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PubMed1984

A return to time, cells, systems and aging: II. Relational and reliability theoretic approaches to the study of senescence in living systems.

In this paper, we approach the problem of attempting to understand senescence by understanding the complexity and hierarchical structure of mammalian organisms. To do this, we make use of some concepts from abstract relational biology; in particular, graph theory. We subsequently utilize these concepts to develop the idea of an irreplaceable element in a mammalian system. We then make use of these elements, and some concepts from reliability theory, to show how senescence processes in mammalian systems may be related to the failure of a critical number of irreplaceable elements. Finally, we show how we may derive formulas for the expected number of elements which fail by a given time, and how this time is related to actual lifespan and expected lifespan of the organism. In particular, we relate this to some recent work by Cutler on the evolution of longevity.

Aging↗
PubMed2004

Practice nurses' intentions to use clinical guidelines.

BACKGROUND: Evidence indicates that, although nurses are increasingly using clinical guidelines to ensure higher quality of care, there is a wide variance in their adherence to them. The utility of the Theory of Planned Behaviour (TPB) has not been previously investigated in explaining this variance in community nursing. AIM: This paper reports a study whose primary aim was to examine the utility of the TPB in explaining variations in practice nurses' intentions to offer smoking cessation advice in accordance with coronary heart disease guidelines. METHODS: A cross-sectional survey using a postal questionnaire was carried out. A 52-item questionnaire was administered to 48 practice nurses in England. The questionnaire was designed to assess the components of the TPB, and included measures of intentions to offer smoking cessation advice, self-reported past behaviour, attitudes, subjective norms, perceived behavioural controls (PBCs), behavioural beliefs and evaluations, normative beliefs and motivation to comply, and control beliefs and evaluations. RESULTS: The TPB explained up to 40% of variance in intentions to offer smoking cessation advice. Attitudes and PBCs were the most important predictors of intention. Among other elements of the TPB, indirect attitudes and indirect PBCs made significant positive contributions to explaining variance in intention. DISCUSSION: Future trials of interventions to increase practice nurses' adherence to clinical guidelines could attempt to address the elements identified in this study as important factors. Further studies are required to examine the utility of the TPB in predicting practice nurses' behaviour.

Adult↗
PubMed2005

Surface migration of branched molecules: analysis of energetic and entropic factors.

We have introduced energetic factors into the response theory developed by Wu and Fredrickson [Macromolecules 29, 7919 (1996)] to predict the enrichment of branched molecules due to architectural effects at surfaces. This development simultaneously increases the utility of the theory for guiding experimental investigations, and makes possible a rigorous assessment of theoretical predictions in careful studies of isotopically labeled linear/branched species binary blends at surfaces. For example, the introduction of energetic factors allows us to predict the existence of a crossover molecular weight, below which an energetically unfavorable species at a surface can be enriched entirely due to architecture. For binary blends of linear chains, the degree of polymerization (Kuhn) of the energetically unfavorable species at the crossover point is r(c) approximately =2U(e)/DeltaU(s). Here, U(e) is the attraction of chain ends towards the surface and DeltaU(s) is the difference in the interaction potential of main chain segments to the surface due to chemical differences and/or isotopic labeling. We also show that surface segregation of an additive in a host polymer due to architectural effects alone is significantly enhanced as the spinodal temperature of a branched/linear blend is approached. Detailed comparisons of the modified response theory with lattice simulations are used to evaluate the theory and to determine the limits of its applicability.

Journal Article↗
PubMed1987

Smokeless tobacco use by middle school males: a preliminary test of the reasoned action theory.

This study identified psychosocial variables associated with smokeless tobacco use within the context of the reasoned action theory. One hundred twelve male students, ages ten-14, completed a questionnaire that operationalized components of the theoretical model. Multiple regression analyses revealed intention to use smokeless tobacco correlated significantly with attitude toward the behavior and perceived social pressure. As predicted by the theory, significant differences between those who intended to use smokeless tobacco and those who did not were found on several outcome and normative beliefs. The data support the utility of the theory as a means of explaining smokeless tobacco use. Future research recommendations are offered.

Adolescent↗
PubMed1994

King's theory in practice with elders.

