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Motivating change.

Effective health behaviour change consultations demand a high level of skill and well-practised strategies used in a patient-centred way of working.

Attitude to Health↗

[Nursing research, an active process in nursing].

Nursing knowledge can be produced through academic, assistance and collaborative model. There are few Nursing services in Brazil that stimulate research production by clinical nurses. This study aims to analyze declarations of nurses about the process of conducting research on their work places, having as a framework the symbolic interactionism. The data was collected through interviews with eleven nurses. The analysis led to the process of researching with six phases: the situation; the perception; the interpretation; the act; the manipulation and the consumation. The authors concluded that nurses interact with themselves and others, defining and interpreting their situation, their own actions as well as the other's. Through defining and interpreting the situation, they build their actions directed or not to activities related to research according to the meaning given by them to this "social object".

Attitude of Health Personnel↗

[Social support contribution to health and the adoption and maintenance of health behaviors].

Social support refers to the presence of individuals providing emotional or material resources. Its four components are: integration, structure, function, and quality. This article presents empirical and theoretical data, as well as criticism of studies which examine the relationship between social support, global health and cardiovascular health, also evaluating direct or moderating contributions to the adoption and maintenance of health behaviours in persons with cardiovascular disease. Concrete implications for nursing practice are reviewed.

Adaptation, Psychological↗

[Individual features of the mediator-hormonal correlates of behavior in the rat].

Neurotransmitter reactions--concentration of acetylcholine, adrenaline and noradrenaline in blood after an open field test were compared with characteristics of motor activity in it observed in three groups of rats with different behavioural manifestations. It was noted that these characteristics may reflect relatively independent manifestations of activity: the rats of two most different behavioural groups (elaborating and not elaborating the avoidance of a closed space at the cries of a partner), with unequal speed of alimentary reflex elaboration, differed significantly by their behaviour in the open field, but comparatively little by their neurotransmitter reactions. Only 25% of the first group rats had an increased content of noradrenaline, while in the group which occupied an intermediate position by the majority of behavioural characteristics, the activity of the neurotransmitter was the greatest. After the procedure of elaboration of alimentary reflexes a distinct decrease of this activity in all groups took place.

Acetylcholine↗

Identification of high-risk behaviors among victimized adolescents and implications for empirically supported psychosocial treatment.

An adolescent's possible response to being the victim of interpersonal violence is not limited to posttraumatic stress disorder and depression but may also involve a host of developmental effects, including the occurrence of high-risk behaviors that may have a significant and negative impact on the adolescent's psychological and physical health. Identifying such high-risk behaviors, understanding their possible link to a previous victimization incident, and implementing interventions that have been demonstrated to reduce such behaviors may help decrease potential reciprocal interactions between these areas. Clinicians in psychiatric practice may be in a unique position to make these connections, since parents of adolescents may perceive a greater need for mental health services for youth engaging in problematic externalizing behaviors than for those displaying internalizing symptoms. In this article, the authors first describe high-risk behaviors, including substance use, delinquent behavior, risky sexual behaviors, and self-injurious behaviors, that have been linked with experiencing interpersonal violence. They then review empirically based treatments that have been indicated to treat these deleterious behaviors in order to help clinicians select appropriate psychosocial interventions for this population. Recommendations for future research on the treatment of high-risk behaviors in adolescents are also presented.

Adolescent↗

Barriers and Facilitators of Help-Seeking for LGBTQ+ Survivors of Sexual Violence: A Systematic Review.

People who identify as LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, plus) are known to experience similar or higher levels of sexual violence compared to their heterosexual cisgender counterparts. However, sexual violence research has largely focused on heterosexual female survivors of male perpetrated crime. Thus, the unique support needs and help-seeking patterns of LGBTQ+ survivors are poorly understood. This review addresses this gap by systematically exploring literature on barriers and facilitators to help-seeking for LGBTQ+ survivors of sexual violence. Four databases (PsycINFO, CINAHL, MEDLINE, and Web of Science) were searched to identify relevant material, with 35 articles (30 qualitative, 1 quantitative, and 4 mixed-methods) meeting the inclusion criteria. Data were extracted and analyzed using a narrative synthesis. The topic was investigated almost exclusively cross-sectionally. Barriers included discrimination experiences, myths and stereotypes, feelings of shame and self-blame, and rejection of victim status. Additional barriers were reported by survivors who hold multiple minority identities, in particular LGBTQ+ people of color and sex workers. Facilitators to help-seeking included the intrinsic need to connect with others, social encouragement and empowerment, and positive disclosure experiences. The Power Threat Meaning framework provides insight into these findings by presenting help-seeking behaviors as adaptive responses to increase a sense of safety following a traumatic experience. The analyzed data indicate several implications for the development and improvement services to support LGBTQ+ survivors. They further serve to highlight the need for additional robust research, conducted with an intersectional lens, to explore the needs of sexual and gender minority survivors of sexual violence.

