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PubMed2002

Men's health promotion by general practitioners in a workplace setting.

A project to promote men's health through diabetes education and screening was undertaken throughout rural industries in 1999/2000 in the south-west of Western Australia. Five hundred and twenty-five men aged 40-65 years participated from 27 industries. Sixty-four per cent of these men were identified at high-risk of developing diabetes and were referred to their general practitioner (GP) for follow-up. Seventy-six per cent of those at-risk visited their GP and hence the strategy adopted has been appropriate in engaging men in the preventive concept of seeking care, that is, getting them to attend their GP when they only have the risk factors but not the disease. However, men were left short of knowing how to achieve a change in their lifestyle behaviour and take appropriate action. Given the constraints of rural practice and the need to prioritise those with disease and gaps in service provision for both health services and GPs, there are two challenges: identifying those at-risk and modifying their behaviour.

Adult↗

PubMed2004

Randomized controlled trial of a brief behavioural intervention for reducing hepatitis C virus risk practices among injecting drug users.

AIM: To develop and evaluate a brief intervention for reducing risk behaviours associated with HCV transmission in injecting drug users (IDU). DESIGN: Randomized controlled trial of an individually tailored brief behavioural intervention (BBI) (experimental) versus a standardized educational intervention (control). SETTING: Specialist drug treatment facility in Melbourne, Australia. PARTICIPANTS: One hundred and forty-five IDU (aged 18 or over, injecting at least weekly in the preceding 6 months) recruited and randomized to the experimental condition (n = 73) or the control condition (n = 72). INTERVENTIONS: The BBI was based on the Blood-Borne Virus Transmission Risk Assessment Questionnaire (BBV-TRAQ)-a standardized blood-borne virus risk assessment instrument comprising injecting risk, sexual risk and other skin penetration risk subscales. The BBV-TRAQ was used to identify individual HCV risk practices and to tailor the 30-minute experimental BBI. Control participants received a standardized HCV educational session, using current educational materials. MAIN OUTCOME MEASURES: BBV-TRAQ subscale and total scores and measures of participant satisfaction. RESULTS: One hundred and twenty-four participants (86%) were followed-up at 4 weeks (+/-7 days). Analyses revealed a significant reduction in HCV risk behaviours for both groups at 1-month follow-up, with participants in the experimental BBI condition reporting higher overall satisfaction with the intervention compared to the control group. CONCLUSIONS: Both groups reported significant reductions in risk behaviour, indicating that while BBI methods hold promise for HCV education and prevention, they were not demonstrated to be more effective than the provision of standard educational materials. Future research could evaluate the efficacy of the BBV-TRAQ as a risk behaviour intervention and counselling tool in clinical, NSP and peer education settings.

Adolescent↗

PubMed2000

The influence of recipe modification and nutritional information on restaurant food acceptance and macronutrient intakes.

OBJECTIVE: To examine the influences of nutritional information and consumer characteristics on meal quality expectations, food selection and subsequent macronutrient intakes of consumers offered a reduced-fat option in a restaurant. DESIGN: A target, full-fat (FF) main restaurant meal option was developed in a version substantially reduced in fat and energy (RF). Restaurant patrons were randomly placed into one of four treatment groups varying in provision of menu information about the target dish, and the actual version of that dish served (if ordered). A full-fat blind (FFB) control group was given no nutritional information in the menu and was served the FF version. The other three groups were all served the modified RF version: (i) reduced-fat blind (RFB), who were given no nutritional information; (ii) reduced-fat informed (RFI), who were given nutritional information; and (iii) reduced-fat informed with details (RFID), who were given the same nutritional information plus recipe modification details. Subjects rated their expected and actual liking, the pleasantness of taste, texture and appearance of the dish, how well the dish matched their expectations, and the likelihood of purchase again. Additional measures included the other dish selections, sociodemographic and attitudinal information. SETTING: A silver service (training) restaurant. SUBJECTS: Members of the public (n = 279) consuming meals in the restaurant. RESULTS: The presence of nutritional information on the menu did not significantly increase subsequent intakes of energy and fat from the rest of the meal, and did not significantly influence sensory expectations or post-meal acceptance measures (which also did not differ between the FF and RF versions). Consumer characteristics relating to fat reduction attitudes and behaviours were significantly related to the selection of different dishes. CONCLUSIONS: Provision of RF alternatives in a restaurant can have significant positive dietary benefits. Menu nutritional information did not affect measures of meal acceptance. Further studies should identify which types of information formats might be most effective in enhancing the selection of 'healthy' options.

