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PubMed1996

Maintaining safer sex behaviours in HIV-infected adolescents with haemophilia. The Hemophilia Behavioral Evaluative Intervention Project Committee.

Adolescents with haemophilia comprise 44% of the reported AIDS cases in teenagers. Unprotected sexual intercourse among this group increases the risk of HIV transmission. Understanding the influences which others may have on the sexual behaviour of adolescents with HIV and haemophilia may lead to the development of effective risk reduction strategies. An evaluative instrument, administered to 307 HIV-infected adolescents with haemophilia, assessed their behavioural stage of change (Prochaska & DiClemente), attitudes, beliefs and behaviours about safer sex practices. The influence of parents, peers and sexual partners on sexual behaviour was compared between (1) those who were sexually experienced and (2) and those who were sexually inexperienced. Barriers and facilitators to practising safer sex were identified. Although parents influenced the sexual behaviour of both groups, this influence was significantly greater in the sexually inactive group. Fewer than 20% reported that their peers impacted their decisions about sexual behaviour. Eighty-six per cent of the sexually active indicated that partners significantly impacted their sexual decisions, while 60% of the sexually inactive indicated that future partners would affect their decisions about sex. Most participants agreed that disclosure of HIV status before intercourse was desirable, but only 31% of the sexually active said they told every partner. Fear of rejection or a negative reaction from the partner, and lack of communication skills were the greatest barriers to disclosure of HIV status and practising safer sex. This study indicates that behavioural interventions for both groups should focus on developing communication skills and self-efficacy. Interventions should include the key influences for each group--parents for the sexually inactive and partners for the sexually active.

Adolescent↗
PubMed1994

AIDS and injecting drug use: very risky behaviour in a Perth sample of injecting drug users.

This research was carried out in 1990 to examine high-risk injecting and sexual behaviour in a sample of injecting drug users (IDUs) in Perth. The study was a cross-sectional survey with a convenience sample drawn from drug treatment (54%) and non-treatment (46%) populations. In the sample of 150 IDUs, there were 11 very risky drug behaviour (VRDB) and 63 very risky sex behaviour (VRSB) respondents. Four respondents fell into both categories. Independent comparisons were made between each risk group and the rest of the sample. The VRDB respondents were heterosexual men, most of whom were in long-term monogamous relationships, with heavier levels of drug use than the rest of the sample. The VRSB respondents were largely single and mainly heterosexual, with more sexual partners than the rest of the sample. It was concluded that there was little evidence that very risky behaviour was related to a general risk-taking dimension, to inadequate knowledge about AIDS or to a low assessment of personal vulnerability to AIDS. However, situational influences in association with heavy drug use appeared to be a major component of high-risk injecting behaviour, while high-risk sexual behaviour appeared more to be a reflection of community norms about heterosexual sexual behaviour. The study should be replicated with larger samples, particularly as the VRDB group was so small, but if the findings are reproduced in other studies, it suggests that serious attention should be paid to the promotion of safer sex among injecting drug users.

Journal Article↗
PubMed2002

A review of studies of sexual behaviour of school students in sub-Saharan Africa.

AIMS: This is a review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999. The objective was to describe what is known in this regard and identify gaps in knowledge. METHODS: Literature search using electronic databases and a thumb search of relevant journals identified 47 articles reporting sexual behaviours of school-based young persons aged between 14 and 24 years. RESULTS: The findings indicate a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region; high prevalence rates of sexual intercourse; infrequent use of condoms and other contraceptives; and significant proportions of adolescents who have two or more lifetime sexual partners. More data are needed on the extent to which adolescents engage in non-penetrative sexual behaviour and penetrative sex other than heterosexual vaginal intercourse; characteristics of the sexual partners of adolescents; and proximal psychosocial antecedents of sexual behaviour and consistent risk-reduction behaviours. CONCLUSIONS: Cultural influences on sexual behaviour, the sensitivity of such research in adolescent populations, and the opportunity afforded by school systems for intervention suggest a need for additional exploratory and methodological studies. Placing such information firmly within sociocultural contexts in which young people are raised will better inform effective interventions that both delay the onset of sexual intercourse and encourage use of risk reduction strategies.

