and clinical experience settings. We used analyses of variance and 2-tailed, independent-samples t tests to assess differences among ACI demographic characteristics and the methods, barriers, educational content areas, settings, and opportunities for feedback regarding clinical proficiency evaluation. Qualitative analysis of respondents'' comments was completed.

Results:

The ACIs (n  =  106 of 133 respondents, 79.7%) most often used simulations to evaluate clinical proficiencies. Only 59 (55.1%) of the 107 ACIs responding to a follow-up question reported that they feel students engage in a sufficient number of real-time evaluations to prepare them for entry-level practice. An independent-samples t test revealed that no particular clinical experience setting provided more opportunities than another for real-time evaluations (t₁₁₉ range, −0.909 to 1.796, P ≥ .05). The occurrence of injuries not coinciding with the clinical proficiency evaluation timetable (4.00 ± 0.832) was a barrier to real-time evaluations. Respondents'' comments indicated much interest in opportunities and barriers regarding real-time clinical proficiency evaluations.

Conclusions:

Most clinical proficiencies are evaluated via simulations. The ACIs should maximize real-time situations to evaluate students'' clinical proficiencies whenever feasible. Athletic training education program administrators should develop alternative methods of clinical proficiency evaluations.     

Subjective memory complaints in the elderly: a sign of cognitive impairment?

OBJECTIVES:

Cognitive impairment in the elderly is frequently overlooked by general practitioners. The use of subjective memory complaints as a sign of cognitive impairment by the general practice is controversial.

METHODS:

Elderly individuals (N = 248) were asked whether they had memory complaints and underwent a cognitive impairment screening. Subjects classified as exhibiting “probable cognitive impairment” underwent a complete cognitive evaluation, and the final diagnoses were established by expert consensus.

RESULTS:

A total of 147 patients presented with subjective memory complaints, and 43 were further classified as demented or “cognitively impaired not demented”. Subjective memory complaints presented a sensitivity of 100% and a negative predictive value of 100%.

CONCLUSION:

Subjective memory complaints are an indicator for cognitive impairment screening.     

Current Knowledge,Attitudes, and Practices of Certified Athletic Trainers Regarding Recognition and Treatment of Exertional Heat Stroke

Context:

Previous research has indicated that despite awareness of the current literature on the recommended prevention and care of exertional heat stroke (EHS), certified athletic trainers (ATs) acknowledge failure to follow those recommendations.

Objective:

To investigate the current knowledge, attitudes, and practices of ATs regarding the recognition and treatment of EHS.

Design:

Cross-sectional study.

Setting:

Online survey.

Patients or Other Participants:

We obtained a random sample of e-mail addresses for 1000 high school and collegiate ATs and contacted these individuals with invitations to participate. A total of 498 usable responses were received, for a 25% response rate.

Main Outcome Measure(s):

The survey instrument evaluated ATs'' knowledge and actual practice regarding EHS and included 29 closed-ended Likert scale questions (1  =  strongly disagree, 7  =  strongly agree), 2 closed-ended questions rated on a Likert scale (1  =  lowest value, 9  =  greatest value), 8 open-ended questions, and 7 demographic questions. We focused on the open-ended and demographic questions.

Results:

Although most ATs (77.1%) have read the current National Athletic Trainers'' Association position statement on heat illness, only 18.6% used rectal thermometers to assess core body temperature to recognize EHS, and 49.7% used cold-water immersion to treat EHS. Athletic trainers perceived rectal thermometers as the most valid temperature assessment device when compared with other assessment devices (P ≤ .05), but they used oral thermometers as the primary assessment tool (49.1%). They identified cold-water immersion as the best cooling method (P ≤ .05), even though they used other means to cool a majority of the time (50.3%).

Conclusions:

The ATs surveyed have sound knowledge of the correct means of EHS recognition and treatment. However, a significant portion of these ATs reported using temperature assessment devices that are invalid with athletes exercising in the heat. Furthermore, they reported using cooling treatment methods that have inferior cooling rates.     

Medical ethics in sub-Sahara Africa: closing the gaps

Background

Health care providers are expected to have the skills and knowledge relevant to their field and should also be familiar with the ethical and legal expectations that arise out of the standard practices.

