Behaviour change at population, community and individual levels: NICE Public Health Guidance 6

This guidance is aimed at those responsible for helping people to change their behaviour to improve their health. This includes policy makers and those working in local authorities and the community and voluntary sectors. It gives advice on how to plan and run relevant initiatives. The recommendations include the following advice: base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success  work with other organisations and the community itself to decide on and develop initiatives build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other take account of and resolve problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes) base all interventions on evidence of what works train staff to help people change their behaviour evaluate all interventions.This resource was contributed by The National Documentation Centre on Drug Use.

Moonlight and blood-feeding behaviour of Lutzomyia intermedia and Lutzomyia whitmani (Diptera:Psychodidae:Phlebotominae), vectors of American cutaneous leishmaniasis in Brazil

Lutzomyia intermedia (Lutz & Neiva, 1912) and L. whitmani (Antunes & Coutinho, 1939) (Diptera: Psychodidae: Phlebotominae), two important vectors of American cutaneous leishmaniasis in Brazil, occur in sympatry in the locality of Posse county, Petrópolis municipality, state of Rio de Janeiro, Brazil. We investigated the influence of the lunar cycle on the frequency of specimens of the two species caught while attempting to bite the collectors and in CDC light traps. Analysis of the numbers of sand flies captured in different lunar phases for two consecutive years in the peridomestic site and forest shows that there is a significant positive correlation between moonlight intensity and the numbers of L. intermedia and L. whitmani females collected while blood-feeding, whereas the opposite was observed for the CDC traps.

The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes ILC-UK

The International Longevity Centre - UK��launched a new paper (Wednesday, 6th July 2011). The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes, provides care home workers and managers with information and practical advice on this complex, controversial and sensitive issue.The need for affection, intimacy and relationships for people with dementia in care homes has too often been ignored and side-lined in policy and practice. The onset of old age or a cognitive impairment does not erase the need for affection, intimacy and/or relationships. While the issues involved can be complex, controversial and sensitive and may challenge our own beliefs and value system, it is essential that we understand more about them to foster a more person-centred approach to dementia care. Care home residents with dementia often have complex care needs and trying to understand and respond to the more intimate and sexual aspects of a resident’s personality can be challenging.Aimed at care home workers and managers, the guide not only provides essential information on this aspect of dementia care but offers practical advice to support current work-based practices. Set out in an accessible and easy-to-read format, this guide includes case studies, questions, suggestions and a self assessment quiz to promote easy learning. It also provides a possible pathway for care home managers to develop a guiding policy on sexual expression in dementia.The guide for care staff is summarised in 10 key points:1. Some residents with dementia will have sexual or sensual needs.2. Affection and intimacy contribute to overall health and wellbeing for residents.3. Some residents with dementia will have the capacity to make decisions about their needs.4. If an individual in care is not competent to decide, the home has a duty of care towards the individual to ensure they are protected from harm.5. There are no hard and fast rules. Assess each situation on an individual basis6. Remember not everyone with dementia is heterosexual.7. Inappropriate sexual behaviour is not particularly common in dementia.8. Confront your own attitudes and behaviour towards older people and sex generally.9. Communicate – look at how you can improve communication with your colleagues, managers, residents and carers on this subject10. Look after yourself and remember your own needs as a care professional��The full paper is available: The Last Taboo

Low-income Groups and Behaviour Change Interventions: A review of intervention content and effectiveness

This is the second paper in a series, Kicking Bad Habits, on how people can be encouraged to adopt healthy behaviour. Looking at interventions targeted specifically at low-income groups, this paper asks which interventions are effective in getting people to quit smoking, eat healthily and exercise. It reveals that the most frequently used techniques are providing information and encouraging people to set goals, which can be particularly effective at changing behaviour in disadvantaged groups.

Health Related Behaviour Questionnaire

The Health-Related Behaviour Questionnaire (HRBQ) was first developed in 1976 for use in secondary schools [PDF] and adapted for use in primary schools [PDF] in 1988. The HRBQ provides baseline data to identify priorities for health education planning, assessments and intervention programmes. Teachers and the medical professions have shaped the content of the HRBQ to reflect the needs of the users. http://sheu.org.uk/content/page/secondary-schools-health-related-behavio...

