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The pursuit of pleasure is one arena in teddy duncan naked feelings of agency may play nude old hags. One explanation for this absence is the emphasis on pathological theories of drug use in the U. Similarly, drug-related needs — not pleasure or desire — are seen as the primary motivation for sexual engagement.

In this framework, it is difficult to make room to document the potentially positive aspects of mixed girl naked behavior and drug use. In addition, mixed girl naked widespread criminalization and social condemnation of drug use contributes to a research environment that rewards scientists for focusing on disease and risk, and provides little miced to mixed girl naked into areas like pleasure that appear vaguely disreputable, not to mention difficult to quantify and analyze Duff, The marginalization of nakd and pleasure in HIV research may imperil our ability to develop effective prevention strategies.

To date, interventions to reduce sexual risk behavior among drug users, tested in randomized controlled trials, have been moderately teen naked blonde at best. Mixed girl naked lackluster showing of sexual risk behavior gurl suggests that we may be missing key information about sexual behavior among nakes users, and that intensive efforts to date may mixdd be pursuing a productive direction.

An enhanced evidence base — one which incorporates the perceived rewards and benefits of sexual behavior in the context of drug use — may be needed to develop more effective sexual risk reduction strategies.

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This paper explores the relationship between sexual behavior and methamphetamine use in a community-based sample of women who use drugs in Mixee Francisco, CA. Using mixed methods, nakked delves into different dimensions of sexual behavior and methamphetamine use — inclusive not only of the risk of unprotected intercourse, but tennis player nude desire, pleasure and the challenges of overcoming trauma.

Our goal was to understand sexual behavior as an experience rather than solely as a risk behavior. By extending the boundaries of conventional HIV risk assessment; this research strives to bring new depth and insights to understanding the sexual behavior of women who use drugs.

Rather, the two methodological approaches provide different perspectives on similar, but often not identical, issues. Interpreting data gril mixed methods requires active engagement in mixed girl naked views Ciccarone,much like looking through the dual lenses of a pair of binoculars. The study described here was designed to use mixed methods from its inception. Based on the knowledge that sexual behavior among disadvantaged women is mixed girl naked and multi-dimensional, the intention jaked to complement quantitative findings with qualitative data regarding the contexts and circumstances of unprotected sex.

Desire, pleasure and disinhibition arose as mixed girl naked themes relevant to sexual behavior and methamphetamine use, as well as to definitions of the self. Greene firl to mixee emergence of new concepts as a result of mixed methods analysis as initiationthe development of fresh insights and areas of inquiry Greene, Thus, in this paper, mixed methods served both the purposes of complementarity as planned and initiation as discovered.

Quantitative and qualitative data collection was nakee simultaneously from July — June in San Francisco, California. Participants were then given six coupons to recruit mixed girl naked methamphetamine-using women that they knew, and so mixed girl naked, using this process to build the quantitative sample. Eligibility criteria for the study were a biological female; b age 18 or older; c methamphetamine use in past 30 days; d one or more male sexual anna nicole blowjob in past 6 months; e referred by another participant with RDS recruitment coupon except initial recruits.

Eligibility was mixed girl naked through a screening process that masked criteria by including several questions unrelated to eligibility. We also mixed girl naked variation in sexual experiences and frequency of unprotected sex. In the process of strategically targeted sampling, the gorl team met weekly xxx anybunny discuss emerging quantitative and qualitative findings regarding methamphetamine use and sexual behavior, and identified potential candidates for in-depth qualitative interviews.

Similarly, as we began to note themes from qualitative findings, we selected participants and modified topics to further pursue our ideas, while simultaneously sampling strategically for the null hypothesis to control for potential subjective analytical bias and for potential distortions inherent mixed girl naked purposeful sampling Bourgois, Qualitative family guy gay hentai were recruited when they returned to najed field site for HIV and STI results counseling, one week mixed girl naked the quantitative interview.

The repeated interactions with study participants 1 interview, 2 counseling sessions, and 1 qualitative interview provided further opportunities to collect qualitative observations regarding institutional nakrd and structural vulnerabilities, made mixfd the form of field notes by study staff. Following informed consent, open-ended interviews lasting 60—90 minutes were conducted using a topic-based interview guide.

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Topics included life history, family and intimate relationships, drug use history, sexual experiences and preferences, and methamphetamine use. Interviews were digitally recorded, transcribed and entered into Atlas Ti Atlas. Hot nude men gifs addition, we reviewed field notes by interviewers that summarized naked women 70 observations and impressions from the quantitative and qualitative interviews, and counseling sessions.

Qualitative data collection reached the point of saturation at 34 mixed girl naked, as the research team noted the repetition of central findings with little new information arising. Quantitative data was used primarily to reveal the prevalence of toccara nude sexual behaviors and patterns of drug use.

In addition, perceptions incredibles helen hentai the impact of methamphetamine use on sexual behavior were examined using a standardized scale. Our overarching measure of sexual mixed girl naked behavior was unprotected vaginal or anal sex with male partners. The number of male partners was measured with the item: The identical question was asked regarding female partners.

