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Crossing roads safely: an experimental study of age differences in gap selection by pedestrians.

The over-representation of older pedestrians in serious injury and fatal crashes compared to younger adults may be due, in part, to age-related diminished ability to select gaps in oncoming traffic for safe road-crossing. Two experiments are described that examine age differences in gap selection decisions in a simulated road-crossing environment. Three groups of participants were tested, younger (30-45 years), young-old (60-69 years) and old-old (>75 years). The results showed that, for all age groups, gap selection was primarily based on vehicle distance and less so on time-of-arrival. Despite the apparent ability to process the distance and speed of oncoming traffic when given enough time to do so, many of the old-old adults appeared to select insufficiently large gaps. These results are discussed in terms of age-related physical, perceptual and cognitive limitations and the ability to compensate for these limitations. Practical implications for road safety countermeasures are also highlighted, particularly the provision of safe road environments and development of behavioural and training packages.

Accidents, Traffic↗

Microbial allies in a cotton pest: A descriptive account of associated microbiota dynamics in Dysdercus cingulatus across development.

BACKGROUND: Hemipteran insects harbour several symbiotic partners, mainly bacteria, which play pivotal roles for hosts like dietary provision, support overall physiology, xenobiotic degradation and manipulate/regulate behaviour. Most of these symbionts usually reside and operate from the digestive tracts of the animals. Cotton is one of the major cash crops in India and Dysdercus cingulatus (D. cingulatus) though a secondary pest, is causing significant destruction of cotton bolls, poor lint quality and reduce oil content of seeds. Premature opening of cotton bolls often leads to bacterial and fungal infections, thus resulting in extensive economic loss worldwide. D. cingulatus is a hemimetabolous insect that comprises of developmental stages like egg, nymph (5 instar stages), and adult. The present work explored the ontogeny specific diversity in the associated microbiota and predicted their probable functional inputs in D. cingulatus. RESULTS: The data obtained using 16S rRNA gene sequencing (NovaSeq 6000) revealed presence of members of Proteobacteria (65.83%), Firmicutes (24%), Actinobacteria (10%) phyla throughout the ontogeny of D. cingulatus. Highest alpha diversity of these symbiotic bacteria was recorded in the third instar nymphs in contrast to rest of the developmental stages. Among all the observed genera, Stenotrophomonas, Hungatella and Glutamicibacter were predominant from egg to adult stages. MicFunPred, a tool used for predicting the probable functional inputs of these symbionts, hinted at their probable stage specific contribution in crucial biochemical pathways such as polyketide biosynthesis, ascorbate/aldarate metabolism, pentose phosphate and glyoxylate cycles, steroid hormone and peptidoglycan biosynthesis, and glycolysis/pyruvate metabolism. CONCLUSIONS: The primary investigations on the ontogenetic composition and diversity of associated microbiota, suggest dynamic shifts in D. cingulatus, concurrent with their probable functions/roles in the host development and metabolism. To the best of our knowledge, this is the first report on symbiotic microbiota variation across the developmental stages of D. cingulatus that provides preliminary descriptive observations that may guide future functional and experimental investigations into microbiota-based pest management.

Animals↗

Consequences of HIV testing without consent.

The objective of this study is to explore the HIV-infected individuals' experience with HIV testing, counselling, disclosure of diagnosis and subsequent life events following diagnosis. The method used is a questionnaire survey of 340 consecutive HIV-positive victims, seen in two health institutions in southeast Nigeria within a one-year-period, November 2003 to October 2004. Three hundred and twenty respondents answered the questionnaire, 121 were men and 199 women, with 79% in the age range 20-39 years. Most respondents had known their HIV status for 3.2 (+/-1.1) years and the majority are in the lower social class. About 80% reported that their consent for HIV test was not asked for, resulting in feelings of fear, disbelief, shock and embarrassment on learning about their HIV status. Despite the initial reaction to the diagnosis, majority (81.9%) expressed satisfaction with the pattern of disclosure of diagnosis. There was some reluctance to inform spouse/partner of the diagnosis especially among asymptomatic, unmarried, childless or divorced victims. A serodiscordant couple resulted in mistrust and increased incidence of abandonment. Apart from spouse/partner the respondents are more likely to inform their siblings of the diagnosis than parents, children or friends. Despite being supportive, the respondents are more likely to suffer more neglect from siblings than their spouse (P<0.05) but the risk of being abandoned was more with the spouse than with siblings (P<0.05). Only 32.6% of the 129 respondents on antiretroviral therapy are regular with it mainly because of cost and non-availability of drugs. Default in treatment was more evident among the unmarried, those with low educational status and treatment with antiretroviral drugs for more than two years. Proper pre- and post-test counselling, promotion of behavioural change among the society about HIV/AIDS and provision of support and cost-effective care for HIV victims is advocated.

