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Correlates of STI testing among vocational school students in the Netherlands
Mireille EG Wolfers, Gerjo Kok, Johan P Mackenbach, Onno de Zwart
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-725
Abstract: This study was conducted among 501 students attending vocational schools aged 16 to 25 years (mean 18.3 years ± 2.1). Data were collected via a web-based survey exploring relationships, sexual behavior and STI testing behavior. Items measuring the psychosocial correlates of testing were derived from Fishbein's Integrative Model. Data were subjected to multiple regression analyses.Students reported substantial sexual risk behavior and low intention to participate in STI testing. The model explained 39% of intention to engage in STI testing. The most important predictor was attitude. Perceived norms, perceived susceptibility and test site characteristics were also significant predictors.The present study provides important and relevant empirical input for the development of health promotion interventions aimed at motivating adolescents at vocational schools in the Netherlands to participate in STI testing. Health promotion interventions developed for this group should aim to change attitudes, address social norms and increase personal risk perception for STI while also promoting the accessibility of testing facilities.Adolescents are at risk for acquiring sexually transmitted infections (STIs). In fact, worldwide, the prevalence of STIs is substantially greater in young adults than in many other populations [1]. Surveillance systems in various industrialized countries show that Chlamydia is the most commonly reported STI and that the highest prevalence of Chlamydia is observed among female adolescents [1,2].In 2008, national surveillance figures for the Netherlands showed a concentration of Chlamydia cases in heterosexual young people under 25 years of age with low to moderately educated adolescents living in urban centers being most at risk. Additionally, STI prevalence was found to be higher among adolescents of non-Dutch ethnicity such as Antillean and Surinamese adolescents [2,3]. Because high risk immigrant adolescents do engage in sexual intercourse with their D
Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men
Mireille EG Wolfers, Caty van den Hoek, Johannes Brug, Onno de Zwart
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-141
Abstract: First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives") and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups.This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials.This intervention development project indicates that careful well-informed intervention development using Intervention Mapping is feasible in the daily practice of the MPHS, provided that sufficient time and expertise on this approach is available. Further research should test the effectiveness of these interventions.The number of registered new sexually transmitted infections (STI) in the Netherlands has been increasing for several years [1], and reinforcement and extension of preventive actions is necessary. In the Netherlands, as well as in other Western European countries, ethnic minority groups originating from countries with a high prevalence of heterosexually transmitted HIV (Sub-Saharan Africa, Caribbean region) have higher HIV incidence levels. These groups are therefore recognized as important target populations for prevention [1-4]. Heterosexual migrant men are a priority gro
Effects of a short individually tailored counselling session for HIV prevention in gay and bisexual men receiving Hepatitis B vaccination
Mireille EG Wolfers, John BF de Wit, Harm J Hospers, Jan H Richardus, Onno de Zwart
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-255
Abstract: A quasi-experimental design was used to evaluate the counselling session. This session was conducted during consulting hours at four municipal health clinics during a Hepatitis B vaccination campaign. These clinics offered free vaccination to high-risk groups, such as gay and bisexual men.All gay and bisexual men attending health clinics in four cities in the Netherlands were asked to participate. Each participant in the intervention group received a fifteen-minute individual counselling based on the Theory of Planned Behaviour and Motivational Interviewing. Changes in UAI were measured over a 5-months period, using self-administered questionnaires. UAI was measured separately for receptive and insertive intercourse in steady and casual partners. These measures were combined in an index-score (range 0–8).While UAI in the counselling group remained stable, it increased in the controls by 66% from 0.41 to 0.68. The results show that the intervention had a protective effect on sexual behaviour with steady partners. Intervention effects were strongest within steady relationships, especially for men whose steady-relationship status changed during the study. The intervention was well accepted among the target group.The fifteen-minute individually tailored counselling session was not only well accepted but also had a protective effect on risk behaviour after a follow-up of six months.In the Netherlands, as in many industrialized counties, men who have sex with men (MSM) are at highest risk for HIV infection. Since the late 1990s, incidence of HIV among MSM remains high and increasing numbers of newly diagnosed HIV infections in MSM have been observed in western industrialised countries [1-6]. HIV-prevalence among MSM in the Netherlands is estimated at 5.3% in 2005 [7], and incidence has increased from 314 new infections in 1998 to 513 in 2006 [8]. In the past decade epidemics of STIs occurred simultaneously among MSM, suggesting an increase in sexual risk behaviour [9,10].
Promoting STI testing among senior vocational students in Rotterdam, the Netherlands: effects of a cluster randomized study
Mireille Wolfers, Gerjo Kok, Caspar Looman, Onno de Zwart, Johan Mackenbach
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-937
Abstract: In a cluster-randomized study the intervention was evaluated in 24 schools, using three experimental conditions: 1) health education, 2) sexual health services; 3) both components; and a control group. STI testing was assessed by self reported behavior and registrations at regional sexual health services. Follow-up measurements were performed at 1, 3, and 6-9 months. Of 1302 students present at baseline, 739 (57%) completed at least 1 follow-up measurement, of these students 472 (64%) were sexually experienced, and considered to be susceptible for the intervention. Multi-level analyses were conducted. To perform analyses according to the principle of intention-to-treat, missing observations at follow-up on the outcome measure were imputed with multiple imputation techniques. Results were compared with the complete cases analysis.Sexually experienced students that received the combined intervention of health education and sexual health services reported more STI testing (29%) than students in the control group (4%) (OR = 4.3, p < 0.05). Test rates in the group that received education or sexual health services only were 5.7% and 19.9%, not reaching statistical significance in multilevel analyses. Female students were more often tested then male students: 21.5% versus 5.4%. The STI-prevalence in the study group was low with 1.4%.Despite a low dose of intervention that was received by the students and a high attrition, we were able to show an intervention effect among sexually experienced students on STI testing. This study confirmed our hypothesis that offering health education to vocational students in combination with sexual health services at school sites is more effective in enhancing STI testing than offering services or education only.Sexually transmitted infections (STIs) are serious health problems with 333 million new cases of curable STIs occur worldwide each year, with the highest rates among 20-24 year-olds, followed by 15-19 year-olds. Adolescents are beli
Economic incentive in community nursing: attraction, rejection or indifference?