Effects of sarcoptic mange on the behaviour of the red fox and influence on other fox-born zoonoses in Geneva, Switzerland

Résumé : Une épidémie de gale sarcoptique (Sarcoptes scabiei) touche le canton de Genève depuis 1996. Nous avons étudié l'impact de cette maladie sur différents caractères comportementaux du renard roux (Vulpes vulpes) : l'écologie alimentaire, les comportements spatiaux et l'activité, ainsi que les contacts sociaux. Nous avons également évalué si la gale pouvait influencer la composition et la transmission de la communauté helminthique intestinale du renard. En effet, cette espèce est l'hôte de parasites qui sont liés à des zoonoses importantes, en particulier le ténia échinocoque du renard (Echinococcus multilocularis) pour lequel Genève est considérée comme une zone de haute endémie. Durant 5 années, des carcasses de renards ont été récoltées sur l'ensemble du canton. Nous les avons disséquées et avons conservé différents échantillons pour des analyses ultérieures. Des données sur le poids, l'âge et le statut reproductif des femelles ont ainsi pu être obtenues. Les contenus stomacaux ont été analysés pour déterminer le régime alimentaire, les intestins pour collecter des helminthes, des échantillons de sang pour faire des sérologies et des échantillons de peau pour récupérer les sarcoptes. Des renards sauvages ont également été capturés et équipés de colliers émetteurs afin de déterminer leur activité et leur utilisation de l'espace. Finalement, nous avons réalisé des affûts sur des terriers et des observations nocturnes à l'aide d'un détecteur thermique afin d'étudier les contacts sociaux. Nous avons ensuite considéré tous ces aspects pour comparer les renards galeux aux individus sains. Trois catégories de gale ont été prises en compte selon l'importance de l'infection. L'épidémie a traversé le canton en 8 ans environ et elle a provoqué une forte diminution des populations de renard. Les animaux malades étaient caractérisés par un poids réduit, ils utilisaient des domaines vitaux réduits et présentaient un rythme d'activité irrégulier. En ce qui concerne le régime alimentaire, les renards galeux avaient souvent des estomacs vides ou contenant peu d'aliments d'origine animale. Cette réduction de l'alimentation ne semble pas seulement être liée à des capacités de prédation réduite, mais également à un désintérêt face à la nourriture. Tous les changements de comportement cités étaient plus marqués chez les animaux soumis à une forte infestation. Dix taxons d'helminthes ont été identifiés dans les intestins des renards analysés. Deux d'entre eux représentent un risque de santé publique: Echinococcus multilocularis et Toxocara carvis. Pour ces helminthes, nous n'avons pas identifié de différences de prévalence entre les renards galeux et les animaux sains, mais la charge parasitaire était significativement supérieure chez les individus galeux, en particulier ceux souffrant d'une infestation importante. Ceci est probablement lié à une susceptibilité accrue des individus qui présentent une condition physique amoindrie et des défenses immunitaire affaiblies. Selon nos résultats, nous pouvons conclure que la gale induit des changements comportementaux importants et que ces changements ont une influence potentielle sur la transmission de la gale elle-même, mais également sur la transmission du reste de la communauté parasitaire de l'hôte. Les individus qui souffrent d'une infestation importante sont susceptibles de provoquer une contamination de l'environnement accrue en ce qui concerne des helminthes pouvant provoquer des zoonoses. La gale apparaît être un facteur à ne pas négliger dans le cadre de la gestion de la faune sauvage, mais également en ce qui concerne des problématiques de santé publique. Summary An epidemic outbreak of sarcoptic mange (Sarcoptes scabiei) has struck the canton of Geneva since 1996. The impact of the disease on various behavioural traits of the main host, the red fox (Vulpes vulpes), was investigated: feeding ecology, spatial behaviour and activity, and social contacts. We also evaluated if mange might have an influence on the composition and transmission of the intestinal helminth community of foxes. Indeed, this species is host of parasites with potential zoonotic importance, particularly the fox tapeworm (Echinococcus multilocularis) for which Geneva is reported as endemic area. During 5 years, red fox carcasses have been collected throughout the canton. They were then dissected and various samples conserved for further analysis. Data on weight, age, and reproductive status of females were obtained. Stomach content were analysed for diet analysis, intestines to recover helminths, blood to proceed to ELISAs and skin samples to check for the presence of Sarcoptes mites. Further, wild foxes were captured and fitted with transmitters in order to determine their activity pattern and space use. Finally, we proceeded to direct observations at dens and using a thermal imaging sensor at night to gain information about social contacts. A comparison between healthy and mangy foxes was made for all these aspects. Three categories of mangy foxes were considered from moderately to severely infected. The epidemic wave crossed the canton in about 8 years and induced a significant reduction in fox densities. Mangy individuals appeared to have reduced body weights, to use more restricted home ranges and exhibited an irregular activity pattern. Regarding food, sick foxes often had empty stomachs and consumed less food items of animal origin. The reduction in food intake appeared to be linked not only to a reduced ability to hunt, but also to a reduced interest in food. The changes observed were particularly pronounced in individuals with severe infestation. Ten helminth taxa were recovered from the intestines on the analysed fox carcasses. Two of them have an importance with regard to human public health: Echinococcus multilocularis and Toxocara cams. The prevalence of these helminths did not differ between healthy and mangy foxes, however the worm burden was significantly higher in mangy foxes, particularly those with severe mange. This is probably linked to an increased susceptibility in individuals with a reduced body condition and weakened immune defences. From our observations, we can conclude that mange induces pronounced behavioural changes in the red fox, and that those changes influence the transmission risks of mange itself, but also of the rest of the parasite community of the host. Individuals with severe mange are for example likely to increase the environment contamination of free living stages of helminths with zoonotic importance. Mange appears thus to represent a factor not to be neglected for the management of wild species and for public health issues.

