557 resultados para sedentary behaviours


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Sports tourism has received growing attention in academic research over the past two decades (Weed and Bull, 2009, Gibson, 2005) but greater understanding of the consumer is needed, particularly the factors influencing decisions to include sport as part of a leisure trip. This paper provides, through a focus on the sport of golf, insight into the characteristics of the sports tourist and how sports tourist behaviours influence the selection of locations deemed suitable for sports participation. This qualitative research employs a grounded theory methodology, underpinned by a constructivist epistemology, to evaluate twenty-six in-depth interviews with golf tourists. The findings propose a model which explains the relationship between golf tourist behaviours and destination selection. This identifies six strands which determine the relationship between the golf tourist, golf behaviours and destination selection (constructing the golf holiday, emotional rewards of taking a trip, total trip spend, amenities and support facilities, course characteristics and reputation of the destination). Furthermore it illuminates the complexity of these relationships through recognition of four spheres of influence (group dynamics, competition and ability, golfing capital and intermediaries). Discussion elucidates how this increased understanding of the golf tourist behaviours and destination selection might be applied to other sports, with conclusions exploring implications for the sports tourism industry and destinations.

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For the official publication, see: http://dx.doi.org/10.1016/j.lindif.2016.06.021

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The Health Behaviours in School Children (HBSC) survey 2014 shows that overall health levels are good. There are encouraging findings on consumption of fruit and vegetables, teeth cleaning, and a drop in smoking levels and consumption of sweets and soft drinks.  However, many children said they find it easy to get cigarettes, too many children are going to bed hungry, and there are concerns about levels of cyber bullying. A total of 13,611 pupils were surveyed with questions on topics like general health, food and dietary behaviour, exercise and physical activity, self-care, smoking, use of alcohol and other substances, bullying including cyber bullying, and sexual health behaviours.

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Objective Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. Methods A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. Results All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence “maintaining standards”), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that “distributed leadership” was predominant, whereby leadership was “distributed” or “shared” among team members. The leadership behaviors within TBS also seemed to fall in line with the “direction, alignment, and commitment” ontology. Conclusions Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.

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Ethanol, classified as a drug, affects the central nervous system, and its consumption has been linked to the development of several behaviours including tolerance and dependence. Alcohol tolerance is defined as the need for higher doses of alcohol to induce the same changes observed in the initial exposure or where repetitive exposures of the same alcohol dose induce a lower response. Ethanol has been shown to interact with numerous targets and ultimately influence both short and long term adaptation at the cellular and molecular level in brain [1]. These adaptation processes are likely to involve signalling molecules: our work has focussed on G proteins gene expression. Using both wild type and several mutant fruit fly (Drosophila melanogaster) as a model for behaviour and molecular studies, we observed significant increases in sedation time (ST50) in response to alcohol (P<0.001) Fig.A. We also observed a consistent and significant decrease of Gq protein mRNA expression in Drosophila dUNC and DopR2 mutants chronically exposed to alcohol (*P<0.05). Fig B. Method: Six male flies were observed in drosophila polystyrene 25 x 95mm transparent vial in between cotton plugs. To the top plug, 500uL of 100% ethanol was added. Time till 50% of the flies were sedated was recorded on each day following the schedule. Fig. C (n=4-6). Using RT-PCR, we also quantified G protein mRNA expression levels one hour post initial 30 minutes of ethanol expression on day 1 and day 3 relative to expression in naïve flies.(n=2) [A] Increase in sedation time indicative of tolerance in different mutant lines and wild type flies. Six male flies were used in each experiment and (n= 4-6. ***P<0.001 unpaired t tests). [B] RT-PCR results showing significant reduction in Gq mRNA in flies chronically exposed to alcohol. (n=2. *P<0.05) [C] Alcohol exposure schedule. (1) Kaun K.R., R. Azanchi, Z. Maung, J. Hirsh, U. Heberlein. (2011). A Drosophila model for alcohol reward. Nature Neuroscience. 14 (5), 612–619.

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Flow experience, a holistic sensation of total involvement in an activity, seems to have positive influences on musical performance activities. Although its main requirements (balance between challenges and skills, clear goals and unequivocal feedback) are inherent elements of musical practice, there is a lack of research about flow occurrences in the context of musical practice and on how specific practice behaviours affect the experience of flow and its particular dimensions. The aims of this thesis were to investigate advanced performersʼ dispositions to flow in musical practice, and to investigate whether the frequency of these experiences of holistic engagement with practice are associated with self-regulatory practice behaviours. 168 advanced classicallytrained performers (male = 50.0%; female = 50.0%), ranging in age from 18 to 74 years (m = 34.41, SD = 12.39), answered a survey that included two measures: the Dispositional Short Flow Scale, assessing performersʼ flow dispositions, and the Self-Regulated Practice Behaviours Questionnaire, developed specifically for the present research. The overall results of the survey suggested that advanced musicians have high dispositions to flow in musical practice, but not associated with the participantsʼ demographic characteristics. Three of the individual flow indicators were less experienced, suggesting that the most intense flow experiences are rare in musical practice. However, the results point to the existence of another relevant experience, named optimal practice experience. Practice engagement levels were positively associated with knowledge of oneʼs own personal resources and a capacity for practice organization, but not with inclusion/use of external resources. A capacity for setting optimal practice goals was related to self-regulation and to immersion aspects of flow. Current findings offer new clues about the assessment of flow dispositions in performers, helping to clarify how daily practice can heighten positive affective responses in musicians who are vulnerable to the requirements and difficulties of deliberate practice, as well as to other negative practice outcomes. The current research questions issues pertaining to the optimization and sustaining of flow in daily practice, suggesting future directions in the study of the affective subjective functioning of engagement with deliberate practice.