Cooking↗

PubMed1993

The health care experience and health behaviour of the Chinese: a survey based in Hull.

Lack of knowledge about the health care experience and health behaviour of an important ethnic minority group prompted a study to inform the provision of health care and promote local action in Hull. Thirty Chinese 'takeaway' shops were randomly selected from the Yellow Pages of the Hull telephone directory, and all Chinese people working in them asked to complete a questionnaire. It contained questions on their knowledge, use and experience of primary health care and health promotion, together with aspects of their health behaviour. The same questionnaire in English was delivered to all workers in 30 fish and chip shops, to provide a White comparison group. Eighty (71 per cent) of the Chinese returned their questionnaire, and 73 (67 per cent) were returned from the chip-shop workers. The results indicate that the Chinese in Hull are not making optimal use of health services; they use some services inappropriately, whereas others, such as preventive health programmes, are under-used. One of the main reasons is identified as the language/communication difficulties faced by many Chinese. Other reasons are also highlighted and their implications discussed. The findings of this survey are in keeping with the mainly unpublished work undertaken elsewhere on this comparatively little researched ethnic minority group.

Adult↗

PubMed1999

Sex roles, parental experience and reproductive success of eastern kingbirds, Tyrannus tyrannus.

We quantified parental behaviour of eastern kingbirds during the incubation and nestling periods to determine parental roles, and to examine the impact of previous breeding experience (defined as having bred on the territory in the past) on behaviour and reproductive success. Females performed all incubation, while males spent more than 60% of their time in vigilant or nest guarding behaviour during incubation. Parental roles were not defined as sharply during the nestling period. Females spent more time vigilant, but males provisioned young at only 54% of the rate of females. Vigilance and nest watching were still primarily male duties. Male and female behaviour did not vary with the pair's combination of experience (e.g. experienced-experienced versus inexperienced-inexperienced in previous-current breeding season, respectively) during either phase of reproduction, but experienced males were more vigilant during incubation and fed young relatively more than inexperienced males. Experienced females were also more efficient foragers. Although behaviour did not differ among the four combinations of pair experience, inexperienced pairs none the less lost the most young to starvation and predation. Consequently, inexperienced pairs fledged one less nestling per nesting attempt than did pairs with at least one experienced breeder. Our results suggest that having at least one experienced breeder substantially improved a pair's reproductive success. We propose that female site fidelity is a safeguard to avoid the lower breeding success a female would incur if she were to move to a new territory and breed with an inexperienced male. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗

PubMed1991

Perinatal lamb mortality--its investigation, causes and control.

Methods of investigating perinatal loss in grazing sheep flocks are reviewed and evaluated. The "wet-dry" method is the simplest method for assessing minimal prevalence, whereas the differences between the numbers of single and twin foetuses present at ultrasonic determination of litter size during pregnancy, and the numbers of single and twin lambs present at lamb-marking, is the most precise. The veterinary investigation of field mortality involves full autopsy of a representative sample of dead lambs, a history of prenatal nutrition, disease and husbandry, as well as a qualitative estimate of weather conditions over the period of lamb collection. Pathological processes may be identified in over 95% of deaths and the specific cause determined in about 75% of deaths. The identification of the specific causes in the remainder of deaths, all classified as the starvation-mismothering-exposure (SME) complex, requires intensive, costly, on-site observation, and physiological and biochemical assessment. The probable causes of these deaths include prenatal physiological handicaps resulting from placental insufficiency, aberrant parent-offspring behaviour, management-induced mismothering, misadventure, inadequate milk supply or teat and udder abnormalities, and cold-induced starvation. The gross pathology and pathophysiology of birth stress and the SME complex, which are associated with at least 80% of mortality, are summarised. Birth injury to the foetal central nervous system, characterised by cranial and spinal meningeal haemorrhage is exclusive to parturient deaths and the SME complex. Observed flock prevalences range from 81% to 100% in parturient deaths, and 20% to 57% in the SME complex. The high total prevalence and experimental evidence, indicate the major causal role of birth stress in the pathogenesis of these entities. Lethal congenital malformations, infections (both congenital and acquired after birth), trace element deficiencies and predation are reviewed as minor causes. The new understanding of the pathogenesis of perinatal lamb mortality, recognises the heritable nature of birth mass, maternal pelvic dimensions, parent-offspring behaviour, and the resistance of neonates to cold. Control measures need to incorporate selection for maternal rearing ability, further refinement of prenatal nutritional management of twin-bearing ewes, disease control, provision of shelter for lambing flocks, and avoidance of husbandry practices which frustrate innate parent-offspring behaviour. A selection programme is summarised.