Adolescent↗
PubMed2006

Comorbid behavioural problems in Tourette's syndrome are positively correlated with the severity of tic symptoms.

OBJECTIVE: We studied the comorbid behavioural and mood problems in children with non-psychiatric Tourette's syndrome (TS) and their relationship with severity of tic disorder. METHOD: Sixty-nine TS children and 69 healthy controls were assessed by Child Behavior Checklist (CBCL) and Yale Global Tic Severity Scale (YGTSS). The relationships between behavioural problems and severity of tic symptoms were analysed statistically by comparison, correlation and multiple linear regression. RESULTS: Tourette's syndrome patients scored significantly lower (p<0.01) on the CBCL competency subscales and total score, and higher on all behavioural problem subscales and total score (p<0.01). Expectedly, the TS children had lower social competence than normal children. Among the TS children, the severity of tic symptoms is positively correlated with the severity of overall impairment in school and social competence. When the behavioural and mood problems commonly associated with TS were studied in detail, we found that delinquent behaviour, thought problems, attention problems, aggressive behaviour and externalizing are positively correlated with severity of tic symptoms. CONCLUSION: The findings indicated that children with TS-only also had a broad range of behavioural problems, and some of these were related to the severity of tic symptoms.

Adolescent↗
PubMed1997

Residential care for elderly people: the prevalence of cognitive impairment and behavioural problems.

AIMS: to investigate the prevalence of and interrelationship between cognitive impairment and behavioural problems in older people in residential care. SUBJECTS: all those aged 65 years and over resident on one night in any type of residential care within the Leicestershire District Health Authority. METHODS: an assessment form for each resident was completed by care staff. The assessment included demographic information and functioning (both mental and physical) during the previous week. Cognitive impairment was measured by the confusion sub-scale of the Crichton Royal Behavioural Rating Scale. RESULTS: 6079 people were enumerated in 241 establishments, including hospitals, homes and hostels provided by the National Health Service (NHS), local authority social services and private and voluntary agencies. Thirty-eight percent (2219) were moderately or severely cognitively impaired and behavioural problems were present in 11.5%, most being associated with the presence of cognitive impairment. Compared with elderly people in private residential homes, residents in local authority (part III) homes had significantly higher odds of demonstrating offensive behaviour of 1.40 (95% confidence interval 1.11-1.78) after adjustment for age, sex and cognitive impairment. No significant association between number of patients in the home and the proportion exhibiting offensive behaviour was found in any of the non-NHS facilities. CONCLUSIONS: this survey of old people in institutional care found that most of those with behavioural problems were cognitively impaired. This has implications for staff training in the management of behavioural problems in demented people.

Aged↗
PubMed1976

Geriatrics in relation to the social and behavioural sciences.

Social and behavioural gerontology is the scientific study of how men and women adapt to their environment as they grow older. It is a multidisciplinary area, comprising subjects each of which asserts an existence in its own right, as a scientific enterprise, apart from other subjects in the area, and apart from geriatrics. Social and behavioural gerontology, however, forms part of the total context within which geriatrics gets its meaning and value. Geriatrics, in turn, affects these other adjacent disciplines. Social and behavioural gerontology could help in a general way by putting geriatrics into this wide perspective and thus demonstrating the wider issues that might otherwise be neglected in the busy round of geriatric care. Social and behavioural gerontology could also help in numerous particular ways such as: the collection of normative data; improved conceptual analysis; better methods of observation, experimentation, measurement and data analysis; the integration of social and behavioural case-work with clinical geriatrics for both treatment and training purposes; improved techniques of social and behavioural assessment; improvements in communication; better social attitldes; increased self-help and understanding of the role of the elderly in society; more effective consumer behaviour; and more effective social policies incorporating long-range, broad-spectrum preventive measures.

Aged↗
PubMedDate not supplied

The effects of the nitric oxide synthase inhibitor 7-nitroindazole on the behaviour of mice after chronic ethanol administration.