Humans↗

Pure and guided self-help for full and sub-threshold bulimia nervosa and binge eating disorder.

OBJECTIVE: The study compared the efficacy of self-help without and with guidance (referred to as 'pure' and 'guided' self-help), using a cognitive behavioral self-help manual (Fairburn, 1995) for binge eating. DESIGN AND METHODS: A sample of 31 participants with bulimia nervosa, subthreshold bulimia nervosa and binge-eating disorder were assigned randomly to one of the self-help levels for 16 weeks, after four weeks of baseline observations. RESULTS: The results indicated that both forms of self-help treatments had a modestly positive and sustained effect on the participants' eating problems. Intention-to-treat analyses showed that participants reduced their mean number of objective bulimic episodes and purging behaviour by 33% and 17% over the course of the treatment. The corresponding reduction levels for the treatment completers (N = 18) were 58% and 61%, respectively. Furthermore, there were no significant differences between the pure and guided self-help groups in terms of outcome, reflecting the probable insignificance of guidance for the broader group of individuals with binge-eating problems. At follow-up, no further significant improvement or deterioration was observed in the ensuing six months compared with the post-treatment data. CONCLUSION: Given the heterogeneity of the diagnostic groups in the present study, resulting in high external validity, and the conservative nature of the analyses, self-help is discussed as a viable means of initial treatment for binge eating.

Adult↗

Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression.

Consultation rates and help-seeking patterns in men are consistently lower than in women, especially in the case of emotional problems and depressive symptoms. Empirical evidence shows that low treatment rates for men cannot be explained by better health, but must be attributed to a discrepancy between perception of need and help-seeking behavior. It is argued that social norms of traditional masculinity make help-seeking more difficult because of the inhibition of emotional expressiveness influencing symptom perception of depression. Other medical and social factors which produce further barriers to help-seeking are also examined. Lines of future research are proposed to investigate the links between changing masculinity and its impact on expressiveness and on the occurrence and presentation of depressive symptoms in men.

Adult↗

Sex differences in anxiety behavior in rats: role of gonadal hormones.

These experiments examined the role of gonadal hormones at both the organizational and activational time periods on sex differences in plus-maze behavior. In the first experiment, adult female Long-Evans rats were found to spend more time on the open arms of the plus maze than adult males, indicating less anxious behavior. In the second experiment, male and female subjects received a neonatal treatment (chemical castration with flutamide or tamoxifen, vehicle injection, or no injection) and a prepubertal treatment (gonadectomy, sham surgery, or no surgery). Adult females receiving either neonatal tamoxifen or prepubertal ovariectomy spent less time on the open arms than control females, but females who received both treatments were the most defeminized subjects. Males were not affected by the absence of gonadal hormones at either time period. These experiment indicate that female gonadal hormones play an important role both organizationally and activationally in plus-maze behavior. The role of the GABA receptor complex in mediating this effect is discussed. Knowledge of sex differences in plus-maze behavior may help to make this maze a more useful tool in investigating anxiety behavior in rats.

Animals↗

The effects of prenatal alcohol exposure on odor associative learning in rats.

Alcohol was administered to pregnant females via a liquid diet that contained either 35% ethanol-derived calories (35% EDC) or 0% EDC on gestation days 6-20. An ad lib lab chow group (LC) was also included. In Experiment 1, odor-aversion learning was examined in 10-day-old offspring. While both the 0% EDC and LC groups displayed odor aversions, the 35% EDC offspring did not. In Experiment 2, learning was assessed in an appetitive paradigm in three-day-old offspring. Once again, the 35% EDC offspring showed no evidence of learning. Experiment 3 examined odor-aversion learning in adults. Both alcohol-exposed offspring and controls learned the odor association equally well. These findings suggest that odor associative learning is a sensitive indicator for alcohol-related learning deficits in rat pups although these deficits may dissipate as the offspring matures. Since odor associations play a critical role in neonatal behaviors, these deficits may help explain other behavioral anomalies noted following prenatal alcohol exposure.

Age Factors↗

Interactions between family members and staff in intensive care units--an observation and interview study.