Animals↗

PubMed2003

Behavioural responses of farm mink towards familiar and novel food.

The study aimed to (i) describe the response of farmed mink towards familiar and novel food, and (ii) assess the suitability of using novel food in order to measure fear responses in mink. A total of 48 farm mink from two behaviourally selected genetic lines were caged individually with one standardised daily feeding. The experimental feedings were carried out in a balanced order on 2 successive days. Behaviour of the mink was video recorded for 10min after food provision. In general, the mink were reluctant to approach and eat the novel food compared to familiar food, which indicates a neophobic feeding strategy, i.e. increased latency to come close to (P<0.01) and eat (P<0.001) the novel food, and a higher frequency (P<0.001) and a longer duration (P<0.001) of sniffing. Provision of unknown food items may be used to evaluate fear responses in mink since mink respond reluctantly towards novel food. However, high inter-individual variation in the present study obliterated a previously shown difference between confident and fearful mink, suggesting that this method for measuring fear responses in mink is appropriate only on a large animal material.

Journal Article↗

PubMed1999

Attitudinal factors associated with community pharmacists' involvement in services for drug misusers.

AIM: To assess the relationship between pharmacists' attitudes towards drug misusers and the availability and provision of services for drug misusers. DESIGN: A cross-sectional postal questionnaire survey. SETTING: All community pharmacies in Scotland (n = 1142). PARTICIPANTS: A total of 864 pharmacists managing community pharmacies on a day-to-day basis (response rate 79%). MEASUREMENTS: Descriptive data were collected on demography, drug misuse services provided and training in drug misuse. Attitude statements were used to measure attitudes to drug misusers, the role of the pharmacist in dispensing controlled drugs and providing injecting equipment, providing advice on drug misuse and financial aspects of service provision. Statements were incorporated into a scale which was correlated with behavioural data on whether and how services were provided. RESULTS: The attitude scale had good internal reliability and was unidimensional. Pharmacists that provided needle/syringe exchanges, sold needles/syringes, dispensed methadone, supervised the consumption of methadone and provided health promotion services to drug misusers had significantly more positive attitudes towards drug misusers. Attitudes were associated with health board area, sex and number of years registered as a pharmacist. After controlling for these characteristics, attitude was an independent predictor of whether needles/syringes were sold, methadone was dispensed and methadone consumption supervised. CONCLUSIONS: Addressing negative attitudes could encourage more pharmacists to provide services and enhance the process of service delivery.

Attitude of Health Personnel↗

PubMed2006

Treating dysarthria following traumatic brain injury: investigating the benefits of commencing treatment during post-traumatic amnesia in two participants.

PRIMARY OBJECTIVE: The aims of this preliminary study were to explore the suitability for and benefits of commencing dysarthria treatment for people with traumatic brain injury (TBI) while in post-traumatic amnesia (PTA). It was hypothesized that behaviours in PTA don't preclude participation and dysarthria characteristics would improve post-treatment. RESEARCH DESIGN: A series of comprehensive case analyses. METHODS AND PROCEDURES: Two participants with severe TBI received dysarthria treatment focused on motor speech deficits until emergence from PTA. A checklist of neurobehavioural sequelae of TBI was rated during therapy and perceptual and motor speech assessments were administered before and after therapy. MAIN OUTCOMES AND RESULTS: Results revealed that certain behaviours affected the quality of therapy but didn't preclude the provision of therapy. Treatment resulted in physiological improvements in some speech sub-systems for both participants, with varying functional speech outcomes. CONCLUSIONS: These findings suggest that dysarthria treatment can begin and provide short-term benefits to speech production during the late stages of PTA post-TBI.

Adult↗

PubMed1989

Implications of preventive health behaviour for cervical and breast cancer screening programmes: a review.

