As the use of ICDs increases, more young patients will be eligible to receive these devices. Such patients may have different concerns than older patients who more commonly receive ICDs. We investigated quality-of-life issues in patients followed by the Yale electrophysiology service who were < or = 40 years old (mean = 28) at the time of ICD implant. Mean time since ICD placement was 3.3 years. Each patient received a modified SF-36 health questionnaire; 16 (88%) of 18 responded. Nine were women; ten were married. The highest education level attained was high school for 6 (37%), and college or beyond for 10 (63%). Ten patients were employed; eight held the same job before and after ICD placement. Four women conceived after ICD implantation; one experienced ICD discharge during pregnancy. All delivered healthy infants. All patients felt their health was good to excellent, with 6 (38%) reporting an improvement in health since ICD placement. All felt capable of performing the activities of daily living, while 68% engaged freely in moderate physical activities. All patients felt they were average to very attractive. However, 63% worried about how their clothes fit with the ICD. Three quarters of the patients felt the ICD interfered with social interactions, while 50% were concerned about sexual encounters. Thus, even though these young patients have body image concerns and may limit their activities to some degree, they are productive, active members of society who have benefitted from ICD placement.
This article describes the efficacy of two family-oriented, outpatient drug interventions for 84 adolescents who had used and abused drugs. Together, the two brief drug interventions appeared to significantly reduce the drug use of nearly one-half of the adolescentts who received the two family-focused drug interventions. It is surmised that this slccess was due partly to the fact that both outpatient interventions focus on the sxystemic treatment of entire familv groups rather than being given to the adolescents as inidiv iduals. WVheti comnpared, however the family therapy intervention appears to have been effectiv e itn reducing drug use for a greater percentage of the adolescents than did the familv education intervention.
Efforts to increase participation by all company employees, especially among those with high-risk behaviors, would benefit all health promotion programs, particularly the on-site fitness center.
Although males report more same‐sex friendships than women do, most of these are not close, intimate, or characterized by self‐disclosure. Many barriers exist to emotional intimacy between men, some stemming from the demands of traditional male roles in our society, such as pressures to compete, homophobia, and aversion to vulnerability and openness, as well as from the lack of adequate role models. Exercises to increase self‐disclosure, openness, and the potential for deeper affection between men are described as the goals of workshops developed to enable male participants to initiate and maintain meaningful relationships with other men.
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