'Occasional' and 'social' smokers: Potential target groups for smoking cessation campaigns?

Objective: To describe the characteristics [of self-described 'occasional' and 'social' Australian smokers. Design: Analysis of a national cross-sectional survey of smoking patterns, conducted in Australia in 2004. Setting and participants: Australian adults in 2004 who responded to a survey question about self-described smoking status. Main outcome measures: Demographic characteristics, patterns of alcohol and tobacco use, smoking cessation attempts in the past year, and interest in cessation. Results: Smokers who described themselves as 'occasional' and 'social' smokers comprised 29% of all smokers. A significant proportion of occasional and social smokers had been daily smokers, but the majority either believed that they had 'already quit' or had no intention of quitting smoking. Conclusions: Self-ascribed occasional and social smokers potentially represent an important target group for cessation. These types of smokers may be more resistant to public health messages regarding cessation because they do not view their smoking behaviour as presenting a high risk.

Supermodularity and risk aversion

In this paper, we consider the relationship between supermodularity and risk aversion. We show that supermodularity of the certainty equivalent implies that the certainty equivalent of any random variable is less than its mean. We also derive conditions under which supermodularity of the certainty equivalent is equivalent to aversion to mean-preserving spreads in the sense of Rothschild and Stiglitz. (c) 2006 Elsevier B.V. All rights reserved.

Urinary excretion of cadmium among Torres Strait Islanders (Australia) at risk of elevated dietary exposure through traditional foods

This study explored urinary cadmium levels among Torres Strait Islanders in response to concerns about potential health impact of high levels of cadmium in some traditional seafood (dugong and turtle liver and kidney). Cadmium levels were measured by inductively coupled mass spectrometry in de-identified urine samples collected during general screening programs in 1996 in two communities with varying dugong and turtle catch statistics. Statistical analysis was performed to identify links between cadmium levels and demographic and background health information. Geometric mean cadmium level among the sample group was 0.83 mu g/g creatinine with 12% containing over 2 mu g/g creatinine. Cadmium level was most strongly associated with age (46% of variation), followed by sex (females > males, 7%) and current smoking status (smokers > non-smokers, 4.7%). Adjusting model conditions suggested further positive associations between cadmium level and diabetes (p = 0.05) and residence in the predicted higher exposure community (p = 0.07). Positive correlations between cadmium and body fat in bivariate analysis were eliminated by control for age and sex. This study found only suggestive differences in cadmium levels between two communities with predicted variation in exposure from traditional foods. However, the data indicate that factors linked with higher cadmium accumulation overlap with those of renal disease risk (i.e. older, females, smokers, diabetes) and suggest that levels may be sufficient to contribute to renal pathology. More direct assessment of exposure and health risks of cadmium to Torres Strait Islanders is needed given the disproportionate level of diet-related disease and the cultural importance of dugong and turtle. This study highlights the need to consider social and cultural variation in exposure and to de. ne "safe'' cadmium levels during diabetes given its rising global prevalence.

PERCEPÇÃO DE SUPORTE SOCIAL E CONSUMO DE ÁLCOOL EM DESEMPREGADOS

O desemprego tem sido objeto de preocupação no contexto político, econômico e social, uma vez que a população de trabalhadores desempregados enfrenta dificuldades diárias para a obtenção de trabalho/ou emprego, situação que gera intenso sofrimento psíquico e pode repercutir de modo negativo na saúde do trabalhador. Este estudo teve por objetivo investigar a percepção de suporte social e o consumo de álcool em desempregados. Por meio de estudo epidemiológico, quantitativo e transversal constituímos uma amostra de 300 indivíduos, recrutados em uma agência pública em São Bernardo do Campo SP, que capta vagas no mercado e encaminha trabalhadores para recolocação profissional. A amostra resultou em 54,3% pessoas do gênero masculino, com idade média de 29,30, com mínimo de 18 anos e máximo de 56 anos; 67% tinham ensino médio, sendo 50% solteiros, 52% encontravam-se desempregados de um a seis meses, 37% residiam em imóvel próprio, e 37% possuíam renda familiar de um a dois salários mínimos. Foram utilizados três instrumentos auto-aplicáveis para coleta dos dados: a) Questionário de características sócio-demográficas; b) Escala de Percepção de Suporte Social (EPSS); c) Teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT). Os dados coletados foram submetidos ao programa estatístico SPSS, versão 15.0 para Windows que permitiu fazer as correlações entre as variáveis. Os resultados indicaram correlações significativas entre as variáveis: suporte prático e renda; suporte prático e suporte emocional, com idade. Estas correlações sugeriram que os sujeitos apresentavam melhor percepção de suporte prático na medida em que aumentava a renda familiar, e que quanto maior a idade, menor é a percepção do suporte prático e emocional recebido pela rede social. O AUDIT não apontou correlações significativas entre as variáveis estudadas, e 76% da amostra se situou na zona 1 consumo de baixo risco ou abstinência. Não verificamos correlação entre consumo de álcool e desemprego.(AU)