This article discusses the utilization of Imogene M. King's (1981) theory of goal attainment with a group of elderly clients who were living in a nursing home and experiencing many of the chronic health problems frequently associated with advanced age. Group members met weekly for 10 weeks to explore methods to promote continuous health restoration. Application of King's theory of goal attainment, utilizing interactions, transactions, perceptions, and expressions of self, facilitated mutual nurse-client goal identification and achievement.

Adaptation, Psychological↗
PubMed2007

Understanding physical activity in adolescent cancer survivors: an application of the theory of planned behavior.

Notwithstanding the remarkable achievements in survival, there is a growing recognition that pediatric cancer survivors are faced with a variety of chronic health problems that may be exacerbated by maladaptive health behaviors. The purpose of the present study was to examine the utility of the theory of planned behavior (TPB) in understanding adolescent survivors' motivation to engage in physical activity. A group of adolescent cancer survivors recalled their beliefs, attitudes, norms, perceptions of control, intentions and post-treatment physical activity behaviors using a self-administered, mailed questionnaire in a retrospective design. Multiple regression analyses revealed that the TPB explained 29.1% of the variance in physical activity behavior, with the significant independent correlates being intention (beta=0.31,p=0.023) and self-efficacy (beta=0.42,p=0.04). For intention, 33.7% of the variance was explained by the TPB, with affective attitude (beta=0.32,p=0.016) and instrumental attitude (beta=0.31, p=0.037) making significant unique contributions. The present study has provided some of the first data toward understanding physical activity behavior in adolescent cancer survivors. Specifically, the results suggest that interventions designed to promote physical activity in this population should focus on the development of a positive attitude as well as fostering an enhanced sense of self-efficacy.

Adolescent↗
PubMed1991

The reported quality of life of selected home hemodialysis patients.

The quality of life (QoL) of 10 home hemodialysis (HHD) patients was studied using the Aristotelian-Thomistic philosophical theory of the good life. According to this theory, seven types of real goods are required to have a good life. Semistructured interviews were used to determine whether the patients possessed these goods. Also, card sort tasks were used to obtain the patients' ranking of these goods in terms of the importance of the goods and time spent acquiring them. It was found that the subjects were seriously deprived of some of the real goods required to have a good life, including health, vigor, pleasurable feelings, freedom of action, and free time. Goods of personal association and goods of the body were of greatest importance to the subjects. It appears that this theory has some utility in assessing QoL of patients on HHD.

Adolescent↗
PubMed2006

Collaborative goal technology: theory and practice.

Goal striving promotes hope and enhances motivation, which is important for psychosocial rehabilitation and recovery. The Collaborative Goal Technology (CGT) is a new goal striving intervention that is used to support the autonomy and recovery processes of the person with a psychiatric disability. The CGT protocol and its utility are outlined. Theory and research from goal striving, motivation and mental health recovery domains that informed the development of CGT are described. A case example is also provided.

Case Management↗
PubMed1988

Unilateral displacement in the olfactory sense: a manifestation of the unilateral neglect syndrome.

Unilateral neglect is a syndrome primarily occurring with right hemisphere--particularly right parietal lobe--brain damage and involving the failure to respond to stimuli presented to the left side of the body and space. Unilateral displacement (a less severe manifestation of the neglect syndrome) involves the accurate identification of a stimulus, but the displacement or mislocalization of that stimulus to the opposite side of the body and space. This study investigated two major theories of unilateral neglect utilizing the primarily ipsilaterally innervated olfactory sense. The sensory theory states that unilateral neglect is due to a diminished sensory input, whereas the representational theory states that it is due to a disordered internal representation which is not dependent on sensory input. Results revealed that right hemisphere lesion patients with left unilateral neglect exhibited a significantly greater number of displacements in their left nostril on olfactory double simultaneous stimulation, consistent with the representational theory.

Brain Diseases↗
PubMedDate not supplied

Commentary: a patient-centered theory of satisfaction.

