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Lower group productivity under kin-selected reproductive altruism.

Hamilton's rule provides the foundation for understanding the genetic evolution of social behavior, showing that altruism is favored by increased relatedness and increased productivity of altruists. But how likely is it that a new altruistic mutation will satisfy Hamilton's rule by increasing the reproductive efficiency of the group? Altruism per se does not improve efficiency, and hence we would not expect a typical altruistic mutation to increase the mean productivity of the population. We examined the conditions under which a mutation causing reproductive altruism can spread when it does not increase productivity. We considered a population divided into temporary groups of genetically similar individuals (typically family groups). We show that the spread of altruism requires a pleiotropic link between altruism and enhanced productivity in diploid organisms, but not in haplodiploid organisms such as Hymenoptera. This result provides a novel biological understanding of the barrier to the spread of reproductive altruism in diploids. In haplodiploid organisms, altruism within families that lowers productivity may spread, provided daughters sacrifice their own reproduction to raise full-sisters. We verified our results using three single-locus genetic models that explore a range of the possible reproductive costs of helping. The advantage of female-to-female altruism in haplodiploids is a well-known prediction of Hamilton's rule, but its importance in relaxing the linkage between altruism and efficiency has not been explored. We discuss the possible role of such unproductive altruism in the origins of sociality. We also note that each model predicts a large region of parameter space were polymorphism between altruism and selfishness is maintained, a pattern independent of dominance.

Altruism↗

Predictors of high-risk behavior in unmarried American women: adolescent environment as risk factor.

BACKGROUND: Heterosexual intercourse with two or more partners in a short time period represents a high-risk behavior for acquisition and transmission of sexually transmitted pathogens (STDs). Identification of factors that may predict high-risk sexual behavior can help to focus primary prevention strategies on women at risk for future acquisition of infection. METHODS: We analyzed survey data obtained in 1988 from a nationally representative sample of 8,450 American women of reproductive age in order to identify such factors. RESULTS: Of all sexually experienced unmarried women, 6.6% reported having had two or more sexual partners in the preceding three months. Earlier age at first sexual intercourse was associated with multiple recent partners, and with lower reports of abstinence. Birth region in the West, lack of attendance at religious services as an adolescent, and having a mother who had her first child before she was 25 years of age were factors associated with multiple recent partners. Among unmarried white women having a mother who worked full time and not living with both parents during adolescence were associated with multiple recent partners; among unmarried black women, the inverse was true (p for racial difference < .05). Multivariate analysis showed western birth region and earlier age at first sexual intercourse to be significant predictors of having multiple recent sex partners. CONCLUSIONS: Early environment and race influence later sexual behavior. These factors should be considered in targeting and planning education for STD prevention.

Adolescent↗

Parents' concerns about children's development: prescreening technique or screening test?

OBJECTIVE: Due to the limitations of previous studies, parents' concerns have been recommended as a prescreening technique, a brief method for identifying a subset of children in need of more in-depth developmental screening. The purpose of this study was to assess whether parents' concerns could: (1) serve instead as a screening measure; (2) aid in making focused referral decisions; and (3) help pediatricians target families for developmental promotion and in-office counseling. An additional goal was to determine why most parents' concerns are accurate although some are not. DESIGN SURVEY/SETTING: Public schools and day care centers in four diverse geographic sites representing the northern, central, southern and western United States. PATIENTS AND OTHER PARTICIPANTS: A total of 408 children between 21 and 84 months of age and their parents, whose socioeconomic and demographic characteristics reflect proportions in the 1990 United States Census. MAIN OUTCOME MEASURES: Licensed psychological examiners and educational diagnosticians elicited parents' concerns about children's development and measured children's development with a broad battery including measures of intelligence, language, motor, and school skills. RESULTS: Certain concerns, ie, motor, language, global/ cognitive, and school (in children 4 years and older) had high levels of sensitivity and identified 79% of the 56 children with disabilities. Accurate referrals could be made for 70% of the 56 children. The absence of concerns or concerns in other areas, ie, socialization, self-help, or behavior, had reasonable specificity and identified 72% (N = 255) of the 352 typically developing children. Of the remaining 28% (N = 97) of parents with significant concerns but whose children did not have disabilities, most had children with substantially lower performance in almost all developmental areas than the children of the 255 parents without significant concerns. Further, more than half of the 97 children could be distinguished by a single concern (usually about expressive language) whereas the majority of accurately concerned parents had multiple concerns. A significant proportion of the 12 parents of disabled children who did not raise concerns could be identified by difficulties communicating in either English or Spanish. CONCLUSION: If systematically elicited, parents' concerns approach standards for screening tests and can be used to make reasonably accurate referral decisions. Over-referrals can be significantly reduced by administered screening tests to the small group of children (16%) whose parents have a single significant concern. Those who pass screening or whose parents have nonsignificant concerns can be targeted for developmental promotion and in-office counseling. Under-referrals can be minimized by administering screening tests (with the help of an interpreter as needed) to children whose parents have communication difficulties.

