Original Research: Sexual Risk in Lesbians and Bisexual Women

Objective: To describe the frequency of human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) sexual risk behaviors in lesbian and bisexual women. Design: Cross-sectional anonymous self-administered questionnaire. Setting: Women's cultural events; HIV/STD service organizations; women's health collectives. Participants: 504 self-identified lesbian and bisexual women. The sample was composed of predominantly white, well-educated women with a mean age of 35 years. Results: Both lesbian and bisexual women engaged in behaviors that potentially lead to transmission of HIV and other STDs. Lesbians were more likely to have a single sexual partner than were bisexual women. Bisexual women were more likely to report a history of STD. Of those sexually active with male partners, one-third reported multiple male partners in the previous year. Significantly more bisexual women reported condom use. Women with multiple partners were more likely to consider themselves at risk for HIV/STD. Having unprotected sex or male partners was not associated with an increased risk perception. Conclusions: Lesbian and bisexual women are engaging in sexual behaviors that may increase their risk for HIV or STD infection. Culturally sensitive prevention programs are needed.     

Original Research: Characteristics of Nonrespondents to Questions on Sexual Orientation and Income in a HMO Survey

Objective: The objective of this analysis was to explore variation in item nonresponse to two potentially sensitive questions, sexual orientation and income, among respondents to a large mailed HMO health survey. Method: Multivariate logistic regression analyses were conducted with nonresponse to the items on sexual orientation and income as outcome variables. Predictor variables included gender, age, race/ethnicity, and level of formal education. Results: Overall item nonresponse was 6.0% for the question on sexual orientation and 7.5% for the question on income. Women, older individuals, and people with less formal education were less likely to respond to both questions. Whereas there was no variation in nonresponse to the income question by race, African Americans, Hispanics, and Asians were much more likely than Non-Hispanic Whites to be nonrespondents to the sexual orientation question (odds ratio 1.9, 2.2, and 7.2, respectively). Discussion: This study indicates that although there was relatively low item nonresponse to the question on sexual orientation on a large health survey, special consideration must be given to studies that target older individuals, people of color, and people without a college education.     

Psychological Meaning of a Woman with a Hysterectomy Among Mexican Physicians and Women

The psychological meaning of women who have had a hysterectomy, and attitudes toward them, were explored in 121 Mexican gynecologists, 155 women who had undergone a hysterectomy, and 115 women who had not had a hysterectomy. The surveys were completed between January and May 2011. Both groups of women defined a woman who had had a hysterectomy using words with positive meanings (healthy, happy, reassured, and complete), as well as words with negative meanings (sad, incomplete, and irritable). However, the participants who had not had a hysterectomy defined a woman who had had a hysterectomy using more negative words and showed more negative attitudes toward such a woman with a hysterectomy than those women who had undergone a hysterectomy. Among participants who had undergone a hysterectomy, those who were premenopausal prior to the surgery and those who had undergone bilateral salpingo-oophorectomy defined a woman who had had a hysterectomy in a more negative manner and showed the most negative attitudes. The gynecologists did not use words with emotional content regarding women who had had a hysterectomy and showed more neutral attitudes toward such a woman than did both groups of women. These findings could be helpful in designing support programs for women facing a hysterectomy.     

非脱垂大型子宫阴式子宫切除术与腹式子宫切除术的研究对比

目的：研究对比非脱垂大型子宫阴式子宫切除术与腹式子宫切除术的效果。方法：随机选取200例非脱垂大型子宫患者,分为观察组与对照组,每组100例,分别行阴式和腹式手术治疗,对两组患者的手术基本情况以及术后镇痛药使用率和并发症发生率分别进行比较。结果：观察组手术出血量明显更少,且手术时间、术后排气时间、下床时间以及住院时间均明显要短;观察组术后并发症发生率为2.0%,术后使用镇痛药比率为20.0%;而对照组并发症发生率为8.0%,使用镇痛药比率为76.0%;观察组整体手术效果更显著,差异有统计学意义（P〈0.05）。结论：非脱垂大型子宫采用阴式子宫切除术效果显著,值得临床继续推广应用。     

Attitudes of Physicians in New Mexico Toward Gay Men and Lesbians

Previous studies suggest that negative attitudes held by many physicians toward gay men and lesbians may adversely affect this population's health care. This study examined the attitudes of physicians toward homosexuality through a questionnaire mailed to 1949 physicians in New Mexico. The questionnaire included a validated attitudinal scale. Each respondent was categorized as homophilic, neutral, or homophobic based on their responses. We had a 53.6% response rate. Over 8% of male respondents had homophobic scores versus 1.6% of female respondents. Of those practicing in cities with populations between 25,000 and 50,000, 20.6% had homophobic scores versus 4.5% of those practicing in larger cities and 6.4% of those in more rural areas. Multivariate analysis showed that gender, specialty, community size, and personal experiences help determine whether a physician is likely to hold negative attitudes toward gay men and lesbians. Our study found less homophobia among physicians than reported previously; however, we found that negative attitudes toward homosexuality persist in medicine. This study is the first to measure homophobia among physicians working in smaller cities; this may affect the quality of care available to lesbians and gay men who reside in these areas.     