The Primary Provider Theory holds that patient satisfaction occurs at the nexus of provider power and patient expectations. More specifically, patient satisfaction is principally the function of an underlying network of interrelated satisfaction constructs--satisfaction with the primary provider, waiting for the provider, and satisfaction with the provider's assistant(s). Hierarchically linked to patient-centered expectations of provider value, the Theory specifies that primary providers offer the greatest clinical utility to patients. The Theory is operationalized by patient-centered measures exclusively, where only patients judge the quality of service and all other judgments are immaterial. Bearing in mind the Institute of Medicine's recent recommendations to clinicians regarding the implementation of a new level of patient-centered care, the Primary Provider Theory offers an alternative paradigm for the measurement and realization of patient satisfaction. It can inform patient-centered physician practice, medical education, quality improvement, outcome measurement, and satisfaction survey construction.

Decision Making↗
PubMed1990

Effects of a brief theory-based intervention on the practice of testicular self-examination by high school males.

This preliminary study evaluated a brief intervention, based on the theory of planned behavior, designed to encourage high school students to practice testicular self-examination (TSE). Ninety-nine male ninth and 10th grade students were exposed to a message challenging beliefs about outcomes of performing TSE as suggested by the theory of planned behavior, a message providing information about TSE and testicular cancer, or a control message, after which they completed a questionnaire operationalizing components of the theoretical model. Four weeks later, students reported their practice of TSE. As predicted, students exposed to the theory-based message reported a stronger intention to perform TSE and, at follow-up, were more likely to report having performed the exam than study participants exposed to other messages. Data provide partial support for the utility of the theory of planned behavior as a framework for constructing health-promoting messages. Future research recommendations are offered.

Adolescent↗
PubMedDate not supplied

Exploring social cognitive theory constructs for promoting exercise among breast cancer patients.

Physical activity during breast cancer treatment can significantly reduce treatment-related fatigue and improve quality of life. Unfortunately, the majority of women with breast cancer either do not exercise at all or exercise below recommended levels. Little is known about how to enhance physical activity among breast cancer patients. The social cognitive theory, a useful framework for the design of physical activity interventions, has not been studied among breast cancer patients. Our study purpose was to explore physical activity knowledge, attitudes, and behaviors among breast cancer patients during adjuvant therapy utilizing social cognitive theory constructs in preparation for a larger, survey study and future intervention research. Twelve breast cancer patients attended 1 of 3 focus group sessions. Focus group questions were based on the social cognitive theory constructs of self-efficacy, environment, behavioral capability, expectations, expectancies, self-control and performance, observational learning, and reinforcement. The focus group participants generally felt confident in their ability to exercise during treatment if fatigue, time management, and social networking were addressed. The majority of participants had not been given information related to exercise by their physicians during treatment. The participants felt that exercise was more beneficial than harmful during treatment, with the 2 most important benefits identified as reduced fatigue and the potential for improved survival. The use of reinforcements by participants was minimal. The participants consistently expressed the desire for education and guidance by knowledgeable staff during an exercise program. Walking was the most acceptable exercise modality. Social cognitive theory may be a useful framework for future study of exercise behavior among breast cancer patients and measurement of constructs related to this theory should be included in such studies. Future exercise intervention studies should consider the unique barriers and program preferences of breast cancer patients while focusing on self-efficacy, outcome expectations/ expectancies, observational learning, and reinforcements.

Adult↗
PubMed2004

Does theory inform practice in health promotion in Australia?

In recent years, there have been numerous papers discussing the importance of improving the link between health promotion researchers and practitioners. Several reviews have been undertaken to determine the extent to which health promotion research is disseminated to, and utilized by, practitioners in the development and implementation of health promotion programs. These studies have generally been limited to reviews of literature rather than directly gathering data from practitioners. This paper reports on a survey of Australian health promotion practitioners undertaken to investigate the extent to which they are aware of, understand and utilize the major health promotion theories and models derived from research in the areas of psychology and communication. We found that none of the theories or models included in this study-the 'standard' theories and models taught in health promotion courses, and included in the leading textbooks-were used by more than 50% of practitioners in their work. The only models being used by more than one-third of the practitioners were PRECEDE-PROCEED and the Transtheoretical (Stages of Change) Model. The paper concludes with possible explanations for the low level of utilization of theories and models, and suggestions for increasing their usage based on information sources accessed by these practitioners.

Australia↗
PubMed1997

The use of metaphor by an artless first-time psychotherapist.

