Targeting sexual health services in primary care: a systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

BACKGROUND: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age. METHODS: We searched bibliographic databases for probability surveys of women aged 16-44years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014. RESULTS: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships. CONCLUSION: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply

Measures Matter: Scales for Adaptation, Cultural Distance, and Acculturation Orientation Revisited

Building upon existing measures, four new brief acculturation scales are presented, measuring sociocultural adaptation, psychological adaptation, perceived cultural distance, and acculturation orientation. Following good scale reliability in initial samples, the English scales were translated into nine different languages (Chinese, French, German, Italian, Japanese, Portuguese, Spanish, Thai, and Turkish). The translated scales were administered to a large sample of sojourners (N = 1,929), demonstrating good reliability and adequate structural equivalence across languages. In line with existing theory, sociocultural adaptation and psychological adaptation were positively correlated, and showed a negative association with perceived cultural distance. General measures of well-being were correlated with adaptation and distance, with better adaptation relating to higher well-being, and more distance relating to lower well-being. Acculturation orientation toward the home and host culture were measured separately and a weak negative correlation was found between the two, supporting their independence. Arguing against dichotomization, these subscales were analyzed as continuous variables. Regression analysis showed sojourners to be better adapted, if they were oriented more toward the host culture and less toward the home culture. These new scales are proposed as alternatives to existing measures

Do self-reported intentions predict clinicians behaviour: a systematic review.

Background: Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this review was to explore the relationship between intention and behaviour in clinicians and how this compares to the intention-behaviour relationship in studies of non-clinicians. Methods: We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med), ISI conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually. Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included measures of both intention and behaviour, measured behaviour after intention, and explored this relationship quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two reviewers, with disagreements resolved by discussion. Discussion: Ten studies were found that examined the relationship between intention and clinical behaviours in 1623 health professionals. The proportion of variance in behaviour explained by intention was of a similar magnitude to that found in the literature relating to non-health professionals. This was more consistently the case for studies in which intention-behaviour correspondence was good and behaviour was self-reported. Though firm conclusions are limited by a smaller literature, our findings are consistent with that of the non-health professional literature. This review, viewed in the context of the larger populations of studies, provides encouragement for the contention that there is a predictable relationship between the intentions of a health professional and their subsequent behaviour. However, there remain significant methodological challenges

Conscientiousness and fruit and vegetable consumption: exploring behavioural intention as a mediator

Clear associations have emerged between conscientiousness and health behaviours, such that higher levels of conscientiousness are predictive of beneficial health behaviours. This study investigated the conscientiousness-fruit and vegetable consumption relationship and whether behavioural intention mediated this relationship. A large sample of adults (N = 2136) completed an online battery of questionnaires measuring conscientiousness, behavioural intentions to consume fruit and vegetables, together with self-reported behaviour. Correlation analysis revealed that conscientiousness and each of its facets were positively associated with behavioural intention and self-reported behaviour. Hierarchical multiple regression analyses revealed that after controlling for age, gender and education, total conscientiousness, and the facets of responsibility, industriousness, order and virtue predicted self-reported behaviour. Further analysis revealed that in line with the Theory of Planned Behaviour, behavioural intention fully mediated the conscientiousness-fruit and vegetable behaviour relationship. In conclusion, low levels of conscientiousness were found to be associated with lower fruit and vegetable intentions, with the latter also associated with fruit and vegetable consumption

Is age a risk factor for liver disease and metabolic alterations in ataxia Telangiectasia patients?