Aptitude Tests↗

Sex typing and androgyny: further explorations of the expressive domain.

Previous research by Bem has indicated that androgynous individuals of both sexes display "masculine" independence when under pressure to conform as well as "feminine" nurturance when interacting with a kitten. In contrast, sex-typed individuals were low in one or both of these behaviors. The two studies reported here were designed to replicate the low nurturance of the masculine male and to clarify the unexpected finding that feminine females were low in both independence and nurturance. In the first study subjects interacted with a human infant, and in the second study they listened to a lonely student. Taken together, the results of these two studies conceptually replicated the low nurturance of the masculine male and demonstrated that the low nurturance of the feminine female does not extend to her interaction with humans. Finally, evidence was presented in support of Spence, Helmreich, and Stapp's distinction between "androgynous" individuals, who are high in both masculinity and feminity, and "undifferentiated" individuals, who are low in both of these characteristics.

Female↗

[Epidemiology of obsessive-compulsive disorder: a review].

Epidemiological surveys are important because clinical samples are subject of several selection biases. Sociodemographic factors and clinical aspects of the morbid condition itself influence help seeking behaviors. Due to the egodystonic nature of obsessive-compulsive disorder, sufferers tend to hide their symptoms and avoid or delay treatment seeking. However, most of our current knowledge about obsessive-compulsive disorder is based on clinical samples, which do not represent the totality of cases. A conventional Medline, PsychoInfo and Lilacs review of epidemiological studies on obsessive-compulsive disorder from 1980 to 2004 was conducted, using the following keywords: "epidemiology", "obsessive-compulsive disorder", "populational surveys" and "prevalence". Studies from different countries show an average point-prevalence of 1% and lifetime prevalence of 2-2.5% for obsessive-compulsive disorder. In contrast with clinical samples, most populational samples have a predominance of females and cases with only obsessions. The frequent comorbidity with other mental disorders, particularly depression and other anxiety disorders, has also been found in cases from the community, which have an association with substances misuse as well. Many sufferers are not been treated, particularly the "pure" cases. Indicators of functional incapacitation show a considerable negative impact of obsessive-compulsive disorder. It is necessary to increase the awareness about obsessive-compulsive disorder symptoms in the community and among health professionals, in order to increase help seeking, as well as the proper identification and treatment of this rather serious medical condition.

Comorbidity↗

Empathy: Its ultimate and proximate bases.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors (e.g., alarm, social facilitation, vicariousness of emotions, mother-infant responsiveness, and the modeling of competitors and predators) that are crucial for the reproductive success of animals living in groups. The Perception-Action Model (PAM), together with an understanding of how representations change with experience, can explain the major empirical effects in the literature (similarity, familiarity, past experience, explicit teaching, and salience). It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations.

Adult↗

Forgiveness and its associations with prosocial thinking, feeling, and doing beyond the relationship with the offender.

Past research has revealed that forgiveness promotes prosocial cognition, feeling, and behavior toward the offender. The present research extends this research by examining whether forgiveness may spill over beyond the relationship with the offender, promoting generalized prosocial orientation. Consistent with hypotheses, three studies revealed that forgiveness compared to unforgiveness is generally associated with higher levels of a generalized prosocial orientation, as indicated by higher levels of a we frame of mind (as indicated by a greater use of first-person plural pronouns, e.g., we, us, in a language task) and greater feelings of relatedness toward others in general. Moreover, forgiveness (vs. unforgiveness) was even associated with greater probability of donating to charity and greater willingness to engage in volunteering. Finally, the authors found that unforgiveness reduces tendencies toward generalized prosocial orientation, whereas forgiveness restores generalized prosocial orientation to baseline levels within the relationship.

Adult↗

Assimilation and ethnic boundaries: Israeli students' altitudes toward soviet immigrants.