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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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The 'Dark Triad' of socially aversive personality traits (Machiavellianism, Narcissism, and Psychopathy) is typically associated with grandiosity, callousness, and exploitation. Despite this, people with such traits can be very successful in life, especially in the occupational context. This study investigated the characteristics of individuals who enable and abet people high on Dark Triad traits (e.g. through tolerating unpleasant behaviours, not challenging unethical conduct, etc.). High Dark Triad individuals may be able to identify individuals who are susceptible to social manipulation and who are therefore less likely to challenge their behaviours. This study used a 20-item Vulnerability Scale to capture the characteristics of individuals who fall victim to people high on the Dark Triad traits. Cronbach's alpha for the Vulnerability Scale was .80. Pearson's correlation between total vulnerability scores and each of the Big Five personality traits revealed that predictors of vulnerability to social manipulation include low extraversion, low conscientiousness, high neuroticism, and high agreeableness. The vignette method was used to elicit perceptions of Dark Triad behaviours from those who are found to demonstrate signs of social vulnerability. Differences in response styles on Likert-type statements and open-ended questions were found between the high and low vulnerability groups.

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Understanding the evolution of sociality in humans and other species requires understanding how selection on social behaviour varies with group size. However, the effects of group size are frequently obscured in the theoretical literature, which often makes assumptions that are at odds with empirical findings. In particular, mechanisms are suggested as supporting large-scale cooperation when they would in fact rapidly become ineffective with increasing group size. Here we review the literature on the evolution of helping behaviours (cooperation and altruism), and frame it using a simple synthetic model that allows us to delineate how the three main components of the selection pressure on helping must vary with increasing group size. The first component is the marginal benefit of helping to group members, which determines both direct fitness benefits to the actor and indirect fitness benefits to recipients. While this is often assumed to be independent of group size, marginal benefits are in practice likely to be maximal at intermediate group sizes for many types of collective action problems, and will eventually become very small in large groups due to the law of decreasing returns. The second component is the response of social partners on the past play of an actor, which underlies conditional behaviour under repeated social interactions. We argue that under realistic conditions on the transmission of information in a population, this response on past play decreases rapidly with increasing group size so that reciprocity alone (whether direct, indirect, or generalised) cannot sustain cooperation in very large groups. The final component is the relatedness between actor and recipient, which, according to the rules of inheritance, again decreases rapidly with increasing group size. These results explain why helping behaviours in very large social groups are limited to cases where the number of reproducing individuals is small, as in social insects, or where there are social institutions that can promote (possibly through sanctioning) large-scale cooperation, as in human societies. Finally, we discuss how individually devised institutions can foster the transition from small-scale to large-scale cooperative groups in human evolution.

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The purpose of this study was to examine if the effects of exposure to educational videos on climate change and exposure to a view of nature could elicit environmentalist behaviours and increase one’s environmental identity. It was predicted that participants who were exposed to a view of nature and saw a video on climate change would have a higher likelihood to plant a seed and experience greater connectedness to nature. Fifty-four students (38 females, 15 males, and 1 gender fluid) with ages ranging from 18 to 47 were recruited for the experiment. A 2 (type of video) x 2 (type of view) factorial design was conducted, in which participants were randomly assigned to watch either an educational video on climate change or on popsicles, and they either had a view of outdoors or indoors. There was no significant interaction for setting and video (p = .172) on whether participants chose to plant a seed or not. Likewise, there was no significant interaction for setting and video (p = .262) on planting intentions. There was a significant effect for the video on experiencing connection to nature (p = .039, ηp2 = .08). These findings suggest that this video could change one’s perception of nature.