The effects of the nitric oxide synthase (NOS) inhibitor 7-nitroindazole (7-NI) on the behaviour of mice after chronic and acute ethanol administration were studied. Male albino mice received ethanol by inhalation for 25 days. The plus-maze and staircase tests were carried out with control, ethanol-intoxicated and ethanol-withdrawn mice (7.5 h after the end of ethanol administration). The administration of NOS inhibitor 7-NI [20.0 mg/kg, intraperitoneally (i.p.)] 60 min or 7.5 h before the plus-maze test induced an anxiolytic effect in control mice. Chronic ethanol administration induced an anxiolytic, and ethanol withdrawal an anxiogenic, effect in mice. The administration of 7-NI (20.0 mg/kg, i.p.) caused behavioural depression in ethanol-intoxicated mice, but had no effect on the behaviour of ethanol-withdrawn mice. 7-NI had no effect on the behaviour of control mice in the staircase test. Chronic ethanol administration increased, and ethanol withdrawal decreased, the locomotor activity of mice in the staircase test. Likewise, in the plus-maze test, administration of 7-NI caused behavioural depression in ethanol-intoxicated mice, but had no effect on the behaviour of ethanol-withdrawn mice. In additional experiments, vehicle or 7-NI (20.0-120.0 mg/kg, i.p.) were administered 30 min before ethanol (3.0 g/kg, i.p.). 7-NI dose-dependently increased the duration of ethanol-induced sleep and inhibited ethanol clearance. On the basis of these data we can propose that the NO system has no major role in behavioural changes caused by ethanol withdrawal. At the same time NOS inhibitors can cause synergistic CNS depression with ethanol.

Animals↗
PubMed2006

Predicting binge-drinking behaviour using an extended TPB: examining the impact of anticipated regret and descriptive norms.

AIMS: To investigate the utility of an extended Theory of Planned Behaviour (TPB), including descriptive norms and anticipated regret, in predicting binge-drinking intentions and behaviour. METHODS: A total of 178 undergraduates completed a questionnaire containing measures of TPB variables, descriptive norms, anticipated regret, and previous binge-drinking behaviour. One week later, 104 students completed a measure of binge-drinking behaviour. RESULTS: Hierarchical regression demonstrated that attitudes (beta = 0.30, P < 0.001) and anticipated regret (beta = 0.47, P < 0.001) were significant predictors of intentions, with the final equation accounting for 58% of the variance. Hierarchial regression found that intentions (beta = -0.21, P < 0.05) and previous binge-drinking behaviour (beta = 0.36, P < 0.01) predicted current drinking behaviour, accounting for 33% of the variance. CONCLUSIONS: The study suggests that modifying attitudes and inducing regret may be effective strategies for reducing binge-drinking intentions among undergraduates, which should reduce subsequent binge-drinking behaviour.

Adolescent↗
PubMed2005

Three to four years after diagnosis: cognition and behaviour in children with 'epilepsy only'. A prospective, controlled study.

A 3.5-year follow-up study of cognition and behaviour in 42 children with newly diagnosed idiopathic or cryptogenic epilepsy ('epilepsy only') attending mainstream education and 30 healthy gender-matched classmate controls was carried out to identify differences between groups, to detect factors that contribute to the difference and its change over time, and to establish the proportion of poorly performing children. The neuropsychological battery covered the major domains of cognition, mental and motor speed and academic language skills. Children were tested at the time of diagnosis (before any anti-epileptic drug treatment started) and 3, 12 and approximately 42 months later. Parents and teachers completed behaviour checklists, for which the scoring was adapted to prevent any influence of epilepsy-related ambiguity. Based on parental interviews at the time of diagnosis, children with epilepsy were categorized as having longstanding behavioural and/or learning problems, as belonging to a troubled family, as being exposed to 'off-balance' parenting starting at the time of epilepsy onset and/or as reacting maladaptively to the changes in relation to the onset of epilepsy. Throughout follow-up, the group of children with epilepsy only performed less well than healthy classmates on measures of learning, memory span for words, attention and behaviour. After controlling for school delay, proactive interference (number of responses to the same images as in the learning trials, but now presented in reordered locations) was the only remaining variable that distinguished the group of children with epilepsy only. Group-wise, no changes in cognitive and behavioural differences over time were found, but instability in individual performances appeared to characterize children with epilepsy only. Rather than intrinsically epilepsy-related variables, such as idiopathic versus cryptogenic aetiology, seizure control or anti-epileptic drug treatment, the child's prediagnostic learning and behavioural histories and the parents' ability to continue their habitual parenting in the face of the diagnosis of epilepsy only were shown by both group-wise and case-by-case analyses to be important for understanding the cognitive and behavioural functioning of the children with epilepsy only.