Strategic and operational risk in an international collaboration agency: a knowledge management solution

The International Cooperation Agency (identified in this article as IDEA) working in Colombia is one of the most important in Colombian society with programs that support gender rights, human rights, justice and peace, scholarships, aboriginal population, youth, afro descendants population, economic development in communities, and environmental development. The identified problem is based on the diversified offer of services, collaboration and social intervention which requires diverse groups of people with multiple agendas, ways to support their mandates, disciplines, and professional competences. Knowledge creation and the growth and sustainability of the organization can be in danger because of a silo culture and the resulting reduced leverage of the separate group capabilities. Organizational memory is generally formed by the tacit knowledge of the organization members, given the value of accumulated experience that this kind of social work implies. Its loss is therefore a strategic and operational risk when most problem interventions rely on direct work in the socio-economic field and living real experiences with communities. The knowledge management solution presented in this article starts first, with the identification of the people and groups concerned and the creation of a knowledge map as a means to strengthen the ties between organizational members; second, by introducing a content management system designed to support the documentation process and knowledge sharing process; and third, introducing a methodology for the adaptation of a Balanced Scorecard based on the knowledge management processes. These three main steps lead to a knowledge management “solution” that has been implemented in the organization, comprising three components: a knowledge management system, training support and promotion of cultural change.

Social and scientific issues in the acceptibility of radiation risks

Ionising radiation hazards are perhaps the most documented and regulated occupational and environmental hazard. In the radiological protection field a single expert advisory organisation has had an unusually large influence on the international standard setting process. This is the International Commission on Radiological Protection (ICRP). Two common, and opposing views, exist over the formulation of protection recommendations by the ICRP. The first, and most widely accepted, is that its recommendations are scientifically determined. The second view, is that its recommendations are politically or socially determined. Neither of these analyses adequately accounts for the complex process in which protection recommendations are formulated. A third view, provided by studies of the origins of scientific controversy, suggests that both science and social factors are important in the assessment and limitation of risk. The aim of this thesis is not simply to examine the origin of controversy. Issues of equal, if not more, importance are the resolution of controversy, the formation of consensus and the maintenance of expert authority and influence. These issues form the central focus of this thesis. The aim is to assess the process through which the ICRP formulates its radiological protection recommendations and comment on the extent that these are influenced by the affiliations of its members. This thesis concludes that the ICRP's recommendations have been shaped by a complex relationship of scientific and social considerations, in which a socio-technical commitment to nuclear energy has played a key role. The Commission has responded to new scientific data by making complex changes to its philosophy and methods of describing risk. Where reductions in numerical limits have been applied they have been accompanied by practical measures designed to limit the impact of the change and provide continuity with the old limits and flexibility in the application of the new recommendations.

"Crack down on the celebrity junkies": does media coverage of celebrity drug use pose a risk to young people?

This study analysed news media content to examine the role played by celebrity drug use in young people's perceptions of drug use. We know that young people have access to discourses of drug use through music and other media which may emphasise short term gains (of pleasure or sexual success) over longer term health and social problems. This study goes beyond a simple modelling approach by using Media Framing Analysis (MFA) to take an in-depth look at the messages themselves and how they are 'framed'. New stories about Amy Winehouse's drug use were used and we conducted focus groups with young people asking them questions about drugs, celebrity and the media. Frames identified include: 'troubled genius', 'losing patience' and 'glamorization or gritty realism'. Initially, the press championed Winehouse's musical talent but soon began to tire of her recklessness; the participants tended to be unimpressed with Winehouse's drug use, characterising her as a promising artist who had 'gone off the rails'. Young people were far more critical of Winehouse than might be expected, demonstrating that concerns about the influence of celebrity drug use and its impact on future health risk behaviour among young people may have been over-simplified and exaggerated. This study illustrates the need to understand young people and their frames of reference within popular culture when designing drug awareness information relevant to them. Furthermore, it indicates that critical media skills analysis may contribute to health risk education programmes related to drug use.