Background: Ataxia telangiectasia (A-T) is a neurodegenerative disease that leads to mitochondrial dysfunction and oxidative stress. Insulin resistance (IR), type 2 diabetes and the risk for development of cardiovascular disease was recently associated as an extended phenotype of the disease. We aimed to assess IRliver involvementcarotid intima-media thickness (cIMT) and metabolic alterations associated to cardiovascular risk in A-T patients, and relate them with age. Results: Glucose metabolism alterations were found in 54.6% of the patients. Hepatic steatosis was diagnosed in 11/17 (64.7%) A-T patients. AST/ALT ratio > 1 was observed in 10/17 (58.8%). A strong positive correlation was observed between insulin sum concentrations with ALT (r = 0.782, p < 0.004) and age (r = 0.818, p = 0.002). Dyslipidemia was observed in 55.5% of the patients. The apolipoprotein (Apo-B)/ApoA-I ratio (r = 0.619p < 0.01), LDL/HDL-c (r = 0.490p < 0.05) and the Apo-B levels (r = 0.545p < 0.05) were positively correlated to cIMT. Conclusions: Metabolic disorders implicated in cardiovascular and liver diseases are frequently observed in adolescent A-T patients and those tend to get worse as they become older. Therefore, nutritional intervention and the use of drugs may be necessary.CAPES Foundation, Ministry of Education of Brazil, Brasilia DF, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Pediat, Rua Otonis 725, BR-04025002 São Paulo, SP, BrazilABC Fdn FMABC, Fac Med ABC, Dept Morphol & Physiol, Santo Andre, SP, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Diagnost Imaging, São Paulo, SP, BrazilSanta Casa São Paulo Sch Med Sci FCMSCSP, São Paulo, SP, BrazilFed Univ Alfenas UNIFAL, Sch Nutr, Alfenas, MG, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Pediat, Rua Otonis 725, BR-04025002 São Paulo, SP, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Diagnost Imaging, São Paulo, SP, BrazilWeb of Scienc

Why do consumers trust online travel websites? Drivers and outcomes of consumer trust toward online travel websites

Egypt is currently one of the leading nations especially in the Middle East region with a well-established e-commerce environment and advanced IT infrastructure, but rapid growth of e-commerce will soon occur in other nations with similar consumption patterns. This study tests a model of antecedents (consumer experience, propensity to trust, reputation, perceived website size, ease of use, perceived usefulness, and website quality) and consequences of consumers’ trust toward online travel websites. Trust is expected to predict consumer attitude, perceived risk, and intention to purchase travel online. Data of 1,431 users of online travel websites were selected from the Supreme Council of Universities Database–Egypt (SCU) and analyzed through structural equation modeling. The findings show that all the aforementioned factors with the exception of consumer experience influence consumer trust toward online travel websites. Trust influences consumers’ attitude, perceived risk, and intention to purchase travel online

A functional-cognitive framework for attitude research

In attitude research, behaviours are often used as proxies for attitudes and attitudinal processes. This practice is problematic because it conflates the behaviours that need to be explained (explanandum) with the mental constructs that are used to explain these behaviours (explanans). In the current chapter we propose a meta-theoretical framework that resolves this problem by distinguishing between two levels of analysis. According to the proposed framework, attitude research can be conceptualised as the scientific study of evaluation. Evaluation is defined not in terms of mental constructs but in terms of elements in the environment, more specifically, as the effect of stimuli on evaluative responses. From this perspective, attitude research provides answers to two questions: (1) Which elements in the environment moderate evaluation? (2) What mental processes and representations mediate evaluation? Research on the first question provides explanations of evaluative responses in terms of elements in the environment (functional level of analysis); research on the second question offers explanations of evaluation in terms of mental processes and representations (cognitive level of analysis). These two levels of analysis are mutually supportive, in that better explanations at one level lead to better explanations at the other level. However, their mutually supportive relation requires a clear distinction between the concepts of their explanans and explanandum, which are conflated if behaviours are treated as proxies for mental constructs. The value of this functional-cognitive framework is illustrated by applying it to four central questions of attitude research

