Bakgrund: Feber drabbar barn någon eller några gånger om året, framförallt under småbarnstiden. En vanlig missuppfattning är att feber är ett potentiellt farligt tillstånd som kräver behandling. I motsats till detta har feber gynnsamma effekter när det kommer till kroppens bekämpande av infektioner. Kunskapsläget bland distriktssköterskor som ska tillhandahålla föräldrar rådgivning kring feber och febernedsättande läkemedel varierar, varför föräldrar riskerar att erhålla motstridiga och direkt felaktiga råd. Syfte: Syftet med denna litteraturstudie var att beskriva föräldrars kunskap rörande feber hos barn samt att belysa vårdpersonals attityder kring feberhantering. Metod: Arbetet har utförts i form av en integrativ litteraturstudie som inkluderade totalt 15 artiklar, såväl kvalitativa som kvantitativa. Integrativ studiedesign tillåter kvantitativa data att kvalificeras och kvalitativa data att kvantifieras så att de kan kombineras och sammanfogas till en gemensam helhet. Resultat: Det finns brister i kunskapen om feber hos barn hos vårdpersonal och föräldrar. Feberfobi är en samlande term för den okunskap och oro som riskerar leda till övernitisk behandling med antipyretika, både genom föräldrars eget initiativ och efter rekommendation från vårdpersonal. Feberkramper kan inte förhindras med febernedsättande läkemedel, trots det erhåller barn läkemedel i detta syfte och utsätts därmed för onödig biverkningsrisk. Diskussion: Ett behov av djupare kunskap hos både vårdpersonal och föräldrar finns för att inte evidensbaserad behandlingsregim ska riskera att gå förlorad till förmån för inadekvata och hemsnickrade varianter med onödig administration av antipyretika och vidare spridning av feberfobi. Nyckelord: Antipyretika, Barn, Feber, Feberfobi, Kunskap, Litteraturstudie / Introduction: Fever is something children, especially during infant years, experience one or a few times each year. A common misconception is that fever is a dangerous condition that requires treatment; however contrary to these misconceptions, fevers have positive effects when it comes to body’s ability to fight infections. The level of knowledge on this subject of district nurses, whose task it is to guide parents with advice concerning fevers and antipyretics, varies. This results in parents getting contradictory and erroneous advice. Aim: The aim of this literature study was to describe parents’ knowledge concerning fever in children, and to illuminate attitudes concerning fever treatment among health care professionals. Method: A literature review of 15 scientific articles where examined in accordance with an integrative study design. The integrative design allows qualitative and quantitative data to be combined and merged into a common whole. Results: There is a lack of knowledge about fevers in children among health care professionals and parents. Fever phobia is a collective term for the lack of knowledge and worrying that can lead to overzealous treatment with antipyretics; based on parents’ own initiative and recommendations from health care professionals. Antipyretics do not prevent febrile seizures, but many children are still medicated for this purpose. This, in turn, leads to increased risk for side effects. Discussion: There’s a need for a deeper knowledge, in both health care professionals and parents, to ascertain that an evidence-based treatment regimen is not replaced by inadequate and home-grown techniques, leading to unnecessary administration of antipyretics and further propagation of fever phobia. Keywords: Antipyretics, Children, Fever, Fever phobia, Knowledge, Literature study / <p>2012-11-09</p> / Utbildningsstöd har erhållits från FoU - Forskning och Utbildning i Landstinget Västernorrland.

Previous studies examining memory biases for threatening faces in social anxiety (SA) have yielded inconclusive results. In the present study, memory and expectancy biases were tested within the context of a novel face recognition paradigm that was designed to offset some of the methodological challenges that have hampered previous research. Undergraduates with high (n = 40) and low (n = 40) levels of SA viewed a series of neutral faces randomly paired with phrases that communicated positive or negative social feedback. Participants’ recognition memory was tested for previously encountered faces, and for their categorization of each encoded face as having been associated with negative (mean) or positive (nice) interpersonal statements. For new faces, participants were asked whether the person seemed mean or nice. Results provided no evidence in support of a general memory bias for threatening (mean) faces among high SA individuals, but instead suggested that high SA individuals lack a positive expectancy bias to appraise new social partners as being nice. Implications are considered for cognitive behavioral and interpersonal models of SA.