Perception of risk, feelings of vulnerability and effects on driving behaviour in women drivers across the lifespan.

Sustained driving in older age has implications for quality of life and mental health. Studies have shown that despite the recognised importance of driving in maintaining health and social engagement, many women give up driving prematurely or adopt self-imposed restrictive driving practices. Emotional responses to driving have been implicated in these decisions. This research examined the effect of risk perception and feelings of vulnerability on women’s driving behaviour across the lifespan. It also developed and tested a modified theory of planned behaviour intervention to positively affect driving habits. The first two studies (N=395) used quantitative analysis to model driving behaviours affected by risk perception and feelings of vulnerability, and established that feelings of vulnerability do indeed affect women’s driving behaviour, specifically resulting in increases in driving avoidance and the adoption of maladaptive driving styles. Further, that self-regulation, conceptualised as avoidance, is used by drivers across the lifespan. Qualitative analysis of focus group data (N=48) in the third study provided a deeper understanding of the variations in coping behaviours adopted by sub-groups of drivers and extended the definition of self-regulation to incorporate adaptive coping strategies. The next study (N=64) reported the construction and preliminary validation of the novel self-regulation index (SRI) to measure wider self-regulation behaviours using an objective measure of driving behaviour, a simulated driving task. The understanding gained from the formative research was used in the final study, an extended theory of planned behaviour intervention to promote wider self-regulation behaviour, measured using the previously validated self-regulation index. The intervention achieved moderate success with changes in affective attitude and normative beliefs as well as self-reported behaviour. The results offer promise for self-regulation, incorporating a spectrum of planning and coping behaviours, to be used as a mechanism to assist drivers in achieving their personal mobility goals whilst promoting safe driving.

Reducing the risk of sexually transmitted infections in genitourinary medicine clinic patients:A systematic review and meta-analysis of behavioural interventions

Objectives: Are behavioural interventions effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients? Design: Systematic review and meta-analysis of published articles. Data sources: Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register, National Research Register (1966 to January 2004). Review methods: Randomised controlled trials of behavioural interventions in sexual health clinic patients were included if they reported change to STI rates or self reported sexual behaviour. Trial quality was assessed using the Jadad score and results pooled using random effects meta-analyses where outcomes were consistent across studies. Results: 14 trials were included; 12 based in the United States. Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care. Eight trials reported data on laboratory confirmed infections, of which four observed a greater reduction in their intervention groups (in two cases this result was statistically significant, p<0.05). Seven trials reported consistent condom use, of which six observed a greater increase among their intervention subjects. Results for other measures of sexual behaviour were inconsistent. Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length. Conclusions: While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required.

An overview of psychological and neurobiological mechanisms by which early negative experiences increase risk of mood disorders

Objective: Early life experiences are associated with severe and long-lasting effects on behavioural and emotional functioning, which in turn are thought to increase the risk for unipolar depression and other disorders of affect regulation. The neurobiological and psychological mechanisms through which adverse early life experiences confer risk are poorly understood. Method: Alterations in brain structure and function in limbic and prefrontal cortical regions have been linked to early negative experiences and to mood disorders. Results: There are a number of psychological domains that may be dysfunctional in people with mood disorders, and which, if the dysfunction occurs prior to onset of mood symptoms, may signify a risk factor for depression. Cognitive dysfunction has been examined in patients with mood disorders, with some suggestion that changes in cognitive function may antedate the onset of mood symptoms, and may be exacerbated in those who experienced early negative trauma. Social cognition, including emotion comprehension, theory of mind and empathy, represent under-studied domains of psychological function that may be negatively influenced by early adverse experience. Temperament and personality factors may also leave people vulnerable to mood instability. Conclusion: This review summarizes the evidence for dysfunction in each of these domains for people with mood disorders.