Adaptation, Psychological↗
PubMed1999

A critical examination of the application of the Transtheoretical Model's stages of change to dietary behaviours.

This paper proposes that the application of the Transtheoretical Model's stages of change to dietary behaviours may be fundamentally problematic due to the difference in nature between dietary behaviours and the addictive behaviours upon which the model was originally based. It was considered that specific problems associated with stage categorization for dietary change would include: problems due to the potential mismatch between a person's perceived and actual dietary behaviour; and problems due to the use of specific time periods to distinguish between different stages. A total of 541 volunteers completed questionnaires that measured their stage of change with respect to one of three dietary behaviours (healthy eating, eating a low-fat diet, and eating five portions of fruit and vegetables per day). Results indicate that people who were actively making a change (actors) or maintaining a change (maintainers) had done so for a range of different periods of time, with no specific cut-off point being evident. Also, more realistic stage categorizations were evident for the most specific dietary behaviours where there was least likelihood of a mismatch between perceived and actual dietary behaviour. Problems associated with issues of operationalization of the model and the application of the stage model to dietary change are discussed.

Adolescent↗
PubMed2006

Understanding successful behaviour change: the role of intentions, attitudes to the target and motivations and the example of diet.

Although many attempts to change health behaviour fail, some individuals do show successful behaviour change. This study assessed the role of behavioural intentions, motivations and attitudes to the target in explaining successful changes in diet with a particular focus on positive and negative intentions and positive and negative attitudes. Participants (n=282) completed a questionnaire describing a recent change in eating behaviour (becoming a vegetarian, cutting out a food group, eating fewer calories), their intentions, their attitudes to the food being avoided, a range of motivations and their degree of success. The results showed that the three behaviour change groups differed in terms of their cognitions with those trying to eat fewer calories reporting less success in changing their behaviour. Successful vegetarianism was associated with a lower positive attitude; successfully cutting out a food group was related to ethical motivations, a lower positive attitude and greater positive and negative intentions, and reducing calorie intake was associated with greater positive intentions and a lower positive attitude. Therefore, success was associated with different cognitions depending upon the type of change being made, although cognitions such as 'I will eat more vegetables' and 'I no longer find high fat foods palatable' were consistently most predictive of success. Suggestions for the development of more effective interventions to change health behaviours are made.

Behavioral Research↗
PubMed1998

Does childhood socioeconomic status influence adult health through behavioural factors?

BACKGROUND: The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. METHODS: Data were obtained from the baseline of a prospective cohort study in the Netherlands (13 854 respondents, aged between 25 and 74). Childhood socioeconomic group was indicated by occupation of the father, and adult health was indicated by perceived general health, health complaints and mortality. Adult socioeconomic status was measured by current occupation. Behavioural factors were smoking, alcohol consumption, Body Mass Index and physical activity. Relations were analysed using logistic regression models. RESULTS: A clear association between childhood socioeconomic circumstances and adult health was shown, as well as an association between childhood socioeconomic circumstances and health-related behaviour, even after adjustment for current socioeconomic status. Physical activity shows the strongest relation with childhood socioeconomic circumstances. Behavioural factors explain the relation between childhood socioeconomic status and adult health for approximately 10%. CONCLUSIONS: Childhood socioeconomic circumstances have an independent effect on adult health and health-related behaviour: the risk of health problems and health damaging behaviour is higher in lower childhood socioeconomic groups. The independent effect of childhood circumstances on adult health operates for a small part through unhealthy behaviour.

Adolescent↗
PubMed2001

Birthweight and behavioural problems in children: a modifiable effect?

