This study aimed to answer whether current research addressing executive function abilities in cochlear implant users was accurately depicting their impairments. Secondly, this study aimed to identify differences in identification of executive function impairments when measured using parent report versus behavioral measures of executive function. Results suggest that children do have executive function impairments in areas of measure nonverbal planning, problem-solving, monitoring, and self-regulation abilities as well as attention to a visually presented array of pictures which has been documented in previous research. However, it is likely that these abilities are modulated by children with cochlear implants' poorer language ability as demonstrated on the PPVT, which seems not to be related to their age of implantation. The behavioral measures and parent report measures identified impairments in the subsets which required a greater language demand and subsequently subsets that were significantly more difficult for CI children.

A large body of research has examined the appropriate time course of psychotherapy across a variety of therapeutic modalities. Research in the area of Acceptance and Commitment Therapy (ACT) has indicated the efficacy of single-session interventions in improving anxiety, depression, and even weight loss. These findings, though promising, are accompanied by the question of how much ACT is enough to make a statistically and clinically significant difference in symptoms. The present study sought to clarify this question among individuals with depression. Adults (N = 271) with elevated depressive symptoms were recruited via mass emails for a study comparing the relative effectiveness of time-variant single-session ACT interventions (90 minutes, 3 hours, 6 hours). Inclusion criteria included PHQ-8 score 10, no history of TBI, no current psychotherapy, and no medication changes in the past 60 days. Eligible participants completed a screening interview, which included modules from the M.I.N.I. Exclusion criteria included active suicidality, past or current mania, and past or current psychoses. If interested in participating (n=351), eligible participants could complete the baseline measure after enrolling in the study. Participants were randomized to a single-session 90-minute, 3-hour, or 6-hour group ACT intervention. About half (51.2%) of enrolled and randomized participants completed their assigned group intervention. Follow-up assessments were completed at 1-month and 3-months post-intervention with limited attrition. Longitudinal mixed-effects modeling was used to examine change over time and between conditions. Findings indicated that depressive symptoms and avoidance decreased over time, and social satisfaction increased over time. Differences between conditions and interactions between time and condition were not observed. Equivalency analyses revealed that the 3- and 6-hour groups were not within the margin of equivalence in terms of depressive symptoms. Mindfulness analyses revealed that at 3-month follow-up, the 3- and 6-hour groups reported higher mindfulness than the 90-minute group. The findings have public health implications in terms of reaching a larger number of patients with increased efficiency. Given the far greater patient demand than number of therapists available, increased access and efficiency are of great importance. The results also suggest that individuals with depression can make rapid, sustainable changes, and this is of critical importance clinically. Limitations included a homogenous sample of primarily white, highly educated females, and the lack of a no-treatment control group. The findings of the current study indicate that brief group ACT interventions can result in change in both processes (avoidance, mindfulness) and functioning (depressive symptoms, social satisfaction) months after the single-session intervention. Future research should examine the effectiveness of brief interventions with other symptomatology as compared to a no-treatment control or a more traditional course of psychotherapy.

Different reasons for social withdrawal include a performance deficit, a social skill deficit, lack of peer support, and avoidance of anxiety or aversive interactions. Each of these reasons for social withdrawal may require a different intervention. This study investigated the utility of brief experimental analysis for identifying the most functional intervention to increase positive peer interactions for three socially withdrawn students. Using a multiple baseline and multi-element single subject design, three treatments were administered to compare differences in peer interactions during recess. Interventions were contingent reward, a social skills training with peer mediation, and a brief cognitive-behavioral strategy. Although students responded differently to the three interventions, the social skills training with peer mediation intervention showed the greatest gains for all students during the brief assessment and when implemented over time.