Mireille Kingma
Human Resources for Health , 2003, DOI: 10.1186/1478-4491-1-2
Abstract: Using incentives and disincentives to direct individuals' energies and behaviour is common practice in all work settings, of which the health care system is no exception. The range and influence of economic incentives/disincentives affecting community nurses are the subject of this discussion paper. The tendency by nurses to disregard, and in many cases, deny a direct impact of economic incentives/disincentives on their motivation and professional conduct is of particular interest. The goal of recent research was to determine if economic incentives/disincentives in community nursing exist, whether they have a perceivable impact and in what areas.Understanding the value system of community nurses and how they respond to economic incentives/disincentives facilitates the development of reward systems more likely to be relevant and strategic. If nurse rewards are to become more effective organizational tools, the data suggest that future initiatives should:? Improve nurses' salary/income relativities (e.g. comparable pay/rates);? Provide just compensation for job-related expenses (e.g. petrol, clothing);? Introduce promotional opportunities within the clinical area, rewarding skill and competence development;? Make available a range of financed rewards.- Direct (e.g. subsidized education, additional leave, insurance benefits);- Indirect (e.g. better working conditions, access to professional support network, greater participation in decision-making bodies).The half-life of knowledge in the medical fields is estimated to be between five and seven years [1,2]. Providers who do not conscientiously pursue a programme to maintain state-of-the-art practice could lose half of their competence in that period of time. This implies that the information base upon which clinical judgements are made is in constant flux. Similarly, it suggests that health care policy and interventions must regularly change or adapt in order to keep up with the pace of scientific advances. Change and
Ofício "impossível"? Uma piada inesgotável
Cifali, Mireille;
Educa??o em Revista , 2009, DOI: 10.1590/S0102-46982009000100008
Abstract: the author analyzes the term "impossible professions", of the two texts by sigmund freud: the "preface to aichhorn's wayward youth" (1925) and "analysis terminable and interminable" (1937). she produces a current interpretation to the freudian expression: a joke linked to the three impossible professions: to govern, to cure and to educate. she also addresses three possibly crucial aspects to the future: power, medical practice and ethics.
Claude Zaidman, Genre et socialisation. Un parcours intellectuel
Mireille Baurens
Genre & Histoire , 2009,
Abstract: L’ouvrage intitulé Genre et socialisation, un parcours intellectuel vient rendre hommage à Claude Zaidman, précocement décédée en 2005. Publié à l’initiative de Dominique Fougeyrollas et Louise Bruit-Zaidman, il met en valeur une uvre, celle d’une sociologue engagée, professeure à l’Université de Paris 7 – Denis Diderot. L’ouvrage est publié par le Cedref, Centre d’enseignement, de documentation, de recherches pour les études féministes , groupe de recherche pluridisciplinaire, fondé en 1...
De la experiencia del racismo a su reconocimiento como discriminación.
Eberhard Mireille
Revista Colombiana de Sociología , 2011,
Abstract: El presente artículo aborda los conflictos de interpretación inherentes al reconocimiento del carácter racista y discriminatorio de determinada situación, en el marco de organismos de recepción y seguimiento de quejas individuales. En efecto, tomar estas instancias como punto de partida del estudio, permite evidenciar varias dimensiones del objeto “discriminación”. El conjunto de las experiencias de discriminación denunciadas ante estas instancias permite examinar, en una primera etapa, las modalidades bajo las cuales se lleva a cabo la discriminación en la vida social cotidiana. Su carácter a la vez repetitivo y polimorfo ilustra la doble dimensión —situacional y estructural— del racismo. En una segunda etapa tomaremos como base el discurso de los discriminados potenciales, de los discriminadores designados como tales y de los encargados de recibir la queja de los primeros, para analizar las distintas estrategias discursivas que ponen en marcha cada uno de estos protagonistas, en el marco de la interacción. Para los primeros, se trata de lograr que sean reconocidos como discriminados; para los segundos, de invalidar la acusación formulada en su contra; y para los últimos, de escuchar y atender la queja. Así, la interacción da lugar a estrategias de objetivación, refutación y reparación de la discriminación, las cuales no sólo se abordarán en sus dimensiones fácticas, sino también compasivas y morales. La última parte de esta contribución examinará los límites del seguimiento propiamente judicial de la denuncia por discriminación, así como los conflictos de interpretación que ésta suscita.
Guerre cartographique sous Louis XIV l'Atlas Nouveau de Jaillot
Mappemonde , 1987,
Abstract: Il n'y a pas que des opérations militaires: l'Atlas Nouveau de Jaillot témoigne d'une guerre éditoriale contre les Pays-Bas et le monopole exercé sur la cartographie au XVIIe siècle.
Des bains au tourisme: la tentation de l'eau au début de la Troisième République
Mireille Bruston
Mappemonde , 2000,
Abstract: Les monographies départementales d’Adolphe Joanne permettent de proposer une image touristique de la France des années 1880. Par une analyse du corpus linguistique, on propose de voir les grandes tendances à l’ uvre mais également la variété des situations, d’où se dégage un constat d’importance: le lien originel entre les pratiques de bains et le tourisme.
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