BACKGROUND: Low birthweight has been shown to predict behavioural problems in children. Less is known about the effect of birthweight, and how this may interact with the social environment in determining behaviour in a general population sample. We have examined the relationship between birthweight and social factors on childhood psychological well-being. METHODS: Cross-sectional analysis of data on 5181 children aged 4-15 years from a randomly selected household population, the 1997 Health Survey for England. The main outcome measures were behavioural problems as defined by the Strengths and Difficulties Questionnaire (SDQ) in relation to birthweight and social environmental factors. RESULTS: Birthweight was a significant predictor of total difficulties score (odds ratio [OR] = 1.27, 95% CI : 1.07, 1.49), hyperactivity in boys (OR = 1.25, 95% CI : 1.05, 1.51), and peer problems in girls (OR = 1.24, 95% CI : 0.99, 1.53). There was a strong social class gradient in the prevalence of behavioural problems for all birthweight tertiles. Bivariate analysis showed that high total difficulties score was significantly more common in lower birthweight tertiles for social classes III non-manual and III manual (P:-value for trend 0.05 and 0.03, respectively). There were smaller, non-significant effects of birthweight on the prevalence of behavioural problems in social class I and II, and IV and V. Statistical tests for an interaction between birthweight and social class were not significant. CONCLUSIONS: Early life factors, such as birthweight and social class have important influences on psychological well-being in children. The birthweight effect is influenced by social factors, with the possibility that an advantaged social environment protects against the development of behavioural problems, and a disadvantaged environment increases the risk of behavioural problems, regardless of birthweight.

Adolescent↗
PubMed2003

Dietary self-efficacy: determinant of compliance behaviours and biochemical outcomes in haemodialysis patients.

BACKGROUND: Despite the diversity of proposed theories, researchers are still unable to fully explain dietary compliance behaviours of dialysis patients. Dietary self-efficacy, a concept less studied in dialysis, has been linked to positive compliance outcomes in the chronic illness literature. Therefore, the aim of the present research was to determine how dietary self-efficacy is related to selected biochemical markers and self-reported behavioural outcomes in haemodialysis patients. METHODS: 107 subjects participated in a cross-sectional study. Four questionnaires assessed dietary self-efficacy, compliance attitudes and behaviours, and staff-patient relationships. Laboratory outcomes were retrospectively obtained from patients' medical records and averaged for the previous 6 months. RESULTS: Of the behavioural measures, only dietary self-efficacy was associated with laboratory outcomes. Dietary self-efficacy was also positively related to staff-patient relationships and to patients' self-reported assessment of compliance behaviours. Women had greater dietary self-efficacy than men. The number of family members living with the respondent was inversely related to dietary self-efficacy. CONCLUSIONS: Results indicated that dietary self-efficacy determined both behaviours and laboratory outcomes. Patients with greater dietary self-efficacy had lower serum potassium and weight gain, showed favourable compliance attitudes and behaviours toward prescribed regimens and fostered better relationships with staff. Based on these findings we recommend an experimental approach to clarify whether maximizing dietary self-efficacy efforts is without psychological burden to patients and whether the positive effect of increased dietary self-efficacy is maintained in long-term dialysis patients.

Cross-Sectional Studies↗
PubMed1992

Rutter's Behaviour Scale (B2) for children (Teacher's Scale): validation and standardization for use on Nigerian children.

Nigerian teachers were asked to place the children in their classes in either of two groups: Group I, comprising children of normal behaviour, and Group II, children who, in their opinion, had significant behavioural problems. Validity of the teachers' grouping was confirmed, using as reference measure the findings from traditional psychological assessment of the children. The teachers then completed the Rutter Child Behaviour Questionnaire (Teachers' Scale) for the same children. The children's scores on the Rutter Scale were matched against the teacher's grouping, the aim being to identify the Rutter Score that separates the children into two 'behaviour' groups that agree most closely with the teachers' own grouping. Results show that this was achieved at the Rutter Score of 10 (k = 0.66). Children scoring 10 or more on the Rutter scale appeared mostly in Group II, while those scoring less than 10 were mostly in Group I. Rutter's scale was also found to be a highly valid instrument for identifying Nigerian children with behavioural problems. It is recommended that Nigerian children scoring > or = 10 on Rutter's Behaviour Questionnaire (Teacher's Scale), should be regarded as children with behavioural disorder. This is one point higher than the score of > or = 9 recommended for British children.