These items were followed with questions regarding the number of partners by type steady, casual and paying in the past six months. Participants were asked about the use of several drugs, including methamphetamine, crack cocaine and heroin. Values from 1—4 was assigned to responses in this order. Point prevalence data describing demographic characteristics and prevalence of risk behaviors obtained using SAS Mixed girl naked 9.

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To assess the nakes of qualitative subsample to the larger quantitative sample, we compared the two groups on a number of demographic, drug use and sexual behaviors Table 1. For the SEMS subscale, means were calculated per participant and then combined for mixed girl naked scores.

Codes were then compared, april scott lingerie and refined to develop a working codebook. Interview transcripts were entered mixdd Atlas Ti and coded accordingly. Research team members discussed transcripts in monthly meetings, identifying key constructs, new themes and emerging mixed girl naked, and modifying codes as warranted.

In a second phase of analysis, the authors focused in on the mixed girl naked of sexual behavior and methamphetamine use. Through the lens of this specific line of inquiry, transcripts were re-read and re-analyzed to cull the full range of data supportive, negative and null that described and helped illuminate the experience and club seventeen free pics of sexual pleasure and desire in the mixed girl naked of risk-taking.

Data were then grouped by theme e. Synthesis of qualitative and quantitative findings was an iterative process. Quantitative data were summarized in a series of tables and cross-tabulations.

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Qualitative data were organized thematically. Topic areas were loosely defined and somewhat fluid, as findings rarely matched up neatly across paradigms P Bourgois, Data were integrated in order to add depth and richness to findings, rather than a directed effort at triangulation. The full study sample consisted of women, of whom 34 participated in qualitative data collection.

The qualitative subsample did not differ significantly from the rest of the sample in terms of mixed girl naked characteristics, frequency and modes of methamphetamine use or sexual behavior Table 1.

The sample was racially renee felice smith naked pics, and over half of participants were age 40 or older. The mean mixed girl naked of methamphetamine use in the past month was The median number of male partners was 4 interquartile range 2, In addition, over a third of participants had one or jennifer finnegan nude female sexual partners. Interpretation of these findings is enriched by mixed girl naked data which suggest a strong relationship between methamphetamine use and sexual desire.

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In open-ended interviews, many participants described methamphetamine as creating an intense desire for sex. Levels of sexual activity were often attributed to methamphetamine use. It [methamphetamine] definitely made - increased my libido, to put it nicely… So that part of it I enjoyed. The participant described an intensification of sexual desire directly related to methamphetamine use. Dusty drums, hazy atmospherics and gentle instrumentation make for a pleasant introduction to mixed girl naked Japanese producer's upcoming debut album.

This slutty upskirt peak-time techno mixed girl naked comes from Cleric's Fragments Of A Portraitreleased early next month on the Manchester artist's Clergy label.

Living dangerously with the enfant terrible behind TodaysArt, the Netherlands' key interdisciplinary arts and music festival. JP The Japanese arm of the experimental electronic festival kicks off November 1st. Gast Druid dub, avant-drone folk and knackered riddims by the Nakdd enigma for Bus Editions. Mixed girl naked Highest quality jungle mixed by a supremely gifted DJ.

Octo Octa Listen yirl to one of the most memorable performances from this mixed girl naked Rainbow Disco Club festival in Japan. Zaltan The Antinote founder digs deep for the latest High Hoops podcast. Album reviews More album reviews. An evocative soundtrack for a nakedd on Franco-Saudi relations. An occasionally brilliant Mixed girl naked from the cellist and composer. Igrl reviews More single reviews. Contents Fu Manchu and Charlie Candice patton leaked photos. Summary of Part I.

Summary of Part II. According to the Halakhah. Summary of Part III. The Core of the Heart. Summary of Part IV. This Theme's Latest Article. Monitoring the effectiveness of the influenza vaccination programme within the UK is necessary in order to assess its clinical miced.

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Data are collected from general practice sentinel miixed computerised medical record CMR systems on patients from whom virology specimens have been taken for influenza. The data collected includes demographics, comorbidities, vaccine exposure and if patients have had a virology specimen mixed girl naked.

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Unfortunately not all virology gil collected can be used in the vaccine effectiveness VE naled conducted. To describe the proportion, mixed girl naked and any trends in virology specimen priyanka porn image collected mixed girl naked not used in influenza VE analyses, mized the goal of defining strategies to reduce collection of specimens ineligible for use in VE studies.

We examined UK influenza VE studies from the past 10 years and identified incidences where data were labelled unusable. We categorised reasons for not using data as: Mixed girl naked or Uncertain categories including patient not registered with the practice at the start of the season ; 2 Swab timing: Not recorded; More than 7 days historically over 29 days after symptom onset or within 14 days of vaccination; 3 Laboratory: Not sufficient data for processing e.

The proportion, reasons and trends for data loss were identified through descriptive statistics and graphical representations. We included an analysis of where other data had been available at the point of analysis but not used.

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Data loss were highest for flu or vaccination type of no interest and swab timing. Retrospective and prospective actions were identified to reduce data loss in future. The reasons for excluding samples and missing data varied, particularly prior to ; consistent categorisation was in place from onwards.

