In the developed world, the principal sources of morbidity and mortality are diseases of lifestyle, and one of the central goals of health promotion is the encouragement of risk-reducing behaviour. In a series of 3 studies, the present program of research examined the effect of self-affirmation and manipulated perceived efficacy on perceptions of efficacy, risk perception, and risk-reducing behavioural intentions. Participants were undergraduate students who were randomly assigned to a self-affirmation manipulation (self-affirmation versus no self-affirmation) and a perceived efficacy manipulation (high versus low versus baseline), followed by exposure to negative health risk information (risk of a heart attack or colorectal cancer). Across the 3 studies, factor analyses indicated 3 distinct categories of risk-reducing intentions: intentions associated with maintaining an active lifestyle, seeking medical advice and assessment, and maintaining a healthy diet. There was little evidence that self-affirmation affected efficacy, risk, or intentions. Structural equation modeling and meta-analytic analyses suggested the presence of a suppression effect for risk perception: a manipulation designed to increase perceived efficacy had direct positive effects on risk, but also had indirect negative effects on risk, with measured efficacy acting as a mediator. These analyses also showed that the 3 categories of behavioural intentions had distinct (and often different) antecedents. These results highlight the complexity of variables in health risk behaviour. Implications and future directions are discussed. / Thesis (Ph.D, Psychology) -- Queen's University, 2010-08-20 09:56:44.707

Thesis (MScPhysio (Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Background: Children who lack the motor coordination to perform the tasks that have usually been acquired at their age, given normal intellectual ability and the absence of other neurological disorders, are classified as having Developmental Coordination Disorder (DCD) according to DSMIV. Limited professional resources prohibit individual therapy and these children are being treated in “gross motor groups” regardless of the fact that this has limited proven efficacy. This study aims to investigate whether group exercise physiotherapy does improve the gross motor function of children with DCD aged six to ten years old. Methods: Thirty-nine children were assessed at pre and post intervention on the Movement Assessment Battery for Children (M-ABC) as well as the Perceived Efficacy and Goal Setting (PEGS) questionnaire by a blinded research assistant. They were randomly allocated to either a control (N=19) or an intervention group (N=20). The intervention group was then further subdivided into groups of four to six per group to attend group exercise sessions of 30 – 45 minutes three times per week. Group exercises were aimed at improving manual dexterity, ball skills and balance by incorporating aerobic exercises, strengthening exercises, coordination as well as task specific activities. Results: There was a significant increase (p=.028) in the total scores tested by the experimental group on the M-ABC after the eight week intervention. Manual dexterity skills had improved significantly (p=.035). There was a trend for ball skills to improve (p=.088) but no improvement was recorded for static or dynamic balance post intervention. PEGS results indicated that subjects considered themselves as very competent regardless of their abilities. Conclusions: The results of this study support the hypothesis that an eight week group exercise program can improve the gross motor skills of children with DCD. It would seem that implementing such an intervention is a viable option, especially where resources limit the availability of one to one therapy. / AFRIKAANSE OPSOMMING: Agtergrond: Kinders wat „n gebrek aan motoriese koördinasie het om ouderdoms verwante take te verrig, gegewe dat hulle normale intellektuele vermoëns het en die afwesigheid van ander neorologiese abnormaliteite, word geklassifiseer as “Developmental Coordination Disorder” (DCD) volgens die DSM IV. Beperkte professionele menslike hulpbronne voorkom individele terapie en hierdie kinders word gewoonlik behandel in grofmotoriese groepe, ongeag dat daar min bewyse is dat dit „n effektiewe behandelings metode is. Die doel van hierdie studie is om vas te stel of „n fisioterapie groepsoefenprogram „n effektiewe behandelingsvorm is om die grofmotoriese vaardighede in ses tot tienjarige primêre skool kinders, met „n diagnose van DCD, verbeter. Metodes: Nege-en-dertig kinders was geassesseer met die “Movement Assessment Battery for Children” (M-ABC) en die “Perceived Efficacy and Goal Setting” (PEGS) vraelys deur „n geblinde navorsingsassistent. Hulle is in twee groepe nl kontrole groep wat nie intervensie gekry het nie (N=19) en „n eksperimentele groep (N=20)verdeel deur eenvoudige ewekansige toewysing. Die eksperimentele groep was verder onderverdeel in groepe van vier tot ses om groepsoefeningsessies by te woon drie keer „n week vir 30 tot 45 minute. Die doel van die groepsoefeninge was om die volgende areas te verbeter: handvaardigheid, balvaardigheid en balans deur die inkorporasie van balansaktiwiteite, spierversterkingsoefeninge, koördinasie sowel as taak spesifieke aktiwiteite. Die deelnemers was weer geassesseer met die Movement-ABC en die PEGS na die agt weke lange intervensie program. Resultate: Daar was 'n beduidende toename (p=.028) in die algehele telling deur die eksperimentele groep op die M-ABC na die agt weke deelname. Handvaardigheid het beduidend verbeter (p=.035). Daar was „n tendens vir balvaardighede om te verbeter (p=0.88), maar geen verbetering was aangedui vir balans na die ingryping nie. Die PEGS resultate was moeilik om te interpreteer aangesien die deelnemers hulself as baie vaardig gesien het ten spyte van hulle vermoëns. Gevolgtrekking: Die resultate van hierdie studie ondersteun die hipotese dat 'n doelgerigte groepsoefeningsprogram wel die grofmotoriese vaardighede van kinders met „n diagnose van DCD verbeter. Fisioterapeute kan 'n groepsofeningsprogram met vertroue implementeer waar 'n tekort aan menslike hulpbronne een tot een terapie beperk.