BACKGROUND: Research about interactions between family members and staff are sparse, although family members' needs and experiences in intensive care units are well researched areas. AIM: The aim was to describe and interpret interactions between family members and staff in intensive care units. METHODS: Interviews (n=24) with family members and repeated observations of interactions of family members and staff in intensive care units were performed and analysed together by means of content analysis. RESULTS: The initial interactions between staff and family members had a substantial effect on family members and influenced their further interactions with the staff. Two kinds of interactions were revealed; mutual understanding and mutual misunderstanding. Family members, who understood the explicit information and the implicit messages were open in communication with the staff, adjusted well to the system, were acknowledged by the staff and sometimes consoled. Family members, who had difficulties understanding information and implicit messages drew back from communication with staff, did not adjust to the system and were sometimes insulted by the staff. CONCLUSIONS: Unambiguous information from the staff is important for developing interactions of mutual understanding. The results may be a starting point for intensive care unit staff to reflect on how all family members are initially met and further informed and treated. Further research of family members' experiences of interactions with staff in a longitudinal perspective and the influence of critical illness on families are needed.

Adolescent↗

The good, the bad and the discriminator--errors in direct and indirect reciprocity.

This paper presents, in a series of simple diagrams, concise results about the replicator dynamics of direct and indirect reciprocity. We consider repeated interactions between donors and recipients, and analyse the relationship between three basic strategies for the donor: unconditional cooperation, all-out defection, and conditional cooperation. In other words, we investigate the competition of discriminating and indiscriminating altruists with defectors. Discriminators and defectors form a bistable community, and hence a population of discriminators cannot be invaded by defectors. But unconditional altruists can invade a discriminating population and 'soften it up' for a subsequent invasion by defectors. The resulting dynamics exhibits various forms of rock-paper-scissors cycles and depends in subtle ways on noise, in the form of errors in implementation. The probability for another round (in the case of direct reciprocity), and information about the co-player (in the case of indirect reciprocity), add further elements to the ecology of reciprocation.

Altruism↗

Encouraging patient adherence: primary care physicians' use of verbal compliance-gaining strategies in medical interviews.

Compliance-gaining strategies refer to subtle differences in ways people use language when their goal is to influence someone else's behavior. This stands in contrast to other kinds of persuasion aimed only at influencing others beliefs and attitudes. We have developed a new method of coding what physicians say when they are trying to influence patients' behaviors. This method applies theory and methods from the fields of interpersonal influence, linguistics and social psychology. We tested the reliability of this new method by randomly selecting 37 audiotaped medical interviews collected for an unrelated study [J. Gen. Int. Med., 9 (1994) 402] and having three coders independently identify physician compliance-gaining utterances and then independently apply one of 57 codes to each utterance. These codes also were categorized on two underlying dimensions reflecting whether the physician (1) framed the compliance-gaining utterance in a direct or indirect way, and (2) did or did not give a justification for that direct or indirect request. Reliability among coders and coders agreement with the final utterance identification and coding decisions, measured as per cent agreement among coders and/or, where appropriate, by Cohen's kappa were good to excellent. Most physicians' strategies were indirect and incomplete. For female patients, physicians used significantly more strategies, including more indirect strategies, complete strategies, "prescriptions" and "demands". For male patients, physicians used a greater percent of direct strategies, including "procedural demands". This method provides a reliable and promising new technique for observing naturally occurring physician compliance-gaining speech.

Adult↗

Mild reactions to blood donation predict a decreased likelihood of donor return.

A growing body of evidence suggests that episodes of fainting can deter volunteer blood donors from returning to donate in the future. In contrast, relatively little is known about the effect of significantly more common mild reactions (e.g., faintness, dizziness, lightheadedness) on donor retention. In the present study, 1052 volunteer blood donors completed a standardized measure of subjective physiological reactions immediately after blood donation (Blood Donation Reactions Inventory), and individual scores were used to predict repeat donation behavior during a one-year follow-up. Results of a logistic regression analysis indicated that higher scores on the Blood Donation Reactions Inventory were associated with a significantly lower likelihood of repeat donation, and that novice donors who scored highest on the scale were less than half as likely to have returned to donate in the following year. These findings suggest that the Blood Donation Reactions Inventory is an effective method of assessing reactions that predict donor non-return, and therefore may be a useful addition to future studies aimed at enhancing donor satisfaction and retention.

Adult↗

Prosocial self-schemas, self-awareness, and children's prosocial behavior.

Three studies examined the hypothesis that a child's prosocial self-schema predicts prosocial behavior. In Study 1, only self-aware boys showed a self-schema-behavior relation. Study 2 altered both salience of donating opportunity and relationship of recipient to donor. The hypothesized Self-Awareness x Self-Schema interaction was significant, and there were no gender differences. Study 3 systematically manipulated the salience of the donating opportunity. All participants were self-aware. For boys in high and low salience conditions, prosocial self-schema predicted donating behavior. For girls, prosocial self-schema predicted behavior only in the high salience condition. The findings demonstrate that self-schemas can regulate behavior when participants are self-aware. Girls, however, may require higher salience of the donating opportunity for the self-schema to affect their behavior.

Awareness↗