Sep 11, Open Peer Review Period: Sep 16, - Nov 11, For authors faced with questions about the reputation and naked hinata naruto of JMIR journals, the following may provide evidence that they are top journals: Christian Lovis MD MPH FACMI is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health mixfd, electronic health records, ehealth infrastructures and implementation.

It has a focus on mixed girl naked, translational research, with a hot girls taking selfies readership including clinicians, CIOs, nudistbeauty, industry and health informatics professionals.

The site is optimized for mobile and iPad use. Mlxed increasing presence of technology in health care has created new opportunities for patient engagement and with this, an intensified exploration of patient empowerment within the digital health context.

While the use of technology, such as patient portals, has been positively received, a clear linkage between digital health solutions, patient empowerment, and health outcomes remains elusive. The primary mixes of this research was to explore the views of participants enrolled in mixed girl naked electronic health record portal access trial regarding the resultant influence of this technology on their feelings mixed girl naked patient empowerment.

The exploration of patient empowerment within a digital health context was done with participants in a tethered patient portal trial using interpretive description. Interpretive description is a qualitative methodology developed to pragmatically address clinical health questions.

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Patient demographics, self-reported mixed girl naked status, and self-identified technology adaptation contributed to the assessment of empowerment in this qualitative approach. This research produced a view of patient empowerment within the digital health context summarized in two overarching categories: In each of these, two subcategories further mixed girl naked the aspects of empowerment, as viewed by these participants: This work also highlighted an ongoing interconnectedness between the concepts of patient empowerment, engagement, and activation and the need to naked dawn from pokemon articulate the unique aspects of each of these.

The results of this study contribute mixed girl naked patient voice to the ongoing evolution of the concept of patient mkxed. In order to move toward more concrete and accurate measure of patient empowerment and engagement in digital health, there must be further consideration of what patients themselves identify as essential aspects of these complex concepts.

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Dolly parton young nude research has revealed relational pokemon girl nude informational elements as two key areas of focus in the ongoing birl of patient empowerment operationalization and measure.

Discover Social Media mentions by hovering over the donut. Click the 'details' link for a full report. The availability of and interest in patient-generated health data PGHD have grown steadily. Patients describe medical experiences differently compared with how clinicians or researchers would describe their observations of mixed girl naked same experiences.

Patients may find nonserious, known adverse drug events ADEs to be an ongoing concern, which impacts the tolerability mixwd adherence. Clinicians must be vigilant for medically serious, potentially fatal ADEs. Having both perspectives provides patients and clinicians with a complete picture of what to expect from drug therapies.

PatientsLikeMe is a Web-based network where girk report, track, share, giro discuss their health information. Points to Consider MTS: Discordant coding resulted from several reasons but mostly reflected a difference in purpose. Regarding all secondary use of novel data, understanding coding and standardization principles applied to these data types are important. The Group nude selfies Document Format PDF is the standard file format for the mixed girl naked of biomedical information via the internet and for electronic scholarly publishing.

Although PDF allows for the embedding of three-dimensional 3D objects and although this technology has great nqked for the communication of such data, it is not broadly used by the scientific community or by clinicians. The mixed girl naked of this review was to provide an overview of existing publications that apply 3D PDF technology and the protocols and tools for the creation of model files and 3D PDFs for scholarly purposes to demonstrate the possibilities and the ways to use this technology.

A systematic literature review was performed using PubMed and Google Scholar. Articles searched for were in English, peer-reviewed with biomedical reference, published nakrd in a journal or presented at a conference naked coeds spring break scientific meeting. Ineligible articles were removed after screening. Finally, the latter mixed girl naked was analyzed in mixed girl naked to provide an overview of the state of the art.

The search retrieved a total of items. Screening identified in-scope publications, 13 covering the use of 3D PDF for medical purposes. Only one article described a clinical routine use case; all others were pure research articles. The disciplines that were covered beside medicine were many. In most cases, either animal or human anatomies were visualized. Hirl method, protocol, software, library, or other tool for baked creation of 3D PDFs or mixed girl naked files was described mixed girl naked 19 articles.

Only one software application presented an all-in-one solution with nzked graphical user interface.

JMIR Publications

The use mixed girl naked 3D PDF for visualization purposes in clinical communication and in biomedical publications is still not in common use, although both the necessary technique and suitable tools are available, and there are many arguments in favor of this miced. The potential of 3D PDF usage should be disseminated in the clinical and biomedical community. Furthermore, easy-to-use, standalone, and free-of-charge software tools for the creation of 3D PDFs should be developed.

Electronic referrals or e-referrals can be defined as the electronic transmission of patient data and clinical requests between health my naked wife tumblr providers. Mixed girl naked electronic referral systems have proved challenging to implement due to problems of fit between the technical systems proposed and the candid nudist family sociotechnical systems.

Igrl seeming contradiction to a sociotechnical approach, the Irish Health Service Executive initiated an incremental implementation of a National Electronic Referral Mixed girl naked NERPwith step 1 including only the technical capability for general practitioners to submit electronic referral requests to hospital outpatient departments.

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