Adult↗

Compliance and psychological reactance in schizophrenia.

OBJECTIVES: Non-compliance with neuroleptic medication in schizophrenia is a major cause of relapse. A number of sociodemographic variables, and illness, attitudinal and treatment variables, have been demonstrated to be associated with non-compliance. The present study examined a range of these variables and their predictive value in determining past and current compliance. METHODS: Thirty-nine patients suffering from schizophrenia and three patients suffering from schizoaffective disorder completed a series of questionnaires assessing psychological reactance, insight, subjective response to medication, perceived threat to freedom of choice, and degree of current and past compliance. Logistic regression analyses were performed to determine which factors best predicted past and current compliance. RESULTS: Psychological reactance and age were found to be the best predictors of past compliance, with an interaction between reactance and perceived threat to freedom of choice posed by treatment provision also making a significant contribution. Past compliance behaviour and subjective response to medication predicted current compliance most significantly. CONCLUSIONS: Reactance is an important predictor of compliance history especially when patients perceive treatment to be a threat to freedom of choice. Subjective response to neuroleptics is most important in predicting current compliance. Implications for intervention are discussed.

Adult↗

The management of tinnitus with or without Menière's disease.

More than 95% of tinnitus patients do not require anything but careful examination and explanation, i.e. directive counselling. The first and principal therapy consists of history taking and routine ear, nose and throat (ENT) examination, including a thorough audiometric assessment with tinnitus analysis. The best management of the patient appears to be a behavioural approach centred on the complaint, including information provision and explanation, discussion of treatment options, and an informed selection from the alternatives available.

Humans↗

[The raising of pigs--modern and fair to the animals].

A sow can cope better with a husbandry system if a new situation is in accordance with her expectations and if she has been prepared sufficiently for the social and technical problems, she will have to face. In relation with applied ethology this means, that a sow should be prepared adequately for a group-housing system of pregnant sows, by a previous establishment of the social hierarchy in her (sub)group; a previous training in operating the feeding station; providing a part of the house where she is safe for aggressive other sows; providing two simultaneous and undisturbed meals of roughage per day for all sows; providing appropriate possibilities for locomotory and for exploratory behaviour. For a farrowing house are the following provisions required: the lying places (farrowing nest) shall be clearly distinguishable for the sows; sufficient long straw for allowing satisfactory nest building shall be present in the nests; a sow shall be able to turn around in the farrowing nest; the sows shall be able to ly in a position with their heads close together; the feeding station shall be in the nearest proximity; the piglets shall be able to mix gradually after their first week of life.

Animal Husbandry↗

[Erectile dysfunction].

Erectile dysfunction is somatically (anatomical, vascular, neurogenic, hormonal defect), psychologically and socially conditioned. For the diagnosis and treatment assessment of the ratio of psychogenic and non-psychogenic influences is decisive. The basis is a detailed case-history, somatic examination, result of testing the effect exerted by local negative pressure on erection, intracavernous administration of vasoactive substances and possibly other examinations. From this ensues the range of provisions: regime, relations, psychological, psychotherapeutic (with emphasis on behavioural aspects), medicamentous (non-invasive and invasive), physical and surgical. The limited information of health workers and other people on this problem calls for intensive educational activities.

Erectile Dysfunction↗

[Prevalence of chronic alcoholism in non-medical personnel at a hospital center].

The incidence of chronic alcoholism among the non-medical staff of a hospital was evaluated in an occupational health service context. Three criteria were sought routinely: suspicion by history of excessive alcohol intake, typical findings by physical examination, and suggestive behavioural changes reported by work colleagues. Gamma glutamyl transpeptidase levels and mean corpuscular volume were measured when one of these three criteria existed. The diagnosis of chronic alcoholism was made when two criteria were found or when only one criterion existed but accompanied by laboratory abnormalities. The incidence of chronic alcoholism was 6.2 per cent among male staff and 0.6 among female staff. It appeared to be less than in the population as a whole. The selective and non-systematic use of laboratory investigations and the frequent absence of indication to the occupational health physician of behavioural problems were sources of bias which probably contributed to underestimation of the incidence of chronic alcoholism among employees of the Orleans Regional Hospital Group. Provision of information to all staff is essential in order to explain the behavioural changes associated with chronic alcoholism and the usefulness of reporting employees showing evidence of such changes to the occupational physician. This enables medico-social diagnosis and the early care of those with early chronic alcohol abuse.