Objectives

To elucidate the practice of the health care providers in relation to healthcare ethics in Nigeria.

Methods

A self-administered structured questionnaire was devised and distributed to staff of two tertiary health care facilities in Northern Nigeria. The questionnaire comprised of detailed questions regarding day-to-day aspects of Medical ethical issues.

Results

A total of 307(76.2%) out of 403 health care providers responded to the questionnaire. The median age of the respondents was 34 years. More than half 168(54.7%) of the respondents disagreed as to whether “Ethical conduct is important only to avoid legal action. Many respondents 135 (44.0%) agreed to adhering to “patient''s wishes”, on the other hand over two-third of the respondents 211 (68.7%) agreed that “doctor should do what is best” irrespective of the patient''s opinion. There were significant differences (p<0.05) between the perception of physicians and non-physicians on many ethical issues.

Conclusion

This study has shown gap in knowledge and practice of healthcare ethics among health care providers. There is a need for periodic education on clinical ethics in our hospitals.     

Condom use amongst out of school youths in a local government area in Nigeria

Background

Reported low condom use amongst out of school requires studying the context in which condom use occurs.

Methods

A cross sectional study of 350 out-of-school youth aged 15–24 years in a local government area of Nigeria was enrolled using cluster sampling.

Results

Those who had ever had sexual intercourse were 74.9%. Of these, 56.5% used no protection while 29.0% used condoms. Up to 78.6% have had sex within the preceding 12 months with 38.9% condom use. The commonest reason for non-condom use was that it reduces sexual enjoyment. Those who believed a single unprotected sexual exposure may result in HIV infection reported more condom use than those who believed otherwise (42% vs 27.2%, P<0.05). Those who had prior discussion with their partners on HIV/AIDS reported more condom use compared to those who had not (50% vs 25%, P<0.05). Also, those who had sexual intercourse occurring as a spontaneous event reported less condom use compared to those who have previously discussed about the possibility of having sex (68.0% vs 51.8%, P<0.05).

Conclusion

Condom use is likely to occur within relationships where opportunity exists for discussion on sexual matters. Thus, further studies are needed on communication and condom use within sexual partnerships.     

Cognitive Replay of Visuomotor Learning at Sleep Onset: Temporal Dynamics and Relationship to Task Performance

Study Objectives:

Studies of neural activity in animals and humans suggest that experiences are “replayed” in cortical and hippocampal networks during NREM sleep. Here, we examine whether memory reactivation in sleeping humans might also be evident within reports of concomitant subjective experience (i.e., dreaming).

Design:

Participants were trained on an engaging visuomotor learning task across a period of one or more days, and sleep onset mentation was collected at variable intervals using the “Nightcap” home-monitoring device. Verbal reports of sleep onset mentation were obtained either at the beginning of the night, or following 2 h of initial sleep.

Setting:

Data were collected in participants'' home environments, via the Nightcap monitoring system, and at The Center for Sleep and Cognition, Beth Israel Deaconess Medical Center, Boston MA.

Participants:

43 healthy, medication-free college students (16 males, age 18-25 years).

Interventions:

N/A

Measurements and Results:

The learning task exerted a powerful, direct effect on verbal reports of mentation during light NREM sleep (stages 1 and 2). On post-training nights, a full 30% of all verbal reports were related to the task. The nature of this cognitive “replay” effect was altered with increasing durations of sleep, becoming more abstracted from the original experience as time into sleep increased.

Conclusions:

These observations are interpreted in light of memory consolidation theory, and demonstrate that introspective reports can provide a valuable window on cognitive processing in the sleeping brain.

Citation:

Wamsley EJ; Perry K; Djonlagic I; Babkes Reaven L; Stickgold R. Cognitive replay of visuomotor learning at sleep onset: temporal dynamics and relationship to task performance. SLEEP 2010;33(1):59-68.     

Outcomes in patients with non-ST-elevation acute coronary syndrome randomly assigned to invasive versus conservative treatment strategies: A meta-analysis

OBJECTIVE:

The goal of the present study was to compare the prognoses of patients with non-ST-elevation acute coronary syndromes who were treated with invasive or conservative treatment strategies.

