865 resultados para posttraining behaviors
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Abstract: In the mid-1990s when I worked for a telecommunications giant I struggled to gain access to basic geodemographic data. It cost hundreds of thousands of dollars at the time to simply purchase a tile of satellite imagery from Marconi, and it was often cheaper to create my own maps using a digitizer and A0 paper maps. Everything from granular administrative boundaries to right-of-ways to points of interest and geocoding capabilities were either unavailable for the places I was working in throughout Asia or very limited. The control of this data was either in a government’s census and statistical bureau or was created by a handful of forward thinking corporations. Twenty years on we find ourselves inundated with data (location and other) that we are challenged to amalgamate, and much of it still “dirty” in nature. Open data initiatives such as ODI give us great hope for how we might be able to share information together and capitalize not only in the crowdsourcing behavior but in the implications for positive usage for the environment and for the advancement of humanity. We are already gathering and amassing a great deal of data and insight through excellent citizen science participatory projects across the globe. In early 2015, I delivered a keynote at the Data Made Me Do It conference at UC Berkeley, and in the preceding year an invited talk at the inaugural QSymposium. In gathering research for these presentations, I began to ponder on the effect that social machines (in effect, autonomous data collection subjects and objects) might have on social behaviors. I focused on studying the problem of data from various veillance perspectives, with an emphasis on the shortcomings of uberveillance which included the potential for misinformation, misinterpretation, and information manipulation when context was entirely missing. As we build advanced systems that rely almost entirely on social machines, we need to ponder on the risks associated with following a purely technocratic approach where machines devoid of intelligence may one day dictate what humans do at the fundamental praxis level. What might be the fallout of uberveillance? Bio: Dr Katina Michael is a professor in the School of Computing and Information Technology at the University of Wollongong. She presently holds the position of Associate Dean – International in the Faculty of Engineering and Information Sciences. Katina is the IEEE Technology and Society Magazine editor-in-chief, and IEEE Consumer Electronics Magazine senior editor. Since 2008 she has been a board member of the Australian Privacy Foundation, and until recently was the Vice-Chair. Michael researches on the socio-ethical implications of emerging technologies with an emphasis on an all-hazards approach to national security. She has written and edited six books, guest edited numerous special issue journals on themes related to radio-frequency identification (RFID) tags, supply chain management, location-based services, innovation and surveillance/ uberveillance for Proceedings of the IEEE, Computer and IEEE Potentials. Prior to academia, Katina worked for Nortel Networks as a senior network engineer in Asia, and also in information systems for OTIS and Andersen Consulting. She holds cross-disciplinary qualifications in technology and law.
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Thesis (Ph.D.)--University of Washington, 2016-08
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Thesis (Ph.D.)--University of Washington, 2016-08
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Abstract The developmental changes during adolescence may affect subsequent risk for diseases and health-related behaviors. Traditionally, professionals assume that knowledge is sufficient for behavioral changes; however adolescents continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge". Motivational Interview (MI) may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects. Objectives The objective of this scoping is to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. The review will focus on knowing what is the current extent of the use of nurse-led MI; which adolescent populations were included; in which contexts nurses use MI; which MI techniques/strategies have been used and what outcomes on health behaviors promotion have been reported. Methodology This scoping review will be informed by JBI methodology. The population of this study is adolescents aged 10 to 19 years participating in nurse-led MI. The concept of MI include MI done by personal or telephone call, with any number of sessions, brief interventions and other motivational interventions grounded but not limited to the principles described by Miller & Rollnick (2008). All geographical and all clinical practice contexts where nurses' undertake MI with adolescents such as hospitals, primary health care, health care centers, community or schools will be contemplated. English, Spanish and Portuguese published studies will be considered for inclusion. Results An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the concepts, synonyms (with truncations), MeSH Terms and Cinhal headings of this study. It was identified 5 synonyms for "Adolescents", 7 for "MI" and 2 for "nurse". A first search using the all 14 identified keywords and index terms was made at Medline (Title/Abstract) and brought up 125 articles. Other 16 databases referenced at the protocol will be searched to identify additional studies. Articles identified from the final search will be assessed for relevance to the review, based on information provided in the title and abstract. The full article will be retrieved for all studies that meet the inclusion criteria of the review. It is expected that findings from this Scoping Review provide needed information to nurses related to the use of MI to promote health behaviors in adolescents. Conclusions There is little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to nurse-led MI. There is a need for scoping or mapping the nurse-led MI with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. Moreover, information regarding implemented and evaluated interventions, techniques used, contexts of application and adolescents groups is dispersed in the literature which impedes the formulation of questions about the outcomes and effectiveness of those interventions. The practical implication of this mapping will be clarifying all these aspects.