The cost of sin:the effect of social norms on audit pricing

In this paper we provide evidence for the effects of social norms on audit pricing by studying companies belonging to the alcohol, firearms, gambling, military, nuclear power, and tobacco industries,which are often described as “sin” companies. We hypothesize that the disparities between “sin” firms operations and prevailing social norms create an adverse context which heightens the client's business risk assessment by auditors and is, thereby, reflected in the pricing decisions for audit and consulting services. Having controlled for the impact of variables relating to client attributes, auditor attributes and engagement attributes, we demonstrate that audit firms charge significantly higher audit and consulting fees to companies that deviate from prevailing social norms. Additionally,we show that audit pricing levels within the “sin” group depend both on prevailing political views and on the level of “vice” exhibited by “sin” companies.

Growth aspirations and social capital:young firms in a post-conflict environment

This article explores the growth aspirations of owners and managers of young firms in a post-conflict economy by focusing on social capital. It treats social capital as a multidimensional, multilevel phenomenon, studying the effects of discussion network characteristics, trust in institutions, generalised trust in people and local ethnic pluralism. We argue that in a post-conflict country, ethnic pluralism is indicative of local norms of tolerance towards experimentation and risk taking which support growth aspirations. It also distinguishes between the aspirations of hired managers and owners-managers. The empirical counterpart and hypotheses testing rely on survey evidence drawn from young businesses in Bosnia and Herzegovina.

Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD)

Aims - To investigate the effect of a range of demographic and psychosocial variables on medication adherence in chronic obstructive pulmonary disease (COPD) patients managed in a secondary care setting. Methods - A total of 173 patients with a confirmed diagnosis of COPD, recruited from an outpatient clinic in Northern Ireland, participated in the study. Data collection was carried out via face-to-face interviews and through review of patients’ medical charts. Social and demographic variables, co-morbidity, self-reported drug adherence (Morisky scale), Hospital Anxiety and Depression (HAD) scale, COPD knowledge, Health Belief Model (HBM) and self-efficacy scales were determined for each patient. Results - Participants were aged 67 ± 9.7 (mean ± SD) years, 56 % female and took a mean (SD) of 8.2 ± 3.4 drugs. Low adherence with medications was present in 29.5 % of the patients. Demographic variables (gender, age, marital status, living arrangements and occupation) were not associated with adherence. A range of clinical and psychosocial variables, on the other hand, were found to be associated with medication adherence, i.e. beliefs regarding medication effectiveness, severity of COPD, smoking status, presence of co-morbid illness, depressed mood, self-efficacy, perceived susceptibility and perceived barriers within the HBM (p < 0.05). Logistic regression analysis showed that perceived ineffectiveness of medication, presence of co-morbid illness, depressed mood and perceived barriers were independently associated with medication non-adherence in the study (P < 0.05). Conclusions - Adherence in COPD patients is influenced more by patients’ perception of their health and medication effectiveness, the presence of depressed mood and co-morbid illness than by demographic factors or disease severity.

The paradox of social resilience:how cognitive strategies and coping mechanisms attenuate and accentuate resilience

This paper examines two concepts, social vulnerability and social resilience, often used to describe people and their relationship to a disaster. Social vulnerability is the exposure to harm resulting from demographic and socioeconomic factors that heighten the exposure to disaster. Social resilience is the ability to avoid disaster, cope with change and recover from disaster. Vulnerability to a space and social resilience through society is explored through a focus on the elderly, a group sometimes regarded as having low resilience while being particularly vulnerable. Our findings explore the degree to which an elderly group exposed to coastal flood risk exhibits social resilience through both cognitive strategies, such as risk perception and self-perception, as well as through coping mechanisms, such as accepting change and self-organisation. These attenuate and accentuate the resilience of individuals through their own preparations as well as their communities' preparations and also contribute to the delusion of resilience which leads individuals to act as if they are more resilient than they are in reality, which we call negative resilience. Thus, we draw attention to three main areas: the degree to which social vulnerability can disguise its social resilience; the role played by cognitive strategies and coping mechanisms on an individual's social resilience; and the high risk aspects of social resilience. © 2014 Elsevier Ltd. All rights reserved.