The attitudes of Israeli students toward new immigrants from the former Soviet Union were examined against the theoretical framework of the sociology of ethnicity and sociology of education. The main research question explored was which ethnic relationship model (assimilation, pluralism, or separation) best described the attitudes and self-reported behavior of Israeli youth toward the new immigrants. Israeli students' changing attitudes toward their immigrant counterparts were also investigated, as well as actual Israeli educational practices (not only declared policies) regarding Soviet immigrants. The study was conducted in grades 4-11 at schools in northern Israel. The results indicated positive attitudes and openness of relations by the Israelis toward the new immigrant students in the first year following their immigration. However, the attitudes were less positive in the second year. Although the Israeli students manifested positive attitudes toward immigration and to the immigrants themselves, these views were largely assimilatory; Israeli cultural capital was obviously dominant, and it was expected to be accepted as such by the newcomers. The findings point to Israeli assimilatory educational practice; immigrants are expected to blend in, abandoning their past heritage and culture.

Acculturation↗

A multicenter, randomized, double-blind, placebo-controlled, 6-month trial of bupropion hydrochloride sustained-release tablets as an aid to smoking cessation in hospital employees.

Despite changes in smoking behavior, one-third of the Danish population continues to smoke. Many of these smokers are hospital employees. This 6-month, multicenter, parallel group, randomized, double-blind, placebo-controlled study evaluated treatment with bupropion hydrochloride sustained release (Zyban) compared with placebo as an aid to smoking cessation in health care workers. A total of 336 hospital employees who smoked at least 10 cigarettes daily were randomized (2:1) to 7 weeks of treatment with bupropion (n=222) or placebo (n=114). All participants were motivated to quit smoking and received behavioral counseling. Continuous smoking abstinence during weeks 4-7 was the primary endpoint, and long-term smoking abstinence was among the secondary endpoints. Of the original participants, 212 completed the 6-month trial. Continuous smoking abstinence at week 7 was achieved by 43% in the bupropion group and 18% in the placebo group, p<.001. After 26 weeks, 18% and 7%, respectively, were continuously abstinent, p=.008. Side-effects were frequent but simple and reversible in both groups, and generally consistent with the findings of previous studies. Dizziness, insomnia, and pruritus appeared more frequently in the bupropion group than in the placebo group. Bupropion was effective as an aid to smoking cessation in a broad group of hospital employees in Denmark.

Bupropion↗

[Oral communication with hematologic patients: facilitating and blocking behaviors].

In this descriptive study we adopted the model of FORREST (1983) for the categorization of oral utterances by the members of the nursing team when caring for hematological patients with oncological alterations. In order to identify the frequency of facilitating(F) and blocking(B) categories of communication and of their subcategories, we videotaped and observed the interactions between 8 patients and 14 members of the Nursing team in a Teaching Hospital in the city of Ribeirão Preto-SP. We recorded 8822 categories, 56.9% of which were facilitating. The most frequent of these were: providing information (50.3%), clarifying (28.0%) and recognizing the presence (11.2%). The most frequent blocking categories were: closed questions (64.6%), giving advice (13.9%) and approving or agreeing (10%). The remaining F and B subcategories were observed at frequencies of less than 4.5%. We suggest the more frequent use of other facilitating categories and the use of closed questions in special situations. We believe that, for a more profound relationship between nursing team and patients, it is of fundamental importance to reduce the "giving advice" and "approval" categories as they are being used now.

Communication Barriers↗

Explaining excessive rates of cesareans and other childbirth interventions: contributions from contemporary theories of gender and psychosocial development.

The current rate of cesarean sections in the U.S. is too high. Numerous mothers and babies are being placed at unnecessary risk of medical, behavioral and psychological complications. The problem has proven resistant to solution on a large scale, despite serious efforts on the part of a variety of individuals and groups. This paper considers reports on the interactions between obstetricians and mothers in labor in light of findings and theory in the areas of gender and psychosocial development. Examination of processes and standards of care in light of these findings and theory leads to the conclusion that the present model of obstetric services is consistent with a masculine style, and offers far less than optimal care for women. In fact, the gender-inappropriate elements of the model itself probably contribute to the excessive rates of interventions in labor. Social, political and historical factors are seen to support the obstetric model as is, leading to some pessimism about the possibility that the model could be modified sufficiently without major social change. The obstetric model is compared briefly with the more gender appropriate model of care provided by midwives.

Cesarean Section↗

The language of becoming: helping children change how they think about themselves.