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Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.
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Abstract The developmental changes during adolescence may affect subsequent risk for diseases and health-related behaviors. Motivational Interview (MI) may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects. At this context, it is important to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. Objetives A scoping review has been currently undertaking to find out what is the current extent of the use of nurse-led MI; which adolescent populations were included; in which contexts nurses use MI; which MI techniques/strategies have been used and what outcomes on health behaviors promotion have been reported. The first task was to develop a search strategy to identify relevant studies for this review. It is described here the experience in constructing a search strategy for this review. Methodology This scoping review will be informed by JBI methodology. An initial search of MEDLINE and CINAHL was undertaken. An analysis of the text words contained in the title and abstract, and of the index terms used to describe the searched articles were retrieved and these were then used to construct a search strategy for use in Medline and Cinahl. Results Analysis of the text words and the index terms generated 19 keywords: It was identified 5 synonyms for "Adolescents", 12 for "MI" and 2 for "nurse". A new research formula was designed using the text words identified. Adolescen*[Title/Abstract]) OR Younger*[Title/Abstract]) OR Youth*[Title/Abstract]) OR Teen*[Title/Abstract]) OR Adolescent[MeSH Terms])) AND (((((((((((("Motivational interview"[Title/Abstract]) OR "Motivational intervention"[Title/Abstract]) OR "Motivational interviews"[Title/Abstract]) OR "Motivational interventions"[Title/Abstract]) OR "motivational interviewing"[Title/Abstract]) OR "motivational counseling"[Title/Abstract]) OR "motivational support"[Title/Abstract]) OR "Motivational enhancement"[Title/Abstract]) OR "Brief intervention"[Title/Abstract]) OR "Brief interventions"[Title/Abstract]) OR Motivational Interviewing[MeSH Terms]) OR Directive Counseling[MeSH Terms])) AND ((nurs*[Text Word]) OR Nurses[MeSH Terms]). Limiters - Language: English, Portuguese, Spanish. In MEDLINE this research formula generated 125 results. Other 16 databases referenced at the protocol will be searched to identify additional studies. Articles identified from the final search will be assessed for relevance to the review, based on information provided in the title and abstract. The full article will be retrieved for all studies that meet the inclusion criteria of the review. Conclusions It was presented here the initial results of this search. Next steps of this study will be to develop and refine the search strategy for use in other databases. It is expected that findings from this Scoping Review provide needed information to nurses related to the use of MI to promote health behaviors in adolescents and inform opportunities for future development in nursing practice.
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Background: Adolescent suicidal behaviors are a public health priority. Objectives: Suicidal behavior is an understudied field in the Azores, and the few existing research studies with Portuguese adolescents only include young people from Mainland Portugal. This study aims at analyzing the adolescent student population from this island region so as to describe the current situation and plan community intervention projects in this area to meet the identified needs. Methodology: This is a non-experimental, quantitative and descriptive-correlational study with the purpose of describing phenomena and finding associations between variables. Results: The results showed that 17.9% of the 484 sampled adolescents reported self-harm behaviors, with 12.7% reporting self-cutting and 5.2% medication overdose or ingestion of toxic substances. Around 15.5% of the adolescents reported suicidal ideation. Additionally, they showed high levels of depressive symptoms (19.9%), ranging from moderate (12%) to severe (7.9%). Conclusion: Adolescents had more self-harm behaviors, more severe depressive symptoms, a lower self-concept and fewer coping strategies than similar populations in mainland Portugal.