Tidigare studier har indikerat att extroverta personer använder mobiltelefoni mer än vad introverta personer gör (Inyang et al. 2010). En enkätstudie genomfördes för att testa sambandet mellan personlighetstyp och huruvida en frekvenspreferens gällande brukandet av mobiltelefoni eller portabelt ljud förelåg. Hundra stycken deltagare svarade på enkäten som bestod av tre delar. Fyra hypoteser var formulerade; extroverta förutspåddes vara flitigare brukare av mobiltelefon än introverta, medan introverta förutspåddes vara flitigare i brukandet av portabelt ljud. Personer med social fobi förutspåddes använda mindre mobiltelefoni, men mer portabelt ljud, än personer utan social fobi. Neurotiker förutspåddes använda portabelt ljud i större utsträckning än de brukar mobiltelefoni. En skillnad förutspåddes finnas mellan män och kvinnor gällande användande av mobiltelefoni och portabelt ljud. Resultaten visade inte på något samband mellan extraversion eller social fobi och användningsfrekvens gällande mobiltelefon, eller portabelt ljud vilket inte stöder hypotesen, däremot så fanns ett samband mellan neuroticism och användningsfrekvens vilket delvis stöder hypotesen och förövrigt indikerar resultaten att kvinnor jämfört med män föredrar mobiltelefon framför portabelt ljud i detta avseende. / Previous studies have indicated that extroverts use mobile cell phones more than introverts (Inyang et al. 2010). A survey was carried out to test the relationship between personality type and frequency preference for mobile cell phones and portable sound use. A hundred individuals participated in the survey containing three parts of questions. It was predicted that extroverts will be more active users of mobile phones than introverts, while introverts were predicted to be more active users of portable sound. People with social phobia were predicted to use less of mobile telephony, but more of portable sound, than people lacking social phobia. Neurotics were predicted to use less of mobile telephony, but more of portable sound, than non-neuritics. A gender effect was also predicted. The result did not show any relation between extraversion or social fobia, and mobile phone or portable sound usage, which doesn’t support the hypothesis, on the other hand a relation between neuroticism and mobile phone usage and portable sound usage was supported and women compared to men were also shown to prefer mobile phone to portable sound.

Introduction: Blood- and injection phobia is an anxiety disorder with a prevalence of approximately 3-5% in the general population. The etiology is often a combination of genetic factors and a conditioning experience. The symptoms of blood- and injection phobia are dizziness, confusion, nausea, epigastria discomfort, anxiety and sometimes panic attacks when receiving injections, seeing blood or having a blood sample taken. Unique for this specific phobia is the high probability of fainting when the phobic situation is encountered if there is no possibility to escape or to avoid the stimuli. During pregnancy and labor, women with blood- and injection phobia are exposed to most of their fears and they therefore find themselves in anxiety-ridden situations. Stress and anxiety during pregnancy is known to be risk factors for adverse obstetric and neonatal outcomes. Studies have shown an altered hypothalamic-adrenal-pituitary axis in women with stress or/and anxiety during pregnancy and increased cortisol concentrations can imply negative consequences for the unborn child. Cognitive behavioral therapy (CBT) is known to be effective in treating specific phobias such as blood- and injection phobia. Aim: The prevalence, obstetric and neonatal consequences, impact on the hypothalamic adrenal-pituitary axis and treatment aspects of blood- and injection phobia in a pregnant population have not been investigated before. The aims of this thesis were to study each of these phenomena. Material and methods: During 2005 a total of 1606 pregnant women were approached at their first visit in an antenatal care clinic in the southeast region in Sweden. They were asked to complete the “Injection Phobia Scale-Anxiety” questionnaire. All women who scored ≥ 20 on the “Injection Phobia Scale-Anxiety” questionnaire (N=347), were interviewed and either diagnosed for blood- and injection phobia or dismissed. In total, 110 women were diagnosed as having blood- and injection phobia. Among the women who scored &lt;20 on the “Injection Phobia Scale-Anxiety” questionnaire, 220 women were randomly stratified for age and parity as a control group. The women in the study population answered questionnaires in gestational week 25, 36 and postpartum concerning symptoms of blood- and injection phobia, depression and anxiety. Samples of cortisol in the saliva were collected in the morning and evening in gestational week 25 and 36 in both groups of pregnant women. The medical records from the antenatal care visits, the delivery and postpartum check-up was used to collect data of importance. A treatment study was conducted using a two session cognitive behavioral therapy in a group of pregnant woman with blood- and injection phobia. Results: The prevalence of blood- and injection phobia is 7 % in a pregnant population. Pregnant women with blood- and injection phobia stated more often a fear of childbirth (p&lt;0.001) and were more frequently delivered by elective cesarean section (p=0.032). The incidence of having a baby diagnosed with a complication (p=0.001) was also higher among these women. The women with blood- and injection phobia had increased cortisol concentrations in the saliva compared to the healthy controls (p=0.014). A two-session CBT in group for pregnant women with blood- and injection phobia reduced phobic (p&lt;0.001) anxiety (p&lt;0.001) and depressive (p&lt;0.001) symptoms during pregnancy. Conclusions: Blood- and injection phobia during pregnancy is rather common. Pregnant women with blood- and injection phobia are more likely to be delivered by elective cesarean section and having a baby born with a complication compared to women not suffering from this specific phobia. Untreated blood- and injection phobia during pregnancy increases salivary cortisol concentrations indicating an altered hypothalamic-adrenal-pituitary axis during these weeks of pregnancy. To enhance psychological well being in pregnant women with blood- and injection phobia a two-session program providing CBT for groups of pregnant women is valuable and produces stable results for at least 3 months after delivery.