In this article, I describe the language of becoming, which is a way of speaking to children that enables them to see themselves as continually evolving and changing. By noticing and reflecting back the specific ways the child is becoming, the parent gives a meta-message that one's personality is not set in stone but, rather, evolves and changes over time. In order for parents to use the language of becoming, the child must actually act differently. I will describe a three-pronged approach to helping children try new behaviors. The language of becoming helps parents and children see the child's personality, not just his or her behavior, as fluid rather then static. This helps parents and children break the vicious circles and self-fulfilling prophesies of rigid definitions of self. An understanding of stages of cognitive development in the construction of beliefs about the self and the implications of these stages for using the language of becoming is also discussed.

Child↗

Social support during pregnancy: a unidimensional or multidimensional construct?

The purpose of this study was to test empirically a conceptually derived multidimensional formulation of social support. Analyses were based on responses of 313 expectant couples who varied in age, income, and education. A questionnaire, which included the Support Behaviors Inventory (SBI), was given in the latter half of pregnancy. A four-phased analysis was conducted: discriminate validity testing of the multidimensional support structure, further subscale analysis, factor analysis of the structure of the SBI, and reformulation of the SBI based on results of the factor analyses. Results did not demonstrate independence of measurement with items that were developed to represent a priori social support dimensions of emotional, material, informational, and appraisal support. The factor analysis in particular revealed that the scree test by Cattell (1966) demonstrated a large, dramatic discontinuity in eigen-values and suggested that there was only one systematic factor. These results implied a dominant construct of social support in pregnant couples that organizes at the broad level the perceived degree of experienced support during pregnancy. This broader concept was so dominant in the current study, explaining 48% of the variance in partner support and 61% of the variance in others support, that the idea of multidimensionality was not confirmed. These data suggest an ongoing need to scrutinize carefully and validate empirically the hypothesized multiple dimensions of social support proposed in a number of recent support instruments.

Adolescent↗

Development and evaluation of a sexual history-taking curriculum for first- and second-year family practice residents.

BACKGROUND: Primary care physicians need to assess their patients' sexual behaviors to help prevent, diagnose, and treat sexually transmitted diseases. However, few physicians take sexual histories. We developed an educational curriculum aimed at increasing the frequency with which our residents take sexual histories from patients. METHODS: Residents were observed for 5 months through video monitoring of patient encounters to document the precurriculum rate of taking sexual histories. Residents also completed a sexuality questionnaire about the likelihood of encountering certain patient problems and the residents' degree of comfort and competence with these problems. They then completed the educational curriculum and were monitored for 3 months for any change in taking sexual histories. We added follow-up telephone interviews with the residents to determine the effect of the curriculum and the extent of taking sexual histories. RESULTS: Due to insufficient data collected with video monitoring in the postcurriculum phase, we used telephone interviews to evaluate the curriculum. Prior to the curriculum, only 7% of the residents reported routinely asking patients about their sexual history, compared to 36% of residents 6 months after implementation of the curriculum. CONCLUSION: The sexual history-taking curriculum improved the frequency with which residents collected information from patients on sexual activity. In addition, this article addresses the development of the curriculum based on a needs assessment, and the difficulties in and possible solutions to evaluating curricular changes within family practice residency programs.

Adult↗

Effects of allocare-givers on fitness of infants and parents in callitrichid primates.

The effects of callitrichid primate helpers (allocare-givers other than an infant's father) on the survival, reproduction or behavior of infants and parents are reviewed, using both published studies and data from free-ranging golden lion tamarins (Leontopithecus rosalia). Three lines of evidence suggest that helpers may increase their own inclusive fitness: (1) The number of adult males acting as helpers in free-ranging groups is correlated with the number of surviving infants in 3 callitrichid species. However, the lack of a negative correlation with number of infants dying suggests that activities other than direct infant care (e.g. territory defense) may be more important, especially in newly formed groups. (2) In 2 species, captive groups with helpers carry infants for longer periods of time than do groups without helpers. Whether such differences would translate into meaningful survival differences in free-ranging groups is unclear. (3) Helpers reduce the energetic burden of parents by reducing the amount of time they spend transporting or provisioning infants in at least 4 species. Reproductive males are more likely than reproductive females to benefit from the presence of helpers, reducing their investment in infant care activities as the number of helpers in the group increases. In free-ranging golden lion tamarins, the reproductive tenure of males, but not females, increases with the number of helpers in the group, suggesting that a reduction in energetic investment may translate into increased survival. 'Decisions' made by helpers to participate in infant transport are weighed against competing needs for foraging, vigilance, territory defense and, in some cases, prospecting for breeding opportunities. Given this complexity, a sophisticated model may be required to answer the question of how helpers 'decide' to participate in infant care versus other activities.