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Three projects in my dissertation focus on the termination of internal conflicts based on three critical factors: a combatant’s bargaining strategy, perceptions of relative capabilities, and reputation for toughness. My dissertation aims to provide the relevant theoretical framework to understand war termination beyond the simple two-party bargaining context. The first project focuses on the government’s strategic use of peace agreements. The first project suggests that peace can also be designed strategically to create a better bargain in the near future by changing the current power balance, and thus the timing and nature of peace is not solely a function of overcoming current barriers to successful bargaining. As long as the government has no overwhelming capability to defeat all rebel groups simultaneously, it needs to keep multiple rebel groups as divided as possible. This strategic partial peace helps to deter multiple rebel groups from collaborating in the battlefield and increases the chances of victory against non-signatories. The second project deals with combatants’ perceptions of relative capabilities. While bargaining theories of war suggest that war ends when combatants share a similar perception about their relative capabilities, combatants’ perceptions about relative capabilities are not often homogeneous. While focusing on information problems, this paper examines when a rebel group underestimates the government’s supremacy in relative capabilities and how this heterogeneous perception about the power gap influences negotiated settlements. The third project deals with the tension between different types of reputations in the context of civil wars: 1) a reputation for resolve and 2) a reputation for keeping human rights standards. In the context of civil wars, the use of indiscriminate violence by the government is costly, and as such, it signals the government’s toughness (or resolve) to rebel groups. I argue that the rebels are more likely to accept the government’s offer when the government recently engaged in indiscriminate violence against civilians during the conflict. This effect, however, is conditional on the government’s international human rights reputation; suggesting that rebel groups interpret this violence as a signal particularly when the government does not have a penchant for attacking civilians in general.
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Introduction: Self-perceived weight status among adolescents has been associated with weight-control behaviors. However, this relationship varies across weight status. Objectives: The aim of this study was to examine the effect of self-perceived weight status on dieting and unhealthy weight-control behaviors among Spanish male adolescents, across weight status. Method: Participants were 597 Spanish male adolescents (M = 13.94 years old, SD = 0.60). Body weight and height were measured in situ. Self-perceived weight status, dieting, and unhealthy weight-control behaviors were evaluated. Results: The adolescents were inaccurate on estimating their weight status. Those who were overweight or obese, or who perceived themselves to be so, were more likely to report dieting and unhealthy weight-control behaviors. Discussion: There is a need to promote healthier eating behaviors among adolescents, and to take into account the fact that self-perceived weight status may hinder the adoption of such behaviors.
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This study examined the conversational behaviors of eleven dyads consisting of a person with aphasia (PWA) and their familiar communication partner (CP), and investigated changes in behaviors as a result of attending a communication partner-training program CPT). Attitudes about communication were examined and related to conversational behaviors observed pre- and post- training. Results indicated that CPs and PWA used significantly more facilitating behaviors than barrier behaviors, although most dyads experienced some barriers. A comparison of pre-and post-CPT conversations revealed a significant interaction between time and type of behavior, with the increase in the number of facilitators approaching significance. Overall, persons with aphasia and their conversational partners expressed positive attitudes about communication. There were no significant correlations between scores on attitude surveys and behaviors pre or post-training. This study demonstrated that these dyads employed facilitative conversational behaviors even before CPT, and that facilitative behaviors can increase after a one-day training workshop.
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Background: Leptospirosis, a disease caused by Leptospira species, a spirochaete bacterium that can develop in an appropriate environment and/or grow in human and/or animal hosts, is a serious problem for the Ministry of Public Health, Thailand. Objective: To investigate people’s perceptions and behavioral risks regarding leptospirosis infection. Methods: The cross-sectional descriptive study collected data in May, 2013. Data on individuals’ perceptions and risky behaviors concerning leptospirosis were collected from 104 completed questionnaires. Results: Regarding perceptions of leptospirosis, we found them to be at a high level (97.1%) and risky behaviors regarding leptospirosis were reported at a moderate level (74.0%). The study found no correlation between perceptions and risky behaviors regarding leptospirosis (r 0.186, p-value 0.059). Conclusion: This study suggest that people in these areas have good knowledge about leptospirosis. However, some people have risky behavior associated with leptospirosis. Thus, a behavioral change campaign should be promoted to encourage people awareness of the dangers of such behavior.
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The present article is about a particular form of sexual activity on the Internet: cybersex in chatrooms-in Portuguese by Portuguese people. This study aims to identify the reasons for engaging in cybersex on chats and the behavioral domains that characterize this activity. To carry out the study, we developed a self-report questionnaire that we made available on a website. The sample was collected online (n = 400) through the Portuguese Internet Relay Chat. Factor analyses revealed seven domain structures: (a) social skills, (b) preference for cybersex, (c) filter for a later date, (d) sex by phone, (e) fantasies, (f) using masks, and (g) impact on real relationships. We found a huge variety of sexual attitudes and behaviors connected to cybersex in chatrooms and the existence of two major trends: (a) people that use these chats as a starting place for offline relationships (online anonymity prevents the fear of rejection and social sanctions in real life), and (b) people who want and prefer online sex without any interest in further real contacts.