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Este estudo caracteriza a incidência do excesso de peso e da obesidade no Externato João Alberto Faria (Arruda dos Vinhos), procurando identificar as variáveis que os determinam e definir um projecto de intervenção na área da educação para a saúde no âmbito dos estilos de vida saudáveis e do combate ao excesso de peso e à obesidade. Dos 432 alunos que participaram no estudo, 53,7°/o eram do sexo feminino e 46,3% do sexo masculino. Os resultados relativos ao índice de Massa Corporal (IMC) dos alunos indicaram que, na população em estudo, 31,7% dos alunos apresentavam peso em excesso, dos quais 10,5% eram obesos. A prevalência de excesso de peso e obesidade era superior nos alunos mais novos e nas raparigas, no entanto os rapazes eram mais obesos. Em virtude dos resultados, identificaram-se como áreas de intervenção, a melhoria dos hábitos alimentares, o aumento dos níveis de actividade física e a diminuição das catividades de lazer sedentárias dos alunos, bem como intervenções ao nível das crenças, atitudes e comportamentos dos alunos e dos pais. O projecto de intervenção apresentado tem como objectivo reduzir a prevalência do excesso de peso e obesidade infantil através da aquisição e desenvolvimento de atitudes e comportamentos que visem a promoção e adopção de hábitos e estilos de vida saudáveis. É sabido que mudar atitudes e comportamentos, nomeadamente, os que dizem respeito a mudança de estilos de vida, é um processo difícil e que leva tempo, sendo fundamental uma abordagem integrada que afecte as várias dimensões das causas do problema em que se pretende intervir. ABSTRACT; This study characterizes the incidence of overweight and obesity in Externato João Alberto Faria (Arruda dos Vinhos). lts aim was to identify the variables that causes it and to define a project of intervention in the health educational field related to healthy lifestyles and against overweight and childhood obesity. 432 students participated in the survey: 53,7% females and 46,3% males. The results as far as students Body Mass Index are concerned show that within the surveyed people 31,7% were overweight and 10,5% were obese. Overweight and obesity have more evidence in the younger students and in the girls' group, despite the fact that boys were more obese. Such results lead to the intervention in certain areas: improving eating habits, increasing physical activity, diminishing sedentary hobbies and also interfering in the beliefs and attitudes of children and their parents. The intervention project presented has the following goal: to reduce the prevalence of overweight and childhood obesity through the acquisition and development of attitudes and behaviours witch aim at de promotion and adoption of healthy habits and lifestyles. Changing attitudes and behaviours related to the improving of lifestyles is difficult and takes time. Therefore, the need for an integrated approach is crucial in order to affect the several causes of the problem in witch we want to intervene.

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Introduction: Every individual has a necessity to establish affective relationships throughout life in order to feel comfort and support. This need is called attachment and allows the human being to explore the world, acquiring knowledge about himself and everyone else(1) There are several changes that occur on students’ lives when enrolling and attending university, a period that is known to include a set of situational and academic transitions which might lead to mental health problems, and thus making students more vulnerable and more prone to develop suicidal behaviours. Objectives: To determine the prevalence of suicidal ideation on higher education students and to assess its relationship with attachment patterns. Methods: Quantitative, descriptive and correlational study, applied on a sample of 1074 students from a Portuguese higher education institution. Data collection was possible through an online platform that included a survey with questions regarding sociodemographical and academic profiling, the Portuguese version of the Adult Attachment Scale (EVA)(2) and the Suicidal Ideation Questionnaire(3) Results: Students’ age varies between the 17 and 49 ( = 23,9 years old ± 6,107 Sd), the vast majority (64.7%) are females. Results show that the presence/severity of suicidal thoughts is low ( = 13.84; ± 20.29 Sd) on a scale from 0 to 180 and cut-off point > 41 for values that suggest potential suicidal risk, and based on that, 84 students were identified (7,8%). We verified significant relationships between suicidal ideation and anxiety and attachment (r=0.314 p=0.000). Conclusions: Although there is not a high prevalence of suicidal ideation on students, we found 84 students in our sample (7,8%) that reveal a potential risk for suicide. The results also show that young students with safe attachment patterns display less suicidal ideation. Safe attachment patterns are essential on interpersonal and social relationships and play an important role during the academic period. We cannot be indifferent towards this issue due to its individual, familiar and social repercussions. Every higher education institution should then establish student support offices and develop mental health promotion programs as well as suicide prevention campaigns.

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Background: The principal mode of HIV transmission in Southern Africa is through sexual intercourse, and this has prompted uptake of safe male circumcision. Engaging in risky sexual behaviour by circumcised men increases the risks of acquiring HIV, though male circumcision coupled with preventive behaviour reduces this risk. Objective: To compare the factors associated with risky sexual behaviour among circumcised and uncircumcised men in Botswana. Methods: Nationally representative data from the Botswana AIDS Impact Survey III were used. A sample of 313 sexually active men was used. The data was analysed by cross-tabulation and logistic regression. Results: The study revealed that uncircumcised men (odds ratio, 5.711) were more likely to have sex while intoxicated with alcohol compared to circumcised men. Low levels of education (odds ratio, 8.736), urban residency (city/town: odds ratio, 1.238 and urban village: odds ratio, 1.098) were more likely to influence risky behaviour (more than one sexual partner) for circumcised men. The results also show that marital status (never married) (odds ratio, 1.947) influences risky behaviour (having sex while intoxicated with alcohol) among uncircumcised men. Conclusion: Low level of education, place of residence and alcohol consumption influences risky sexual behaviour for both circumcised and uncircumcised men. Policies and programmes should thus focus on the attitudes underlying sexual behaviour.