Animals↗

Use of the Family CAGE in screening for alcohol problems in primary care.

OBJECTIVE: To establish the reliability and validity of the Family CAGE (an acronym indicating Cut down on drinking; Annoyed by complaints about drinking; Guilty about drinking; had an Eye-opener first thing in the morning), a four-item instrument intended to assess family alcohol-related problems. DESIGN: Two distinct cross-sectional studies using a survey, and in one study, retrospective chart review. PARTICIPANTS: A random sample of 172 adult patients presenting for nonurgent care to a network of family practice settings and a convenience sample of 107 patients who smoked presenting to a university family practice residency training setting. MAIN OUTCOME MEASURES: The Family CAGE was compared with alcohol-related variables and scales measuring psychosocial constructs. In the first study, these scales included the Family Stress and Coping Scale; Profile of Mood States; the Family Problems Checklist; and the Duke/University of North Carolina Mini-Health Profile. Chart review included medical utilization rates and prescription of medications. In the second study, a revised version of the Family CAGE was compared with other scales such as the standard CAGE questionnaire; an "Anomy" Scale; the Catchment Epidemiologic Study-Depression Scale; a global self-assessment of alcohol-related problems; and a self-report of lifetime history of major depression and recent self-limited depression. RESULTS: The Family CAGE showed strong internal consistency reliability, with Cronbach's alpha coefficients of .84 in the first study and .89 in the second. Construct validity was supported by Family CAGE correlations with family stress, family problems, depression, anxiety, individual stress, and marital dissatisfaction. The Family CAGE was strongly correlated with global assessment of family alcohol-related problems, and was superior to this variable in predicting help-seeking behavior. The Family CAGE was also significantly correlated with a higher sick visit rate and more medications prescribed (despite no difference in functional health status). The standard CAGE was correlated with a recent history of self-limited depression, while the Family CAGE was correlated with a lifetime history of major depression. Sensitivity and specificity rates vary depending on the criterion addressed, but a cutoff score of 2 or more appears to offer the best clinical information. CONCLUSION: The Family CAGE appears to be a reliable, valid, utilitarian measure of family alcohol problems. It offers more information than either a single-item global assessment regarding family alcohol-related problems or the standard CAGE questionnaire. The Family CAGE is strongly correlated with other important psychosocial problems, prescription of psychotropic medications, and health-care utilization. It is brief, understandable, and equally effective in interview and self-administered formats.

Adult↗

Techniques to improve physicians' use of diagnostic tests: a new conceptual framework.

OBJECTIVES: To review the published literature on interventions aimed at improving physicians' testing practices and propose methodologic standards for these studies and to review selected studies using the PRECEDE framework, a behavioral model that helps categorize interventions based on which behavioral factors are being affected. DATA SOURCES: MEDLINE, EMBASE, and HEALTHStar databases were searched for the years 1966 to January 1, 1998, for English-language articles pertaining to diagnostic testing behavior; bibliographies were scanned to identify articles of potential interest; and researchers in health services, health behavior, and behavior modification were contacted for proprietary and other unpublished articles. STUDY SELECTION: A total of 102 articles were identified that described the results of interventions aimed at changing physicians' testing practices. We included the 49 studies that compared diagnostic testing practices in intervention and control groups. DATA EXTRACTION: Two investigators independently reviewed each article in a blinded fashion using a standard data collection form to obtain a methodologic score and to abstract the key elements of each intervention. DATA SYNTHESIS: On a 38-point methodologic criteria scale, the mean +/- SD score was 13+/-4.4. The desired behavior change was reported in the intervention group in 37 (76%) of 49 studies. Twenty-four (86%) of 28 interventions targeted at many behavioral factors were successful, while 13 (62%) of 21 studies aimed at a single behavioral factor were successful (P=.12). CONCLUSIONS: A majority of interventions to improve physicians' testing practices reported in the literature claimed success, with interventions based on multiple behavioral factors trending toward being more successful. While methodologic flaws hamper drawing strong conclusions from this literature, application of a behavioral framework appears to be useful in explaining interventions that are successful and can facilitate interpretation of intervention results.

Clinical Laboratory Techniques↗