Professional practice change and the transfer of research into practice are critical issues for the public health field. The program of research presented here investigated the potential for practice change in dental hygienists’ and Emergency Department nurses’ provision of brief interventions targeting smoking (of tobacco) and alcohol consumption respectively. Smoking and risky alcohol consumption are two high prevalence public health issues that have a substantial impact on the burden of death and illness in Australia. Research on dental hygienists’ and nurses’ uptake of these interventions is limited and has largely focused on descriptions of perceived barriers. Little research has been conducted on the attitudes and motivations of health professionals to engage in these interventions. The present research was designed to address that gap. Specifically, two behaviours by dental hygienists and Emergency Department nurses were investigated: identification of patients at risk and provision of assistance to such patients. The program of research applied the Theory of Planned Behaviour to these behaviours in order to: 1) examine the role of dental hygienists and Emergency Department nurses in the provision of brief interventions for smoking and alcohol consumption respectively, 2) assess the ability of the Theory of Planned Behaviour to understand and predict health professionals’ identifying and assisting behaviour, 3) assess the ability of the theory to account for the influence of organisational factors on workers’ behaviour, and 4) design and evaluate a Theory of Planned Behaviour-based professional practice change intervention. This is the first research to apply the Theory of Planned Behaviour to these behaviours, to examine the potential of the theory to account for the influence of organisational factors on workers’ behaviour, and to trial an intervention targeting behaviour in an organisational setting. The four studies undertaken provided a comprehensive application of the Theory of Planned Behaviour. In the first study, a meta-analysis of published research examined the ability of the Theory of Planned Behaviour to predict behaviours in an organisational setting. This was the first meta-analysis of studies applying the Theory of Planned Behaviour applications to organisational settings. The findings were comparable to results of a meta-analysis of studies applying the theory to social and health behaviours, supporting the application of the theory to the organisational setting, and also highlighted the potential importance of perceived behavioural control for work behaviours. Studies 2 to 4 were designed to follow Ajzen and Fishbein’s (1975) 3-step methodology for applying the theory. In Study 2, the behavioural, normative, and control beliefs held by dental hygienists and Emergency Department nurses, and potentially relevant organisational factors, such as workload and available support, were identified through in-depth qualitative interviews. Study 3 measured the ability of the Theory of Planned Behaviour to predict dental hygienists’ and Emergency Department nurses’ frequency of identifying and assisting. The theory was most successful in predicting dental hygienists’ frequency of assisting patients who smoke. The self-efficacy dimension of perceived behavioural control was the strongest predictor of this behaviour. The findings for Emergency Department nurses indicated that subjective norms were an important predictor of intentions to identify and assist patients. The Theory of Planned Behaviour accounted for the influence of organisational factors on behaviour for both dental hygienists and nurses. Study 4 involved a randomised controlled trial which evaluated a professional intervention targeting dental hygienists’ assistance of patients who smoke. Trends indicated potential benefits of the intervention, but overall no significant changes in dental hygienists’ role adequacy, role legitimacy, and targeted control beliefs emerged. This outcome was attributed to ceiling effects and the influence of a media campaign that coincided with the intervention. The research presented here provides partial support for the application of the Theory of Planned Behaviour to professional practice change efforts. Specifically, the ability of the theory to explain the impact of organisational factors and identify variables most predictive of behaviour may provide valuable insight for prioritising future professional practice change efforts.

Analgesic products can produce serious side effects. Because potent analgesics are not under medical surveillance but are available to the public without a medical prescription, any attempt to influence consumer behaviour in relation to these products must be via interventions at pharmacist level. The Australian government is now pressuring the pharmacy profession to monitor effectively the use of such non-prescription medication. The aim of this study was to train community pharmacists on brief intervention strategies for use in a pharmacy setting in relation to combination analgesic products. Focus groups showed that participants had concerns about adopting confrontational counselling styles, as they feared this would antagonise consumers leading to loss of patronage without having an impact on consumer behaviour. This concern was later reinforced by consumer interviews, which showed that a significant proportion of respondents thought that the use of non-prescription analgesics was their responsibility. A protocol for the sales of analgesic products was designed with these issues in mind. The transtheoretical model of change (TTM) and motivational interviewing were selected as theoretical frameworks, as they take into account differences among consumers in motivation and in intention to change behaviour and are congruent with pharmacists' concerns. Consumer-centred intervention strategies were tailored to the individual consumer according to his/her readiness to change. This approach was borrowed from the area of smoking secession in which it has been related to positive clinical outcomes. The assumption was made that TTM-based intervention would also be effective in a pharmacy setting in relation to analgesic products. In the initial pilot study, community pharmacists who simply attended a workshop in the cognitive-behavioural intervention strategies failed to incorporate the newly acquired skills to their practice and consequently lost their proficiency. In the subsequent pilot study, when the workshop was followed by ongoing on-site training with immediate feedback and coaching through the use of pseudo-patron visits, the investigator was able to shape community pharmacists' practice behaviour in relation to the monitoring of pharmacist only analgesic products. The methodology was then refined and in the final study trained pharmacists were significantly more likely than control pharmacists and baseline to engage in a number of behaviours related to the study intervention. These included handling the sales of pharmacist only analgesics themselves, identifying inappropriate use, assessing readiness to change, and delivering an intervention according to the consumer's readiness to change. The results suggested that in pharmacy practice post qualifying therapeutic skill transfer is not achieved by workshop presentation alone. Modelling of the desired behaviour involving reinforcement and feedback is necessary.

Thesis (Ph. D.)--University of Washington, 1984. / Vita. Bibliography: leaves [70]-78.