经阴道与经腹子宫切除术临床效果对比分析

目的评价经阴道与经腹子宫切除术在子宫良性病变中的临床效果。方法对2006年5月—2008年6月因子宫良性病变需行子宫切除术的121例病例进行回顾性分析，其中经阴道子宫切除术58例（阴式组），经腹子宫切除术63例（开腹组）。主要对比2组手术时间、术中出血量、术后住院时间、术后排气时间、术后镇痛药使用率、术后病率、术后并发症等。结果2组手术时间，术中出血量比较差异无统计学意义（P〉0．05）；阴式组术后排气早、住院时间短、术后镇痛药使用率及术后病率低与开腹组比较差异有统计学意义（P〈0．05）。结论经阴道子宫切除术较经腹子宫切除术具有创伤小，恢复快的优点，符合微创观点。     

腹腔镜辅助阴式全子宫切除与开腹全子宫切除的临床对比

目的:研究腹腔镜辅助阴式全子宫切除与开腹全子宫切除的临床疗效。方法:取本院子宫肌瘤患者104例为研究对象,随机分观察组(腹腔镜辅助阴式全子宫切除术)与对照组(开腹全子宫切除术)各52例,比较手术指标与并发症。结果:与对照组比较,观察组出血量少,手术时间、肛门排气与住院时间均较短,观察组并发症率(3.84%)较对照组(15.38%)低,P<0.05(具统计学差异)。结论:与开腹全子宫切除比较,对子宫肌瘤患者采用腹腔镜辅助阴式子宫切除术治疗能缩短手术、肛门排气与住院时间,减少出血量与并发症。     

Health Literacy Teaching Beliefs,Attitudes, Efficacy,and Intentions of Middle School Health and Physical Education Teachers

BACKGROUND

Health education (HE) courses in schools are vital paths for improving teenagers' health literacy. HE and physical education (PE) teachers lead HE courses, and their teaching intentions and competency influence the effectiveness of the courses and the ability to promote students' health literacy. This study attempted to understand HE and PE teachers' health literacy teaching intentions and professional competency and to investigate their relationships.

METHODS

This study adopted a cross‐sectional design. A questionnaire survey was administered to 906 middle school HE and PE teachers in Taiwan by mail, and 545 provided valid data with consent.

RESULTS

Participants had a favorable health literacy (47.78/50), positive health literacy teaching beliefs and attitudes, and acceptable efficacy. They intended to implement health literacy instruction within the subsequent year. Teaching beliefs, attitudes, and efficacy were all positively correlated with intentions (all p < .001). Demographic variables, health literacy, and teaching beliefs, attitudes, and efficacy explained 33.5% of the variance of teaching intentions.

CONCLUSION

Teaching beliefs, attitudes, and efficacy were crucial predictors of health literacy teaching intentions. To improve students' health literacy, educational authorities and schools should pay attention to HE and PE teachers' intentions and vital factors, thereby enhancing teachers' willingness to perform health literacy instruction.

     

Vegetarian and Vegan Diets: Beliefs and Attitudes of General Practitioners and Pediatricians in France

Studies suggest a decreasing trend in the consumption of meat products and a growing interest in vegetarian diets. Medical support may be relevant, especially when switching to a vegan diet. Our objective was to describe the beliefs and attitudes of primary care physicians toward vegetarian diets. A cross-sectional survey was conducted among general practitioners and pediatricians thorough a questionnaire including socio-demographic characteristics, specific care to vegetarians, and the risks and benefits of vegetarian diets according to physicians. Out of the 177 participating physicians, 104 (59%) have seen at least one vegetarian patient in consultation in the last three months. Half of the physicians declared that they would dissuade their patients from switching to a vegan diet (n = 88, 51%) and 14% (n = 24) from switching to an ovo-lacto-vegetarian (OLV) diet. Most physicians (n = 141, 88%) did not feel informed enough about these diets. Physicians thought that the most frequent deficiencies for OLV and vegan diets were iron (76% and 84%, respectively) and protein (45% and 79%, respectively). These results highlight the fact that French primary care physicians feel concerned by this subject and need more information on these diets. Specific recommendations would be useful to support their practice and relationship with vegetarians.     

阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较

目的探讨阴式子宫切除术(TVH)和腹腔镜辅助阴式子宫切除术(LAVH)的临床效果及应用价值。方法回顾性分析2007年1月至2010年12月在本院行TVH的86例患者(TVH组)与同期行LAVH的92例患者(LAVH组)的临床资料,对两组患者术中、术后情况进行统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与其签署临床研究知情同意书)。两组患者既往盆腔手术史、孕次、产次、合并贫血及子宫增大(相应孕周)情况比较,差异无统计学意义(P>0.05)。结果 TVH组患者手术时间、术中出血量及手术费用均较LAVH组短、少和低,两组比较,差异有统计学意义(P<0.05);但术后排气时间、术后病率及住院时间比较,差异无统计学意义(P>0.05)。所有患者无一例中转开腹及脏器损伤或大出血等严重并发症发生,均无发热、肠粘连、肠梗阻和术后血栓性静脉炎等手术相关并发症。结论 TVH较LAVH具有手术时间短、术中出血量少、费用低廉等优势,但TVH更适应于子宫大小<孕4个月、盆腔无明显粘连患者。LAVH可扩大TVH的适应证。临床应根据个体情况选择合适的子宫切除方式,以达到最佳治疗效果。     

Preventive Healthcare of Infants in a Region of Lebanon: Parental Beliefs,Attitudes and Behaviors

Objectives: This study aimed to investigate healthcare seeking behaviors of mothers for themselves and their infants in the Bekaa Valley, Lebanon, to identify attitudes and beliefs towards the preventive healthcare of infants and to assess whether a healthcare-based intervention program would be accepted by the population. Methods: Ninety-two interviews were conducted with women who had delivered a live birth in two hospitals in the Bekaa. The hospitals selected attracted women from different socioeconomic classes. Results: Differences were found in adequacy of healthcare utilization based on household size, number of children and prenatal care utilization. There was a higher perception of barriers to healthcare by parents who did not seek adequate preventive care for their infants. Mothers of infants who had inadequate care had a lower perception of severity of illness and of physicians ability to prevent illness. The population believes strongly that medical professionals are reliable sources of health information and guidance. Infants mothers and grandmothers are important sources of healthcare-related information. Conclusions: Rates of preventive infant healthcare in the Bekaa need improvement. Any intervention must target mothers and grandmothers, as they appear to influence the medical care of infants. Other targets include parents of larger families. Dissemination of information regarding the seriousness of illness and the ability to prevent illness is required. The medical profession may influence health choices made by this population. However, further investigation of healthcare barriers, especially economic and geographic barriers, is needed. In preparing to improve healthcare utilization for infants in the Bekaa, local, regional and international organizations should refer to the populations beliefs, attitudes and behaviors described in this study, as these findings may aid in planning interventions that are likely to positively impact mothers and infants.     

阴式子宫切除术和腹腔镜辅助阴式子宫切除术比较

目的通过100例阴式子宫切除术（VH）、腹腔镜辅助阴式子宫切除术（LAVH）的比较,对比其优缺点。方法选用我院2003年1月-2008年3月符合VH和LAVH手术指征的患者进行手术,其中VH50例,LAVH50例予以对比分析。结果 VH与LAVH结果相同,明显比开腹全子宫切除术为优。LAVH手术适应证明显超过VH。结论 LAVH和VH和传统全子宫切除术比较,可减少手术创伤,避免剖腹,有明显优越之处。     

伊犁少数民族妇女腹腔镜筋膜内子宫切除与开腹子宫切除120例临床分析

目的探讨伊犁州少数民族妇女腹腔镜筋膜内子宫切除术（CISH）的临床疗效。方法回顾分析该院少数民族妇女CISH 63例与开腹子宫切除57的例临床资料。结果腹腔镜手术时间63～92 min,平均（75.3±16.3）min,略长于开腹手术,差异有统计学意义（P〈0.05）;术中出血30～50 ml,平均36.5±17.4 ml,术后排气时间24～36 h,平均（30.3±4.5）h,术后住院天数平均（4.2±1.4）d,与开腹手术比较,差异有统计学意义（P〈0.05）;而术后最高体温2组相比较,差异无统计学意义（P〉0.05）。结论 CISH具有术中出血少、术后恢复快、住院时间短等优点。     

Attitudes of the aged toward nontraditional sexual behavior

Age as a correlate of attitudes toward nontraditional sexual behavior is explored. The data were drawn from a United States national probability sample. Subgroup comparisons were made between two age cohorts — respondents over and under 65. Sexual attitudes were measured toward premarital sexual relations, extramarital sexual relations, and homosexuality. Older respondents held the most conservative sexual attitudes. However, the background variables of sex, social status, church attendance, marital status, and parenthood were predictors of sexual attitudes for both age strata. The findings indicate individual variations among the aged with the likelihood of a greater range of differences in the future.     