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 3 Template for recording bullying behaviour

Anti Bullying Procedures for Primary and Post Primary Schools - Appendix 3 Template for recording bullying behaviour. Provided by the Department of Education and Skills, Ireland.

Physical activity and pregnancy

SUMMARY : The traditional medical advice for pregnant women has been to reduce their physical activity (PA) levels. The advice was based on concerns that exercise could affect pregnancy outcomes by increasing core body temperature, by increasing the risk of maternal musculoskeletal injury and by altering the transplacental transport of oxygen and nutrients to maternal skeletal muscle rather than to the developing foetus. In the meantime, several studies have provided new information on adaptation of the pregnant woman and her foetus to moderate PA. New investigations have shown no adverse maternal or neonatal outcomes, abnormal foetal growth, increase in early pregnancy loss, or late pregnancy complications. Moreover, enrolment in moderate PA has proven to result in marked health benefits including improved maternal cardiovascular function, reduction of excessive weight gain and fat retention, less complicated labour, improved foetal stress tolerance and neurobehavioral maturation. In view of the beneficial effects, current recommendations encourage healthy pregnant women to engage in 30 minutes of moderate PA on most, if not all, days of the week. This thesis work addressed several questions. Firstly, it examined whether compliance with the recommended levels of PA during pregnancy results in better preparedness for the sudden physical exertion of labour and delivery. Secondly, it measured PA during pregnancy as compared to postpartum. Lastly, it assessed the influence of pre-pregnancy body mass index on gestational resting metabolic rate. Data collection was conducted on healthy women living in Switzerland during the third trimester of pregnancy and postpartum. Total and activity energy expenditure was assessed through 24-hour heart rate and accelerations recordings, and cardiovascular fitness through an individual step-test. Information related to pregnancy, labour and delivery was collected from medical records. The results indicate that a minimum 30 min of moderate PA per day during pregnancy are associated with better cardiovascular fitness and lower risk of operative delivery with no negative effects on maternal and foetal conditions (study 1). Despite these benefits, a substantial proportion of pregnant women (39%) living in Switzerland do not meet the PA recommendations. The decrease in activity related energy expenditure during pregnancy compared to postpartum was measured to be around 100 kcal/day (~13%), whereas the total energy expenditure was found to increase by 300 kcal/day (study 2). Thus, the energy cost of late pregnancy in Switzerland corresponds to 200 kca/day. These findings are based on average values of the study group. It should be noted, however, that large variations in individual energy expenditure may occur depending on the pre-pregnancy body mass index (study 3). When adjusted to body weight, gestational resting metabolic rate is significantly lower among women of high pre-pregnancy body mass index compared to women of normal or low pre-pregnancy body mass index. This can be explained by the fact that resting metabolic rate is primarily a function of fat-free mass, and when expressed per kg body weight, it decreases as the percentage of body fat increases. If energy intake is not modified appropriately in order to match lower energy cost per kg body weight in overweight and obese women it will result in positive energy balance, thus contributing to the current trend towards increasing adiposity in affluent society. The results of these studies go beyond the current state of knowledge on PA and pregnancy (study 4) and provide valid evidence to guide clinical practice. In view of the current epidemic of sedentary behaviour and obesity related pathology, the findings contribute new and reliable information to public health policies regarding the effects of PA in pregnancy, an important period of life for both mother and infant.