One hundred nine HIV seronegative gay (HSG) males from the Montreal gay community, drawn from downtown health clinics, advertisements in gay friendly newspapers, and referrals from colleagues, were examined with respect to how they were coping with the HIV and AIDS epidemic (July 3, 1981 to August, 1998). Participants were asked to complete both a detailed demographic questionnaire and the Ways of Coping Questionnaire. Coping theory and coping research relevant to the research at hand are discussed in detail. Results indicate that HSG males in Montreal are coping most frequently with the HIV and AIDS epidemic through the "escape/avoidance" coping strategy, and least frequently through "confrontive coping." In addition it was found that the only significant results, by age group, relate to the "accepting responsibility" and "escape/avoidance" coping strategies. / Research limitations, suggestions for future research, and clinical implications are discussed.

This study examined several aspects of the anxiety program described in the Clark and Wells' (1995; Clark, 2001) cognitive model of social phobia, and provided information about the relationship between some of these variables. This study also examined the effect of social appraisals on cognition, affect, and self-protection. Positive and negative interpersonal appraisals were manipulated in 42 patients with social phobia and 42 community control participants. Participants then engaged in a social interaction with a confederate based on the reciprocity self-disclosure paradigm. Participants completed measures of cognitive appraisal, focus of attention, recall, affect, and self-disclosure. Personnel completed similar measures. Results revealed that, consistent with the cognitive model, individuals with social phobia displayed more self-focused attention, more negative affect, and more selfprotective behaviours, i.e. were less self-disclosive, than non-phobic control participants. There were no differences on the recall measure. The results suggested that it was possible to manipulate social appraisals. Interestingly, the largest discrepancy between participants with social phobia and controls occurred for self-disclosure in the positive social appraisal condition. The results also provided some clarification about the temporal sequence among the components of the anxiety program, and the role of self-focused attention in social phobia.

Hate crime laws in both Canada and the United States purport to promote equality using the language of antidiscrimination law. National criminal codes in both countries authorize enhanced punishment for crimes motivated by “sexual orientation” but not “gender identity” or “gender expression.” Cities and states in the United States have also adopted hate crime laws, some of which denounce both homophobic and trans-phobic crimes. Hate crime penalty enhancement laws have been applied by courts in both Canada and the United States to establish a growing jurisprudence. In both countries, moreover, other hate crime laws contribute to official legal knowledge by regulating hate speech, hate crime statistics, and conduct equivalent to hate crimes in schools, workplaces, and elsewhere. Yet, despite the proliferation of hate crime laws and jurisprudence, governmental officials do not control all legal knowledge about hate crimes. Sociological “others” attend criminal sentencing proceedings and provide support to hate crime victims during prosecutions, but they also frame their own unofficial inquiries and announce their own classification decisions for hate-related events. In both Canada and the United States, nongovernmental groups contend both inside and outside official governmental channels to establish legal knowledge about homophobic and trans-phobic hate crimes. In two comparable Canadian and American cities, similar groups monitor and classify homophobic and trans-phobic attacks using a variety of information practices. Interviews with representatives of these groups reveal a relationship between the practices of each group and hate crime laws at each site. The results support one principal conclusion. The availability of local legislative power and a local mechanism for public review are key determinants of the sites and styles of nongovernmental contention about hate crimes. Where police gather and publish official hate crime statistics, the official classification system serves as both a site for mobilization, and a constraint on the styles of contention used by nongovernmental groups. Where police do not gather or publish hate crime statistics, nongovernmental groups are deprived of the resource represented by a local site for social contention, but their styles of contention are liberated from the subtle influences of an official hate crime classification system.