The success of screening programmes for breast and cervical cancer partly depends on women's acceptance and take-up of the service. Uptake of preventive health care programmes appears to be related to people's underlying motivations and attitudes, not only towards the disease in question, but towards health and illness generally. The perceived costs to the individual of embarking on particular courses of action also have to be taken into consideration. These attitudes and motivations vary between social groups. Unless the reasons for non-participation in preventive health care and screening programmes is understood, programmes will be misdirected and inappropriately designed. However, the failure of any one theory to account for most of the variance in health behaviour between social groups emphasizes the importance of health education and provision of information about health and prevention on a personal basis. General practitioners and practice based nurses are in a good position to be able to elicit the fears, prejudices and priorities of patients in this area, and thus provide more effective health education and information about preventive and screening services.

Adult↗

PubMed2003

Systematic review of the effectiveness of community pharmacy-based interventions to reduce risk behaviours and risk factors for coronary heart disease.

BACKGROUND: The aim of the study was to provide a critical and comprehensive overview of the published peer-reviewed evidence relating to community pharmacy-based activity in the reduction of risk behaviours and risk factors for coronary heart disease (CHD). METHOD: Electronic databases were searched from 1 January 1990 to 1 February 2001. Hand searches for the same period were undertaken of specific journals and proceedings of peer-reviewed conference abstracts. Data abstracted from publications included: participants/setting; study designs intervention including training); outcome measures; key findings. RESULTS: Four randomized controlled trials (RCTs) were identified, two in smoking cessation and two in lipid management. All met review criteria and were included. Two (RCTs) involving 976 subjects and three non-randomized experimental studies were identified that evaluated the effectiveness of community pharmacy advice in smoking cessation. Two controlled trials and one before-and-after study investigated the effect of training on pharmacists' smoking cessation advice. One attitudinal survey collected data on reactive and proactive smoking cessation advice-giving by community pharmacists. Two RCTs involving 642 subjects, and two observational studies were identified for community pharmacy-based lipid management. The published studies provided evidence of clinical and cost-effectiveness of community pharmacy services from UK RCTs in smoking cessation, and from US and Canadian RCTs in lipid management in the prevention of heart disease. Although the role of the community pharmacy in disease detection and case finding has been widely discussed, only a small number of studies was found. The findings indicated that further investigation is warranted in these areas. CONCLUSION: The peer-reviewed literature demonstrates the contribution of community pharmacy-based services to the reduction of risk behaviours and risk factors for CHD. The evidence supports the wider provision of smoking cessation and lipid management through community pharmacies. Health commissioners and planners can use the findings of this review to incorporate community pharmacy based health development activities into local health services. Further research is needed into the contribution of community pharmacy to disease detection and case finding as part of local public health strategies.

Community Pharmacy Services↗

PubMed1994

Preventive strategies for alcohol-related problems.

Preventive strategies for alcohol-related problems need to be in keeping with their socio-political context. Prohibition is inappropriate except where it has widespread support within the culture. Preventive strategies focus on the population and/or high risk groups and behaviours. Primary prevention can be achieved by control policies, education and provision of alternatives. Fiscal measures are of proven value. Legislative approaches influence availability and context of drinking, such as drinking and driving. Advertising control, server training and server liability are further approaches. Encouraging the provision of alternative beverages and promoting alcohol-free environments is a further approach which should be seen as part of an integrated community response. Secondary prevention linked with early recognition of hazardous drinking at primary level is of known efficacy and would form part of a coordinated strategy.

Alcohol Drinking↗

PubMed2006

Information in mental health: qualitative study of mental health service users.

BACKGROUND: Despite the widespread proliferation of consumer health information provision, little is known about information needs or information-seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users. DESIGN: In-depth interview study with purposive sample of 36 men and women with experience of mental health problems. RESULTS: Four main themes were identified. A general lack of information was equated with a lack of respect. People undertook their own research into their condition, and recognized the challenge to professionals. Stigma was widespread and inhibited information seeking. There was a desire for an explanation of mental health problems in physical terms. People particularly valued hearing other people's experience of mental health problems, for reasons of universality, instillation of hope, and understanding and empathy. CONCLUSIONS: The findings provide support for a more equal partnership between patients and professionals. Information providers and health practitioners should take account of the value of other people's experience as an information source.

Adult↗

PubMedDate not supplied

Interventions for confusion and dementia. 3: Reminiscence.

