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Rates of psychological disorders other than personality disorders--in particular, mood disorders, anxiety disorders, and substance use disorders--ranged from 64 percent to 81 percent.1, 4, 5 In two of these studies, rates of personality disorders ranged from 41 percent to 46 percent.1, 4 Some authors argue that sexual compulsivity is a manifestation of other disorders such as bipolar disorder or personality disorders, especially borderline personality disorder. But the fact that no one cluster of other disorders appears to be associated more often with sexual compulsivity suggests that this condition represents a distinct clinical phenomenon. Other symptoms associated with sexual compulsivity are low self-esteem, social anxiety, loneliness, intimacy problems, social skills impairment, guilt, sensation seeking, and additional impulse control problems. It is notable that rates of childhood sexual abuse among people with sexual compulsivity range from 30 percent to 78 percent, 1, 2, 6 suggesting that this experience is an important factor, because long term.
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Dr. Alan White Principal Lecturer Nursing School of Health & Community Care Leeds Metropolitan University Calverley Street, Leeds, England a.white lmu.ac Copies of the report are available on emhf With thanks to Professor Keith Cash and Erick Savoye for their helpful comments on this paper. References Kraemer S: The fragile male. British Medical Journal 2000; 321: 1609-1612. Meryn S & Steiner M: Is being a man a disease? Men's health in the 21st Century. Men's Health Journal 2002; 1: 100. Sattar N: Why are men at higher risk of cardiovascular disease? Men's Health Journal 2003; 2: 53-56. White AK & Cash K: The state of men's health across 17 European countries. The European Men's Health Forum, Brussels 2003 and lisinopril.
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By Deborah Miller, MSN, RN, CNN The adolescent period is often a difficult time for families, and when you have a child with a chronic illness, the difficulties are compounded. The adolescent with chronic kidney disease, or the renal teen is no exception. A major challenge for this age group is the need to progress from dependence on family to dependence on self This is often in direct conflict with the parent`s need to protect the ill child. In most families, the parents have had the responsibility for ensuring proper care including making appointments, getting the prescriptions and being the historian at the doctor`s office. These parental roles are long established, and as the child starts to make the transition into adolescence an increase in family conflict may occur. In order to understand some of the factors at work, let us divide adolescence into three stages; each stage includes distinct developmental processes. Once the processes are identified, let us look at how illness exerts its influence, and then at some approaches families can use with their child. Keep in mind that these are generalities and children are not usually this predictable. The early adolescent age range 11 - 14 ; is the midst of puberty. The child is preoccupied with self, particularly the questions of I normal and what can I expect. The parents still exert a great influence on this age group. The child moves from elementary school to middle school at this time, and with this tremendous change comes a greatly expanded peer group. While there are more choices for friends, there are also more chances for rejection. Young renal teens are exquisitely aware of the biologic changes occurring during puberty and sensitive to their particular timing and rate in relation to their peers. Many adolescents need a great deal of reassurance at this time. Mid-adolescence is more complex. This child is the 14 - 16 age range and is very concerned with independence as well as self image. This is often when risk-taking behavior is seen, as the child is concerned with who I and do I have power. Acceptance is important to the mid-adolescence and peers exert a great influence. With the transition into high school, the teen has an even larger pool of peers from which to choose. Middle adolescents spend much less time with their families than early adolescents, and when not with their peers, they are often alone in their rooms. The tendency to stay away from the family is consistent with trying to establish a separate identity. The late adolescent 17 and older ; is more future oriented. This age group is increasingly concerned with issues of intimacy and career. The questions asked are I smart enough, I attractive enough and what can I do. The need to establish more intimate relationships drives social interaction and there is a greater influence exerted by partners. This change in thinking may 26.
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With the establishment of the WTO. Mr. Pratt has been quoted as saying: "Our [the industry's] combined strength enabled us to establish a global private sector government network that laid the groundwork for what became TRIPS."61 Despite this success, the industry continues to expand and deepen its quest for patent protection. In his testimony to the U.S. House of Representatives' Ways and Means Committee in March 1996 as representative of the IPC, Peter Richardson, senior assistant general counsel for Pfizer, voiced the industry's objections to the transition periods provided to developing countries: "long TRIPS transition periods are forcing us to look outside the WTO for instruments to gain IP protection in the developing countries."62 This contrasts with the recognition by a number of international leaders that many developing countries faced serious implementation problems in meeting the agreed TRIPS transition timetable. Richardson recommended that the U.S. use a number of mechanisms to ensure that TRIPS-compliant legislation was enacted quickly. This included pushing the Singapore WTO Ministerial Meeting to agree to an acceleration in the transition provisions and using the regional free trade initiatives like the FTAA as vehicles for implementation of higher levels of patent protection ; .63 Lobbying has also been conducted at the national level in various developing countries. In Brazil, for example, Pfizer participated in the aggressive lobbying activities of Interfarma, a coalition of multinational pharmaceutical companies that was formed for the express purpose of influencing the early passage of the Industrial Property Law. This law granted patent protection on pharmaceuticals and took effect in 1997, eight years earlier than required under TRIPS.
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