Background: Encounters between patient and health care have been shortened and fragmented. Times when the patient is in the continuum of care is related to how well the patient feels confirmed in the meeting with his/her carers. Aim : The aim of this study is to highlight skills that nurses use to provide good care relationships with patients in the ambulance and emergency room. Method: A literature review was done. Search for articles was conducted in the databases Cinahl and Pubmed. Nine articles were selected for analysis. Results: Nurses used various communication strategies to successfully establish a good nursing relationship in the meeting with the patient. Patients experienced the nurse who took time and was present in the meeting as the one who was really professional. Six themes were found. These were: Establish a communicative environment, establish contact, listening, verbal and nonverbal communication, being available and provide information. Conclusion : Nurses need to use his special skill to meet patient's need to feel valuable, seen and significant.

Zugl.: Berlin, Freie Univ., Diss., 2009

Heavy drinking puts college students at risk for academic failure, alcohol use disorders, and even death. Although several interventions have proven moderately successful, overall rates of collegiate heavy drinking and consequences have significantly increased since 1998, as interventions may not adequately address underlying reasons for drinking. Research has consistently shown that college students who drink primarily to regulate emotions (i.e., internal drinking motives) are heavier drinkers, experience more consequences, and are likely to continue drinking heavily after college. Further, internal drinking motives are indicative of emotion dysregulation and associated personality traits. Dialectical Behavior Therapy (DBT) is empirically supported and includes a group-based component designed to teach concrete behavioral emotion regulation, mindfulness, and distress tolerance skills. DBT skills training alone has been shown to reduce substance abuse and binge eating and is a promising, but untested, strategy for reducing collegiate alcohol abuse. The aims of the current study were threefold: (a) examine the efficacy of a DBT-based emotion regulation skills training (ERST) as an intervention for college student drinking, (b) examine theoretically-informed mechanisms of change (i.e., changes in mindfulness, emotion regulation, and distress tolerance), and (c) examine intervention moderators (i.e., gender, readiness to change, and internal drinking motives). After completing pre-test measures, college students reporting two or more heavy drinking episodes during the past month were randomly assigned to an ERST or assessment-only control (AO) condition. ERST participants completed a single 3-hour group session of ERST within 7 days of completing pre-intervention measures and all participants completed two additional assessments. The current study found that ERST participants showed significantly greater reductions in heavy drinking and alcohol-related consequences relative to AO control participants. Contrary to hypotheses, intervention participation did not increase hypothesized mechanisms of change (i.e., mindfulness, emotion regulation, or distress tolerance) although emotion regulation and distress tolerance moderated intervention efficacy. Finally, ERST participation appeared to serve as a protective factor against heavy drinking and consequences for internally motivated drinkers. Overall findings provide preliminary support for the feasibility of ERST as a new intervention for reducing problematic drinking by college students and suggest future directions for mechanisms of change and moderation hypotheses. / text

Introduktionen: I Sverige brännskadas ca 20 000 människor om året.  Livskvalitet anses vara olika för olika individer. För att bedöma livskvalitet efter en brännskada används The Burn Specific Health Scale- Brief (BSHS- B) som är ett brännspecifikt bedömningsinstrument. Syfte: Syftet med litteraturstudien var att beskriva patienters  upplevelser av livskvalitet efter en brännskada när livskvalitet bedömts med hjälp av The Burn Specific Health Scale- Brief. Metod: En litteraturstudie genomfördes med hjälp av en modifierad niostegsmodell efter Polit & Beck (2012). Artiklarna granskades noggrant enskilt och tillsammans av författarna. Tio artiklar skulle forma resultatet. Resultat: Artiklarna analyserades utifrån domänerna Simple Abilities, Hand function, Work, Heat Sensitivity, Treatment Regimens, Body Image, Affect, Interpersonal Relationship och Sexuality som tillsammans bygger upp BSHS-B. Resultatets teman i denna litteraturstudie är uppbyggt med samma domäner. Mellan 2-7 år efter brännskadan skattades livskvaliteten som högre, det var få individer som hade svårigheter med handfunktionen och män hade något lättare att återgå till arbetet. Även värmekänsligheten skattades med stora svårigheter. Hälften av studierna visade att deltagarna hade en negativ kroppsuppfattning och att relationen till familjen inte var påverkad i så stor utsträckning. Sexualiteten hos män var mindre påverkad av brännskadan än hos kvinnor. Slutsats: Förmågan att arbeta och tiden efter brännskadan påverkar livskvaliteten. Kvinnor upplevde att sexualiteten, värmekänsligheten och arbetet påverkades mer negativt av brännskadan än vad män gjorde.