Electronic monitoring of compliance to lipid-lowering therapy in clinical practice

Nonadherence to treatment is a common problem in the clinical management of hypercholesterolemic patients. This study was carried out with the aim of monitoring the daily compliance to a 6-month course of lipid-lowering therapy, using a microelectronic device, the Medication Event Monitoring System (MEMS), versus pill count. Forty men with primary hypercholesterolemia were prescribed fluvastatin 1 x 40 mg daily, provided in a MEMS package to record the date and time of each opening of the pillbox. Thirty-nine of 40 patients (98%) completed the study. Total cholesterol and LDL cholesterol levels decreased significantly (18% and 25%, p < 0.001) during the 6-month therapy period. A high mean rate of compliance was achieved by MEMS using the following three indexes--compliance to total prescribed dose (88.8% +/- 13.5%), compliance to prescribed days (82.4% +/- 19.5%), and compliance to prescribed time of day (81.86% +/- 19.5%)--and by pill count (93.4% +/- 9.5%). In addition, the MEMS provided some patterns of nonadherence to medication, undetectable by pill count alone, such as a drug holiday in 38% of cases, a drug omission for more than 7 consecutive days in 9% of cases, and, conversely, use of more than the one prescribed daily dose in 47% of cases. A significant correlation between the rate of compliance and the decrease in LDL cholesterol was observed only when the compliance was assessed by MEMS. The results indicate that MEMS is a useful tool for monitoring compliance in clinical practice and may possibly increase adherence to long-term lipid-lowering therapy.

Evolution of foraging behaviour in response to chronic malnutrition in Drosophila melanogaster.

Chronic exposure to food of low quality may exert conflicting selection pressures on foraging behaviour. On the one hand, more active search behaviour may allow the animal to find patches with slightly better, or more, food; on the other hand, such active foraging is energetically costly, and thus may be opposed by selection for energetic efficiency. Here, we test these alternative hypotheses in Drosophila larvae. We show that populations which experimentally evolved improved tolerance to larval chronic malnutrition have shorter foraging path length than unselected control populations. A behavioural polymorphism in foraging path length (the rover-sitter polymorphism) exists in nature and is attributed to the foraging locus (for). We show that a sitter strain (for(s2)) survives better on the poor food than the rover strain (for(R)), confirming that the sitter foraging strategy is advantageous under malnutrition. Larvae of the selected and control populations did not differ in global for expression. However, a quantitative complementation test suggests that the for locus may have contributed to the adaptation to poor food in one of the selected populations, either through a change in for allele frequencies, or by interacting epistatically with alleles at other loci. Irrespective of its genetic basis, our results provide two independent lines of evidence that sitter-like foraging behaviour is favoured under chronic larval malnutrition.

Behaviour evaluation for risk-taking adolescents (BERTA): an easy to use and assess instrument to detect adolescent risky behaviours in a clinical setting.

To create an instrument to be used in an outpatient clinic to detect adolescents prone to risk-taking behaviours. Based on previous research, five identified variables (relationship with parents and teachers, liking going to school, average grades, and level of religiosity) were used to create a screening tool to detect at least one of ten risky behaviours (tobacco, alcohol, cannabis and other illegal drugs use; sexual intercourse and sexual risky behaviour; driving while intoxicated, riding with an intoxicated driver, not always using a seat belt, and not always using a helmet). The instrument was tested using the Barcelona Adolescent Health Survey 1993. A Receiver Operating Characteristics curve was used to find the best cut-off point between high and low risk score. Odds ratios and 95% confidence intervals were calculated to detect at least one risky behaviour and for each individual behaviour. In order to assess its predictive value, the analysis was repeated using the Barcelona Adolescent Health Survey 1999. In both cases, analyses were conducted for the whole sample and for younger and older adolescents. Adolescents with a high-risk score were more likely to take at least one risky behaviour both when the whole sample was analysed and by age groups. With very few exceptions, the Behaviour Evaluation for Risk-Taking Adolescents showed significant odds ratios for each individual variable. CONCLUSION: The Behaviour Evaluation for Risk-Taking Adolescents has shown its potential as an easy to use instrument to screen for risk-taking behaviours. Future research must aim towards assessing this instrument's predictive value in the clinical setting and it's application to other populations.