秧歌舞对中老年女性部分身体素质指标的影响研究

目的探讨秧歌舞运动对中老年女性身体素质指标的影响。方法选择自愿参加的中老年女性32人,随机分为安静组和秧歌舞组。测定实验前后身体素质指标,做组间和组内前后对比分析,探讨秧歌舞运动对中老年女性身体素质指标的影响。结果秧歌舞组握力左、站位体前屈提高具有显著性差异(P<0.05),握力右、单眼闭目站立提高具有极显著性差异(P<0.01)。结论秧歌舞运动是一项对中老年女性身心健康产生重要作用的运动项目,能有效改善和提高中老年女性身体素质和生活质量。     

腹腔镜辅助阴式子宫切除术与阴式全子宫切除术的疗效比较

目的：分析腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）的手术效果。方法：回顾性分析2010年5月-2011年7月在本院进行子宫切除的110例患者,按其术式分为LAVH组55例及TVH组55例,分析比较两组患者的术中出血量、手术时间、术后体温恢复时间、肛门排气时间、住院时间、住院费用及并发症发生率。结果：LAVH组的术中出血量、手术时间、术后体温恢复时间及术后并发症发生率都少于TVH组（P〈0.05）。LAVH组与TVH组的肛门排气时间及住院时间比较差异无统计学意义（P〉0.05）。LAVH组的住院费用因术中使用全麻,高于TVH组（P〈0.05）。结论：腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）皆属微创手术,前者费用较高,但手术效果比后者好。     

Development of the Attitudes About Romance and Mate Selection Scale*

The 32‐item Attitudes About Romance and Mate Selection Scale (ARMSS) was developed to measure constraining beliefs about mate selection. Using factor analysis, seven factors were identified roughly corresponding to Larson's (1992) constraining beliefs about mate selection. The final instrument consisted of four distractor items to help disguise the nature of the instrument plus 28 items on seven subscales: (a) One and Only, (b) Love Is Enough, (c) Cohabitation, (d) Complete Assurance, (e) Idealization, (f) Ease of Effort, and (g) Opposites Complement. Reliability and validity evidence was demonstrated. Results showed few gender differences in the degree to which constraining beliefs about mate selection are held by single young adults. However, significant differences were found when age, religious affiliation, and ethnicity were considered. Implications for using the ARMSS in premarital counseling and education are discussed.     

The Association Among Adolescents' Tobacco Use,Their Beliefs and Attitudes,and Friends' and Parents' Opinions of Smoking

Objective: To examine adolescents' attitudes toward smoking, the presence of a false consensus effect, and the influence of peer and parental attitudes about smoking choices on being a susceptible, never smoker; an experimenter; and a current smoker. Methods: Data from The Robert Wood Johnson Foundation's 1996 National Study of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults (RWJF survey) were used to produce national estimates of the tobacco use behaviors and attitudes of adolescents enrolled in high school. Three logistic regression models were estimated to examine which psychosocial variables were associated with three different stages of smoking uptake. Results: Positive attitudes toward tobacco use were associated with a greater likelihood of being a susceptible, never smoker (OR = 1.50), an experimenter (OR = 1.27), and a current smoker (OR = 2.96). Those respondents who believed that 50% or more of all adolescents smoked were more likely to be current smokers (OR = 1.45). The importance of the opinions of one's friends and parents about his/her choice to smoke was also found to be associated with smoking behavior. Conclusions: Preventing the initiation and continuation of smoking among adolescents will require interventions that address individual attitudes with respect to tobacco and will also need to present a clear picture of adolescent smoking. In addition, prevention and intervention messages should emphasize the importance of parental opinions on youth tobacco use regardless of parental tobacco use behavior.     

Review: Examining Differences in Sexual Expression and Coming Out between Lesbians and Gay Men

In the literature on gay and lesbian people, it is commonly stated that gay men and women differ in the expression of their sexualities. Self-identified lesbians are said to be more bisexual than gay men with respect to their feelings and behavior—that is, to have more heterosexual fantasies and attractions, and also more sexual experiences with the opposite gender. Lesbians are also reported to self-acknowledge their gay identity (come out to themselves) at a later age than gay men. The data commonly used to back up these beliefs is reviewed. Studies are fraught with methodologic errors, and much of the data are inconclusive. Thus the issue is far from resolved, and statements implying that gender differences are proved fact are unfounded. Methodologic difficulties and the complexity of attempting to measure dimensions of sexual cognition and behavior are discussed.