METHODS:

We performed a meta-analysis of studies of patients with non-ST-elevation acute coronary syndromes to assess the benefits of an invasive strategy vs. a conservative strategy for short- and long-term survival. We searched PubMed for studies published from 1990 to November 2012 that investigated the effects of an invasive vs. conservative strategy in patients with non-ST-elevation acute coronary syndromes. The following search terms were used: “non-ST-elevation myocardial infarction”, “unstable angina”, “acute coronary syndromes”, “invasive strategy”, and “conservative strategy”. The primary endpoints were all-cause mortality at 30 days and 1 year.

RESULTS:

Seven published studies were included in the present meta-analysis. The pooled analyses show that an invasive strategy decreased the risk of death (risk ratio [0.839] [95% confidence interval {0.648-1.086}; I², 86.46%] compared to a conservative strategy over a 30-day-period. Furthermore, invasive treatment also decreased patient mortality (risk ratio [0.276] [95% confidence interval {0.259-0.294}; I², 94.58%]) compared to a conservative strategy for one year.

CONCLUSION:

In non-ST-elevation acute coronary syndromes, an invasive strategy is comparable to a conservative strategy for decreasing short- and long-term mortality rates.     

Sexual dysfunctions among people living with AIDS in Brazil

INTRODUCTION

Sexual dysfunction symptoms in patients with HIV have not been fully investigated in Brazil.

OBJECTIVES

To investigate the association between sexual dysfunction symptoms and AIDS among participants in the Brazilian Sex Life Study.

METHODS

The Brazilian Sex Life Study is a cross-sectional population study. The participants answered an anonymous self-responsive inquiry. It was applied to a population sample in 18 large Brazilian cities. Answers given by those who reported having AIDS (75) were compared with those who reported not having AIDS (control; 150). This was a case-control study nested in a cross-sectional population study.

RESULTS

In females, AIDS was associated with “sexual inactivity over the last 12 months” and “does not maintain sexual arousal until the end of the sex act” (P < 0.05) after adjusting for race and thyroid disease. Compared to the control group, men with AIDS had more difficulty becoming sexually aroused (they required more help from their partner to begin the sex act, they required longer foreplay than they wished, they reported losing sexual desire before the end of the sex act, and they required longer to ejaculate than they desired) (P < 0.05). After adjusting for sexual orientation, sex hormone deficiency, depression, and alcoholism, only “does not have sexual desire,” “have longer foreplay,” and dyspareunia were associated with AIDS.

DISCUSSION AND CONCLUSIONS

The results support the hypothesis that sexual dysfunctions are associated with AIDS. Men with AIDS need more time and stimulation to develop a sexual response, and a significant portion (37%) of women with AIDS reported sexual inactivity over the last 12 months.     

Recently Certified Athletic Trainers' Undergraduate Educational Preparation in Psychosocial Intervention and Referral

Context:

“Psychosocial Intervention and Referral” is one of the 12 content areas established by the National Athletic Trainers'' Association Education Council and is required to be taught in athletic training education programs (ATEPs). The perceived preparation of athletic trainers (ATs) in this content area has not been evaluated.

Objective:

To explore the preparation level of recently certified ATs within the content area of “Psychosocial Intervention and Referral.”

Design:

Qualitative design involving semistructured, in-depth, focus group interviews.

Setting:

Interviews were conducted at 2 National Collegiate Athletic Association Division I institutions in 2 regions of the United States.

Patients or Other Participants:

A total of 11 recently certified ATs who met predetermined criteria were recruited. The ATs represented a range of undergraduate ATEPs and current employment settings.

Data Collection and Analysis:

Focus group interviews were transcribed verbatim and analyzed deductively. Peer debriefing and member checks were used to ensure trustworthiness.

Results:

The ATEPs are doing an adequate job of preparing ATs for many common communication and interpersonal issues, but ATs report being underprepared to deal with athlete-related issues in the areas of motivation and adherence, counseling and social support, mental skills training, and psychosocial referral.

Conclusions:

Limitations of undergraduate ATEPs regarding preparation of athletic training students within the “Psychosocial Intervention and Referral” content area were identified, with the goal of improving athletic training education. The more we know about the issues that entry-level ATs face, the more effectively we can structure athletic training education.