The aims of reality orientation, which was discussed in the previous article of this series (Vol 7(17): 1018-20), are to achieve behavioural improvements. The aims of reminiscence, however, are empowerment and the provision of pleasure and it is therefore more associated with quality of life and quality of care. Reminiscence can be an enjoyable activity. Used in a structured way, it can achieve a sense of wellbeing, and increase empathy between healthcare workers and clients. This article discusses the benefits and problems of reminiscence, and suggests means to develop reminiscence skills and materials.

Confusion↗

PubMed1992

Illness behaviour in live-related and cadaver renal transplant recipients.

Illness behaviour was compared in 10 biologically live-related and 30 cadaver renal donor recipients in respect of their long-term psychological adjustment. The results indicated few long-term statistically significant differences postoperatively in illness behaviour between the two groups of patients, but a factor analysis revealed 8 items that were significantly related to illness behaviour associated with post-transplant psychological adjustment for all 40 transplantees studied. These were feelings of inadequacy; the renal graft being 'alien'; an inability to cope with the transplant; the disease resulting in the transplant being an external imposition beyond their control; responsibility for and acceptance of the transplant as a 'gain'; culpability for what has happened to them; anxious preoccupation with long-term prognosis; and dependence on others. Further analysis of these findings and their relevance for optimal patient management are discussed. Appropriate psychological support for these patients is important and, although long-term illness behaviour of biologically live-related and cadaver-related renal transplant recipients was found to be relatively similar, the various issues related to post-transplant illness behaviour in both groups of patients should be addressed in the provision of a psychonephrology service to a renal unit.

Adult↗

PubMed1997

Trends in abortion 1990-1995.

Trends in legal abortion performed to women resident in England and Wales, between the years 1990 and 1995 are reviewed. This article updates an earlier review of abortion trends from the introduction of the 1967 Abortion Act to the end of 1989 which appeared in Population Trends issue no. 64(1). The main findings of this present article indicate that the number of legal abortions performed in England and Wales have gone down since 1990. Outside factors such as patterns in fertility, the provision and uptake of family planning services, and sexual attitudes and behaviour are likely to influence present and future trends. This article is part of an ongoing review of abortion trends which will be continued in future years.

Abortion, Legal↗

PubMed2003

Manipulation: description, identification and ambiguity.

The word manipulation is frequently applied to some of the difficult-to-manage behaviours of the personality-disordered patient. However, the term is rarely defined, and a review of both the clinical and research literature shows that little has been written about its definition and identification, let alone its clinical management in both in- and outpatient settings. Recent empirical work conducted with nurses in forensic settings has demonstrated the range of behaviours that professionals refer to as 'manipulative', thus clarifying the use of the term and allowing the provision of a more precise definition. The scope of manipulation in everyday life, management practice and politics is perhaps relatively small, although manipulation can occur in all areas of human activity. Social behaviour is doubly ambiguous with respect to judgements of manipulation, as such judgements involve a moral evaluation combined with the identification of deception on the basis of little or partial evidence. The implications of this social ambiguity for clinical psychiatric practice are that professionals need to guard themselves from two polar faults: seeing manipulation everywhere; or being blind to its presence. In order to achieve a cautious moderation, staff need to hold both alternatives in mind at all times.

Attitude of Health Personnel↗

PubMed1999

Parents and helpers compensate for experimental changes in the provisioning effort of others in the Arabian babbler.

Biparental investment in birds is implemented through parents making adaptive compensatory adjustments according to the work rate of their collaborator. Predictions for such evolutionarily stable cooperation in parental nestling feeding, and the behavioural mechanisms involved, can also be applied to systems with helpers-at-the-nest. Using the cooperatively breeding Arabian babbler, Turdoides squamiceps, we experimentally increased the provisioning rate of one or two subordinate birds in each group by giving these individuals extra food. Compared with control days before and after, the experimental treatment caused 'fed' birds to increase and 'unfed' birds to decrease their nest visit rates significantly, with no significant changes in load size. Thus, both parents and helpers in this system showed individual compensatory adjustments in their nestling-feeding effort according to the work rates of collaborators. There were no significant increases in total group visits during experimental treatments; therefore this study did not provide evidence for the predicted incomplete compensatory response. These results for helping-at-the-nest are consistent with empirical studies on parental care, and further suggest a central role for nestling begging in any cooperative provisioning of young in the nest. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