Alcohol Drinking↗

Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beijing, China.

AIMS: The aims of the study were to develop an understanding of caring in nursing from the perspective of cancer patients and attempt to identify the concept of caring in the Chinese cultural context. BACKGROUND: Caring as a concept remains elusive, the acceptable definitions of the term care have not been reached. The expressions, processes and patterns of caring vary among cultures, but there is a lack of Chinese culture-based study about caring in nursing. METHODS: A qualitative research design was used and 20 cancer patients were interviewed using a semi-structured interview guide. A qualitative content analysis was used to identify themes in the data. RESULTS: Three themes emerged from the data, which suggested that caring is delivering care in an holistic way: nurses' caring attitudes and their professional responsibility for providing emotional support, nurses' professional knowledge and their professional responsibility for providing informational support and nurses' professional skills and their professional responsibility for providing practical support. The caring behaviour of nurses as perceived by cancer patients involved the provision of emotional, informational, and practical support and help based on patients' needs. A model of caring in nursing was formulated. CONCLUSIONS: Caring in nursing as perceived by cancer patients involves nurses having qualified professional knowledge, attitudes and skills in oncology and providing the informational, emotional and practical supports and help required by cancer patients. RELEVANCE TO CLINICAL PRACTICE: Caring is manifested in nursing actions through nurse-patient communication process. Patients have their inner expectation for nurses' caring behaviour and attitudes and nurses' performance of caring or uncaring behaviour has a direct influence on the feelings of patients. It is necessary for all nurses to continue improving their oncology professional knowledge, attitudes and skills as well as their abilities of offering informational, emotional and practical support and help for their cancer patients.

Adult↗

Social and nonsocial behaviours of sex- and age-matched enclosed and free-ranging rhesus monkeys (Macaca mulatta).

The behavioural profiles (time budgeting of social and nonsocial activities) and the frequencies of major social interactions of corral-enclosed rhesus monkeys were compared with sex- and age-matched free-ranging rhesus monkeys on La Cueva Island, Puerto Rico. All animals (n = 32) were provisioned ad libitum at specific feeder sites. The occurrence of 14 behaviours around feeders was compared with their occurrence away from the feeders by noting the location of each monkey relative to the feeder at the time of observation. An analysis of variance between free-ranging versus corral-enclosed groups and within groups by location (around or away from the feeder) revealed significant differences in several behavioural categories, including foraging, lookout, inactive, dominant, submissive, allogrooming, social contact, social initiative, active, and passive behaviours. When the effect of limited food distribution sites was analyzed by comparing data recorded away from the feeding sites, there were remarkably few differences between the groups.

Age Factors↗

[The treatment of pedophilia under juridical compulsion].

Public opinion is more and more concerned about the fate of victims of sexual violence and sexual abuse. Until now the focus of scientific research concerned the most appropriate approach of children and women as the main victims of male sexual offenders. We need more research on the psychopathology of sexuality and aggression in order to develop scientifically founded treatment modalities to prevent relapse of sexual abuse. The University Forensic Centre of the University of Antwerp started in 1993 with an outpatient consultation for the diagnosis and treatment of paraphilia disorders. During the first 3 years, 265 consecutive clients have been examined, including 157 persons referred for pedosexual activities. This paper reflects the experience of the diagnostic and treatment team with this specific population. The specialised outpatient treatment program is mainly based on cognitive and behaviour therapy. The program can be divided in six phases: 1. intake, 2. provision of the necessary safeguards, 3. diagnostic (bio-psycho-social and criminological), 4. enhancement of motivation for treatment, 5. relapse prevention I where the focus is on behavioural control and 6. relapse prevention II where the focus is on life style imbalances. Difficult ethical problems must be taken into account in the treatment of sexual abusers referred by judicial authorities (74% of our cases), 1) the lack of motivation for treatment, 2) the problem of confidentiality.

Adolescent↗

Psychosocial effects of living with an increased risk of breast cancer: an exploratory study using telephone focus groups.