This study examined the impact of positive or negative interpersonal feedback on standard-setting, affect, and motivational concerns, within the framework of selfregulation theories of social anxiety. Thirty-two individuals who met Diagnostic and Statistical Manual of Mental Disorders (rev. 3rd ed.; American Psychiatric Association, 1987) criteria for social phobia and 32 nonclinical controls participated in a successful or unsuccessful conversation with an assistant. Subjects rated two aspects of self-regulation (self-efficacy and standards), positive and negative affect, and motivational concerns. Consistent with predictions, socially phobic subjects displayed a discrepancy between what they believed they could achieve (efficacy) and what they believed others expected of them (standard) and the magnitude of this discrepancy increased when they had succeeded at the social task. In addition, anxious subjects reported higher levels of positive affect after experiencing social success than they did after experiencing social failure but they did not relinquish protective concerns. There was no evidence that socially phobic subjects were distressed by social success but the results illuminate dysfunctional standard-setting. Specifically, socially phobic individuals perceive larger discrepancies between their ability and expectations following success than they do following failure.

The main purpose of this study was to examine nurses' attitudes toward caring for patients with Acquired Immune Deficiency Syndrome (AIDS). The study also compared the attitudes of nurses who had cared for AIDS patients with the attitudes of nurses who had not cared for AIDS patients. Educational background was also examined to see if education influences attitudes. The Ajzen-Fishbein Model of Reasoned Action was the framework used for this study.A descriptive design was used for the purpose of gaining more information regarding nurses' attitudes toward caring for patients with AIDS. A random sample of all registered nurses in the state of Indiana was used for this study. The data obtained were analyzed using frequency distributions, independent t-tests, and analysis of variance.Nurses in general are sill uncomfortable with caring for AIDS patients. Between 40% and 50% of nurses are fearful of contracting the AIDS virus and fearful of putting their family at risk. On the other hand, approximately the same percentage are comfortable caring for AIDS patients. Furthermore, nurses believe that health care agencies should care for AIDS patients, but believe that nurses should have the right to refuse to care for AIDS patients.Results of this study indicated that educational background does not influence nurses' attitudes toward caring for patients with AIDS. However, as nurses have more experience caring for patients with AIDS, they appear to develop more positive attitudes. / School of Nursing

Die Spezifischen Phobien stellen die häufigste Gruppe der Angststörungen dar. Die Angst vor dem Verschlucken bzw. dem Ersticken wurde jedoch nur sehr selten beschrieben. Bei der Behandlung der Spezifischen Phobien wird fast immer eine Konfrontation in vivo eingesetzt. Die Angst vor dem Verschlucken scheint aber eine der Spezifischen Phobien zu sein, bei der eine Konfrontation schwierig ist. Die hier vorgestellte Fallgeschichte schildert eine mögliche Vorgehensweise, die Ängste vor dem Verschlucken mit einer Reizkonfrontation in vivo zu behandeln. Dabei werden die verschiedenen Schwierigkeiten, die aufgetreten sind, und ihre Lösungen geschildert. Die Therapie wurde erfolgreich abgeschlossen, und auch die Ergebnisse der Nachuntersuchungen zeigten eine stabile Verbesserung. / Specific phobias are the most common anxiety disorders. However, the fear of swallowing the wrong way and choking has rarely been described. Specific phobias are usually treated using exposure therapy. The excessive fear of swallowing the wrong way does not seem to be very well suited for an exposure in vivo. In this case study, a patient afflicted with the fear of swallowing and choking was treated with flooding. The various difficulties encountered during treatment and their remedies will be described. The therapy was successful. The patient showed stable and lasting improvements at posttreatment and at one-year follow-up. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.