Exploiting triatomine behaviour: alternative perspectives for their control

Living in close association with a vertebrate host and feeding on its blood requires different types of adaptations, including behavioural adjustements. Triatomines exhibit particular traits associated with the exploitation of their habitat and food sources and these traits have been the subject of intense analysis. Many aspects of triatomine behaviour have been relatively well characterised and some attempts to exploit the behaviours have been undertaken. Baited traps based on host-associated cues, artificial refuges and light-traps are some of the tools used. Here we discuss how our knowledge of the biology of Chagas disease vectors may help us sample and detect these insects and even increase the efficiency of control measures.

Vaporization behaviour and some thermodynamic properties of the Pd-In, Pd-Pb, Pd-Sn systems

In this study, the vaporization behaviour of solid Pd-rich phases in the Pd-Pb, Pd-In and Pd-Sn systems was investigated by Knudsen-effusion-cell coupled with mass-spectrometry. The Pb, Pd, In vapor pressures [no Sn(g) has been detected in the vapor of Pd-Sn system] were evaluated in the temperatures range 1190-1563 K from the ion intensities measured over two-phases regions. Thermodynamic quantities were derived from vapor pressure data. In particular, for the Pd-Sn binary, the intermediate phase Pd7Sn2, the existence of which has been recently proposed, has been studied here for the first time. Furthermore, preliminary thermochemical data are presented for the diatomic intermetallic molecules PdSn and PdPb, which have been for the first time identified in the vapors in equilibrium over liquid solutions of appropriate composition at higher temperatures (1935-2025 K). (C) 2000 Elsevier Science Ltd. All rights reserved.

Compliance im öffentlichen Sektor : Untersuchung über den allfälligen Nutzen eines Compliance-Management-Systems in der öffentlichen Verwaltung am Beispiel des Bundesamtes für Gesundheit

Par Compliance, on entend l'ensemble des mesures organisationnelles d'une entreprise qui visent à assurer le respect des règles par l'entreprise et ses collaborateurs. Dans le secteur privé - surtout dans les banques et les assurances - la Compliance est un concept bien établi et le poste du Compliance Officer apparaît clairement dans l'organigramme des entreprises. Ce terme apparaît aussi de temps à autre au sein de l'administration fédérale, en relation avec la politique de gestion des risques et le système de contrôle interne (SCI) ; mais une introduction effective de la Compliance n'y a pas encore eu lieu (jusqu'ici). Les Américains ont l'habitude de dire « if you think compliance is expensive, try non compliance ». Cette déclaration, apparemment valable pour le secteur privé, peut-elle cependant être transposée telle quelle au secteur public ? L'introduction d'un système de management tel que la Compliance apporterait-elle effectivement une plus-value par rapport aux systèmes existants afin d'éviter les risques engendrant des conséquences juridiques ou causant une mauvaise réputation suite au non-respect de règles par des collaborateurs ? La présente étude se penche sur ces questions et analyse, sur la base de documents et d'interviews, quels éléments de la Compliance existent au niveau de la Confédération et au sein de l'Office fédéral de la santé publique (OFSP) et s'ils sont propres à atteindre les objectifs visés par la Compliance. Dans plusieurs domaines, on a pu constater des défauts et, par conséquent, un gros potentiel d'amélioration. Le problème principal est l'absence d'organisation au niveau de la Compliance. Cela complique la vue d'ensemble des risques juridiques et de ceux pouvant causer une mauvaise réputation qui existent au niveau de la Confédération et à l'OFSP et rend impossible un management homogène de ces risques. En conséquence et dans l'état actuel des choses, il pourrait s'avérer difficile d'éviter de manière durable la réalisation des risques susmentionnés au moyen des systèmes existants. D'un autre côté, la politique de gestion des risques au sein de la Confédération et l'introduction d'un système de contrôle interne (SCI) ont représenté les premiers pas en direction d'un système de gestion des risques intégré. La Compliance serait un complément idéal et pourrait - dans la mesure où la direction de l'Office la soutient et donne le bon exemple - contribuer à la réduction des risques décrits ci-dessus non seulement au niveau de la Confédération mais encore au sein de l'OFSP. La présente étude ne vise pas pour autant à critiquer les systèmes établis, mais bien plus à montrer le potentiel d'amélioration dont on pourrait tirer profit.