No description available.

No description available.

As a growing body of research has focused on the individual, social, and environmental factors that facilitate life after spinal cord injury (SCI), particular emphasis has been placed on health conditions that are modifiable and preventable. Subsequent injuries are a serious health problem for individuals with SCI. They are a direct threat to further morbidity and mortality, and are both a cause and consequence other secondary health conditions. As a first step toward understanding this public health problem, the purpose of this dissertation research was to describe the patterns, burdens, and prevention of subsequent injury among individuals with SCI. In three distinct, but related studies, this dissertation examined the characteristics of hospitalizations due to an injury among individuals with paraplegia, and compared the differences in length of stay (LOS) and hospital costs of injury hospitalizations between individuals with quadriplegia versus paraplegia. In addition, it explored the experience of subsequent injury among individuals with SCI who return to work and examined perceptions of threat and efficacy in preventing subsequent injury using the Extended Parallel Process Model. Using discharge level weighting available in the Nationwide Inpatient Sample, Study 1 calculated national estimates of injury hospitalizations for individuals with paraplegia by patient, hospital, and injury characteristics. Most injury hospitalizations occurred among males, to individuals 35-49 years, and were due to falls, poisonings, or motor vehicle traffic. With the same dataset, Study 2 used logistic regression to estimate the effect of patient characteristics on odds of hospitalized patients with quadriplegia versus paraplegia, and linear regression to estimate predicted differences in hospital costs for individuals with quadriplegia compared to paraplegia. Fewer injury hospitalizations but longer hospital stays, and higher hospital costs per discharge were found for individuals with quadriplegia compared to individuals with paraplegia. Males, younger age, and the uninsured were significant predictors of higher hospital costs. Finally, Study 3 used in-depth interviews to qualitatively explore the perceptions on subsequent injury among individuals with SCI who return to work, and found individuals with SCI who return to work recognized the importance of preventing subsequent injury, and were taking actions to prevent subsequent injury in their daily life and in the workplace. The significance of this research is that it is the first description of injury hospitalizations for all causes of injury by specific type of SCI, and the associated medical outcomes of LOS and direct medical costs. Prevention of subsequent injury should be a priority. The perceptions of individuals with SCI about the severity of and their susceptibility to injury and the efficacy of individual and environmental actions to prevent subsequent injury described in this research should be used to inform the development of interventions that prevent subsequent injury.