Research to date has mainly focused on the short-term psychological impact of genetic risk counselling for breast cancer. This study aimed to explore the long-term consequences for women of being informed about an increased risk of breast cancer in terms of: the effect on their everyday lives, their coping strategies and their unmet needs in terms of the current service. The participants were 25 women with a family history of breast cancer who had received genetic risk counselling and had consequently been receiving clinical surveillance for at least 2 years. They took part in one of seven telephone focus groups and subsequently completed a feedback questionnaire. Transcripts of the focus groups were qualitatively analysed by three independent researchers with inter-rater agreement between pairs of raters ranging from Kappa = 0.61-0.79. Six key issues emerged from the data, which provide an important insight into the long-term consequences of living with an increased risk of breast cancer concerning: (1) psychological adaptation, (2) behavioural adaptation, (3) family issues, (4) clinical surveillance, (5) provision of information, and (6) peer support. These findings, together with the quantitative results of the feedback questionnaire, have clinical implications that require further investigation in larger scale quantitative research.

Adaptation, Psychological↗

Intrafamilial conflict and parental investment: a synthesis.

We outline and develop current theory on how inherent genetic conflicts of interest between the various family members can affect the flow of parental investment from parents to offspring, and discuss the problems for empirical testing that this generates. The parental investment pattern realized in nature reflects the simultaneous resolution of all the conflicts between the family players. This depends on the genetic mechanism, the mating system and reproductive constraints, on whether extra demand by progeny affects current or future sibs, and particularly on the behavioural mechanisms underlying demand (begging or solicitation) and supply (provision of parental investment by parents). The direction of deviation from the optimal parental investment for the parent(s) depends on the slope of what we term the 'effect of supply on demand', the mechanism that determines how changes in food supply affect begging levels. If increasing food increases begging (positive slope), less parental investment is supplied than the parental optimum and if increasing food decreases begging (negative slope), more parental investment is supplied. The magnitude of deviation depends on both the 'effect of supply on demand' and on the 'effect of demand on supply' (the mechanism determining how changes in begging affect food supply, which always has a positive slope). We conclude that it will often be impossible to deduce the extent of underlying conflict by establishing the amount of parental investment given relative to the ideal optimum for the parent. Some possible directions for future research are discussed.

Animals↗

Epistemology and learning disabilities: invited commentary on Hastings and Remington.

The effect on service provision of describing a variety of actions as challenging behaviour is discussed: it is suggested that studying stereotyped, aggressive and self-injurious acts in their own right has yielded more useful psychological debate, and ignoring such conceptual thinking leads to implicit theorizing where assumptions go unquestioned. Evidence for the relevance of staff actions on different topographies of client responses is critically reviewed, alongside discussion of the authors' rhetoric. The importance of adjusting language and frameworks to make room for alternative conceptualizations is discussed. The article concludes by recommending that research into staff attitudes and actions will be better served by reflexive methods and reporting which emphasize mutuality.

Humans↗

UK Guideline for the use of post-exposure prophylaxis for HIV following sexual exposure.

We present the British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis after sexual exposure (PEPSE) to HIV. This document includes a review of the current data to support the use of PEPSE, considers how to calculate the risks of HIV infection after a potential exposure, and provides recommendations on when PEPSE would and would not be considered. Other areas included are the possible impact on sexual behaviour, cost-effectiveness, and issues relating to service provision. Throughout the document, consideration is given to the place of PEPSE within the broader context of HIV prevention strategies and sexual health.

Acquired Immunodeficiency Syndrome↗

The effect of soap distribution on diarrhoea: Nyamithuthu Refugee Camp.

BACKGROUND: In January 1993, Nyamithuthu Camp in Malawi housed 64000 Mozambican refugees. Communicable diseases, primarily diarrhoea, pneumonia, malaria and measles, contribute to substantially higher mortality rates in refugee populations compared to similar non-displaced populations. METHOD: A systematic sample of 402 households in one portion of the camp were surveyed for diarrhoeal risk factors, and then interviewed twice weekly for 4 months regarding new diarrhoea episodes and the presence of soap in the household. Two-hundred grams of soap per person was distributed monthly. RESULTS: Households had soap on average only 38% of the interview days. Soap was used primarily for bathing and washing clothes (86%). Although 81% of mothers reported washing their children's hands, only 28% of those mothers used soap for that purpose. The presence of soap in a household showed a significant protective effect: there were 27% less episodes of diarrhoea in households when soap was present compared to when no soap was present (RR = 0.73, 95% CI: 0.54 < RR < 0.98). Potential confounding factors were assessed and did not appear to be responsible for the association between the presence of soap and reductions in diarrhoea incidence. CONCLUSION: In summary, our findings suggest that the provision of regular and adequate soap rations, even in the absence of a behaviour modification or education programme, can play an important role in reducing diarrhoea in refugee populations. If subsequent study confirms the soap as a cheap and effective measure to reduce diarrhoea, its provision in adequate amounts should be a high priority in refugee settings.

Adolescent↗