Adolescent↗
PubMed2002

HIV dynamics and behaviour change as determinants of the impact of sexually transmitted disease treatment on HIV transmission in the context of the Rakai trial.

OBJECTIVE: To assess how the impact of sexually transmitted disease (STD) treatment on HIV incidence varies between stages of the HIV epidemic. METHODS: We simulated the spread of curable STD, herpes simplex virus type 2 and HIV in the dynamic transmission model. Parameters were quantified to represent a severe HIV epidemic as in Rakai, Uganda, using demographic, behavioural and epidemiological data from a recent STD treatment trial. RESULTS: The model fitted the HIV epidemic in Rakai if we assumed a considerable behavioural risk reduction, starting at the end of the Ugandan civil war in 1986. An improvement in STD treatment reduced HIV incidence in this population by 35% over 2 years if implemented in 1981, but only by 11 and 8% in 1988 or 1998. This trend resulted partly from the hypothesized behaviour change, which markedly reduced the prevalences of bacterial STD. In a simulated epidemic without behavioural change, the corresponding treatment impacts in 1988 and 1998 would be 19 and 15%. Enhanced herpetic ulceration in immunocompromised HIV patients contributed little to the reduced impact of treatment of bacterial STD over time. CONCLUSION: In HIV epidemics beyond the first decade, the impact of STD treatment programmes on HIV transmission may depend more on behavioural risk reduction than on the stage of the epidemic. Preceding behavioural change associated with restored civil stability may have contributed to the lack of impact of STD treatment on HIV in the Rakai trial. In advanced epidemics with less behaviour change, STD treatment may still be important for HIV prevention.

Adolescent↗
PubMed2001

Readiness to change sun-protective behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden during the last 20 years. The best-known way to revert this trend is primary prevention. Matching health messages to readiness to change in the population may enhance the effect of community-based prevention. The aims of this study were to investigate readiness to change sun-protective behaviour in two groups (visitors to mobile screening units and beach-goers) and to test a single-item algorithm in assessing the stage of change in sun-protective behaviour. Seven hundred and forty-two visitors to the mobile screening units and 202 individuals on nearby beaches answered a short questionnaire. The assessment of readiness to change was based on stages of change in sun-protective behaviour modified from the Transtheoretical Model of Behaviour Change. As expected, the visitors to the screening units were more often in action/maintenance stages than the beach group for most sun-protective behaviours. In conclusion, the single-item algorithm method appears to be sensitive to assess readiness to change sun-protective behaviour, based on the Transtheoretical Model of Behaviour Change. This method can be incorporated into population surveys and may aid in developing successful skin cancer prevention programmes.

Adult↗
PubMed2002

Sunbed use at home: risk behaviour and psychosocial determinants.

The objective of this study was to analyse the behaviour of people with regard to sunbed use at home, and to analyse the psychosocial determinants of intention and behaviour with regard to limiting the health risk of using sunbeds at home. Data were collected by means of a telephone survey among 349 adults from the Dutch general public who use sunbeds at home (response=95%). Determinants that were assessed were: attitude with respect to safer use and the use of sunbeds in general, the social influences people encounter to use sunbeds in a safer way, and the self-efficacy expectations people have of their ability to use sunbeds more safely. The results showed that there were great differences between people's perceptions of their safe sunbed behaviour, and their actual safety behaviour. Almost all respondents (94%) thought that their sunbed behaviour was safe, while in reality only 37% of the respondents used the sunbed in accordance with the safety guidelines. The safer users of sunbeds differed on many determinants from the unsafe users. Intention to minimize the health risk when using sunbeds could be predicted by a person's perceived self-efficacy, the overall attitude and anticipated regret beliefs (R2=0.52). Sunbed users should be made aware of their risk behaviour with regard to sunbeds as well as providing information on changing determinants, in order to positively change people's intentions and behaviour with regard to the safer use of sunbeds.

Adolescent↗