A prévention de l'anorexie, et plus largement des troubles de comportement alimentaire, revêt un intérêt social et sociétal fort. Elle comporte également un intérêt académique, ce contexte étant sous-représenté en recherche. Les communications existantes sur la prévention de l'anorexie utilisent la stratégie de l'appel à la peur, malgré une littérature non consensuelle sur le niveau d'appel à adopter et sur le fonctionnement exact du mécanisme. La littérature propose également, pour expliquer l'échec de l'appel à la peur, l'existence d'une réactance situationnelle, sans que celle-ci n'ait jamais été validée. Quatre expérimentations auprès de jeunes femmes étudiantes, public particulièrement sensible dans ce contexte, permettent de comprendre et valider le fonctionnement de l'appel à la peur par médiations successives et en intégrant la réactance situationnelle. Il est montré que le message avec appel à la peur crée un état cognitivo-émotionnel composé de peur et de sévérité perçue qui vont influer de manière opposée sur la réactance situationnelle. Cette dernière influence à son tour la perception d'efficacité de la recommandation, qui déterminera ensuite le succès ou l'échec du message. En parallèle, le rôle médiateur, mais secondaire, de l'auto-efficacité sur l'efficacité perçue de la recommandation est révélé, de même que celui modérateur de la vulnérabilité perçue. En complément de ce résultat, chacune des études s'attache à manipuler, en plus du niveau d'appel à la peur, différentes composantes et caractéristiques du message, dont les effets sur le mécanisme d'appel à la peur permettent de résoudre, en partie, certains conflits existants dans la littérature. Ainsi, le rôle des composantes, visuelle et verbale, sur le niveau ressenti de peur est examiné (études 1 et 2). L'effet de la formulation de la recommandation (étude 2), de même que l'effet du type d'argument (étude 3) sur le processus de l'appel à la peur sont analysés. Enfin, l'ajout du dégoût à l'appel à la peur et la validation du fonctionnement du processus par une mesure comportementale affinent encore la compréhension des mécanismes d'action de l'appel à la peur (étude 4). Pour conclure, les clés d'une communication préventive de l'anorexie efficace avec recours à l'appel à la peur sont données et les résultats discutés et complétés par des voies de recherche possibles, dont certaines permettent de pallier les limites mentionnées pour la présente recherche. / Anorexia prevention or more widely disorder eating behavior, has a strong social and societal interest. It also presents an academic interest, since this context is under-represented in research. Existing anorexia prevention campaigns use the strategy of fear appeal, despite a non-consensual literature on the level of fear appeal to adopt and the exact functioning of the mechanism. The existing literature also suggests, to explain failure of fear appeal, that there is a situational reactance, even though this has never been validated. Four experiments on young women students, public particularly sensitive to this context, allow us to understand and validate the mechanism of fear appeal in successive mediations and while integrating situational reactance. Through these experiments, it is shown that the message with fear appeal creates a cognitive and emotional state of fear, and perceived severity that will oppositely influence situational reactance. The latter influences the perceived efficacy of recommendation, which in turn determines the success or failure of the message. In parallel, the mediator, but secondary role, of self-efficacy on the perceived efficacy of the recommendation is revealed, as well as the moderator of perceived susceptibility. Furthermore, each study attempts to handle, in addition to the level of fear appeal, various components and characteristics of the message, whose effects on the fear appeal mechanism solve in part, some existing conflicts in the literature. Thus, the role of the components, visual and verbal, on the level of fear felt is examined (studies 1 and 2). The effect of the wording of the recommendation (study 2), as well as the effect of the type of argument (study 3) on the process of fear appeal are analyzed. Finally, the addition of the disgust on fear appeal and the validation process by a behavioral measure yet refine understanding the mechanism of fear appeal (study 4). To conclude, the key preventive effective communication with anorexia use of fear appeals are given and results are discussed and complemented with possible future research directions, some of which are used to overcome the limitations mentioned on this research.