The experience in a psychiatric residency of being a psychotherapist for the first time can be overwhelming and anxiety-provoking. This paper examines a first psychotherapy case which utilizes a theory-distant approach based on the use of metaphor. Metaphorical theory is reviewed, and potential benefits and pitfalls of using metaphor are examined. An in-depth case study is done, focusing on the following six metaphors: Art as Psychotherapy; Psychotherapy as Art; The World Is a Trap; Mothers Are Martyrs; StepMothers Are Evil; and Artists Are Crazy. Each metaphor was utilized in multiple layers through the course of the therapy. Some of the current research in the use of metaphor in psychotherapy is reviewed. Through this approach, I was able to develop necessary psychotherapeutic skills without being overwhelmed by traditional theories such as Freudian, Object Relations or Self Psychology. I conclude that the use of metaphor with my first psychotherapy patient strengthened the therapeutic alliance, allowed an idiosyncratic language to develop in the therapy, structured recurrent themes, and permitted me to respect the patient's defenses.

Adolescent↗
PubMed1995

Relationship between sexual experience and non-sexual behaviours among secondary school students in Arusha, Tanzania.

A sexual behaviour study was conducted among 655 secondary school students to assess the association between sexual experience and non-sexual behaviours. Among students aged 15-19 years, the prevalence of nonvirginity increased with age, from 58.8% to 85.6% for males, and from 21.9% to 44.9% for females. Sexual experience correlated positively with measures of problem behaviours (r = .31) and negatively with a measure of church or mosque attendance (r = -.09). Overall, the relationship between sexual experience and non-sexual behaviours demonstrated the conventionality-unconventionality polarity suggested by problem behavior theory. The observed relationships were relatively stronger at young ages and declined with increasing age, suggesting the developmental functions of these behaviours. Hence, the relations between sexual experience and non-sexual behaviours provided empirical support of the potential utility of the theory of problem behaviour in HIV/AIDS prevention and control among students in Arusha, Tanzania.

Adolescent↗
PubMed1987

Leukotriene B4 catabolism: quantitation of leukotriene B4 and its omega-oxidation products by reversed-phase high-performance liquid chromatography.

LTB4 and its omega-oxidation products may be rapidly, sensitively, and specifically quantitated by the methods of solid-phase extraction and reversed-phase high-performance liquid chromatography (HPLC), which are described in this chapter. Although other techniques, such as radioimmunoassay or gas chromatography-mass spectrometry, may be utilized for quantitative analysis of the lipoxygenase products of arachidonic acid, only the technique of reversed-phase HPLC can quantitate as many as 10 metabolites in a single analysis, without prior derivatization. In this chapter, we also reviewed the chromatographic theory which we utilized in order to optimize reversed-phase HPLC analysis of LTB4 and its omega-oxidation products. With this information and a gradient HPLC system, it is possible for any investigator to develop a powerful assay for the potent inflammatory mediator, LTB4, or for any other lipoxygenase product of arachidonic acid.

Chromatography, High Pressure Liquid↗
PubMed1991

Theories of back pain and health care utilization.

Because most people in the United States have occasional back pain, demand for the treatment of back pain is widespread. Yet, few treatments have proven to be more effective than placebo therapy. We examine patterns of treatment that have emerged in the absence of definitive treatment. We concentrate on high-cost users of back pain treatment (i.e., chronic pain patients) and high-cost treatments (i.e., surgical and non-surgical hospitalization for low back pain). The small minority of back pain patients whose disability persists into chronicity (90 days or more) accounts for a disproportionate amount of all back pain costs. Interventions have been developed to prevent back pain but, once back pain has already occurred, little is done to prevent it from becoming chronic. Drug therapy may be used to treat the symptom of chronic pain, the cause of which may not be thereby affected. Regarding high-cost treatments, surgical and nonsurgical hospitalizations for low back pain are common practices in the United States. Pain specialists for the past 15 years have advocated a conservative approach to back pain, but the rate of surgery for low back pain increased during this time. Average lengths of stay for surgical and nonsurgical low back pain hospitalizations decreased. We explore why, in the instance of low back pain surgery, change was resisted, whereas, in the instance of average lengths of stay, change was accepted. In view of why change may be resisted or accepted, we discuss interventions designed to change physicians' practice style.

Back Pain↗