Values of sexual behaviour in Central and Eastern Europe

Despite the profusion of social cognitive models for the prediction of sexual behaviour, we have only limited knowledge as to the role of individual values in predicting risky sexual activity. This study assessed the relationship between a recently developed value structure and sexual behaviour in the context of rising HIV infection in central and eastern Europe. Five hundred and three respondents (business people, doctors and nurses) from Estonia, Georgia, Hungary, Poland and Russia completed Schwartz’s Portrait Values Questionnaire and reported their condom use, partnership history and record of sexual disease. Results indicated that values had a moderate but consistent relationship with sexual behaviour, with riskier sexual activity reported by those high on Openness to Change, Hedonism and Self-Enhancement. These findings are discussed in the context of the need for culturally sensitive interventions in order to tackle the growing HIV epidemic in this region.This project was supported by a research grant from the Research Support Scheme operated by the Soros Foundation, Prague

The effect of personality traits and knowledge on the quality of decisions in supply chains

Supply chain and operations management requires frequent decision making, and decisions are importantly influenced by the personality traits and knowledge of the decision maker. Thus, we analyse the effect of those factors on the confidence and quality of decisions taken in the context of supply chain management. The data were gathered via an online supply chain simulation game where subjects needed to make several decisions. Personality traits of the participants were tested using the Big Five model. The structural model was estimated using the partial least squares structural equation modelling approach. We found that decision-makers with lower levels of extraversion and agreeableness and higher levels of conscientiousness and openness make better decisions. On the other hand, neuroticism and agreeableness negatively affect confidence in decisions. Tested knowledge positively influences both decision-makers’ confidence in and the quality of their decisions while self-reported knowledge has no significant effect. Therefore, the companies should carefully consider how an individual’s personality matches the type of job at hand and rely on tested instead of self-reported knowledge

Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults

BACKGROUND: Reliable and valid measures of total sedentary time, context-specific sedentary behaviour (SB) and its potential correlates are useful for the development of future interventions. The purpose was to examine test-retest reliability and criterion validity of three newly developed questionnaires on total sedentary time, context-specific SB and its potential correlates in adolescents, adults and older adults. METHODS: Reliability and validity was tested in six different samples of Flemish (Belgium) residents. For the reliability study, 20 adolescents, 22 adults and 20 older adults filled out the age-specific SB questionnaire twice. Test-retest reliability was analysed using Kappa coefficients, Intraclass Correlation Coefficients and/or percentage agreement, separately for the three age groups. For the validity study, data were retrieved from 62 adolescents, 33 adults and 33 older adults, with activPAL as criterion measure. Spearman correlations and Bland-Altman plots (or non-parametric approach) were used to analyse criterion validity, separately for the three age groups and for weekday, weekend day and average day. RESULTS: The test-retest reliability for self-reported total sedentary time indicated following values: ICC = 0.37-0.67 in adolescents; ICC = 0.73-0.77 in adults; ICC = 0.68-0.80 in older adults. Item-specific reliability results (e.g. context-specific SB and its potential correlates) showed good-to-excellent reliability in 67.94%, 68.90% and 66.38% of the items in adolescents, adults and older adults respectively. All items belonging to sedentary-related equipment and simultaneous SB showed good reliability. The sections of the questionnaire with lowest reliability were: context-specific SB (adolescents), potential correlates of computer use (adults) and potential correlates of motorized transport (older adults). Spearman correlations between self-reported total sedentary time and the activPAL were different for each age group: rho = 0.02-0.42 (adolescents), rho = 0.06-0.52 (adults), rho = 0.38-0.50 (older adults). Participants over-reported total sedentary time (except for weekend day in older adults) compared to the activPAL, for weekday, weekend day and average day respectively by +57.05%, +46.29%, +53.34% in adolescents; +40.40%, +19.15%, +32.89% in adults; +10.10%, -6.24%, +4.11% in older adults. CONCLUSIONS: The questionnaires showed acceptable test-retest reliability and criterion validity. However, over-reporting of total SB was noticeable in adolescents and adults. Nevertheless, these questionnaires will be useful in getting context-specific information on SB