Bakgrund: Stickrädsla förekommer i alla åldrar och uppskattningsvis lider minst 10 procent av befolkningen av det. För individen kan stickrädsla innebära stort obehag som kan leda till att en stickrädd person undviker hälso- och sjukvården och därmed riskerar att drabbas av ohälsa. Behoven hos en stickrädd person kan förbises inom hälso- och sjukvården på grund av bristande resurser och kompetens vilket kan leda till lidande. Syfte: Att belysa omvårdnadsåtgärder för vuxna personer med stickrädsla. Metod: En allmän litteraturstudie utfördes med en systematisk litteratursökning i databaserna Cinahl, PubMed och PsycINFO. Resultatet baserades på 12 vetenskapliga artiklar som granskades med avseende på vetenskaplig kvalitet och etik. Resultat: Resultatet mynnade ut i fem teman som belyser omvårdnadsåtgärder för stickrädda vuxna personer: ett empatiskt förhållningssätt, skapa distraktion, ge information och utbildning, anpassa rum och utrustning, ge farmakologisk och icke farmakologisk smärtlindring. Omvårdnadsåtgärderna lindrar lidande hos personer med stickrädsla när de utförs av kompetent hälso- och sjukvårdspersonal genom ett professionellt vårdande. Implikation: Genom dialog, utbildning och förändrade arbetsrutiner kan medvetenheten kring stickrädsla och lindrande omvårdnadsåtgärder ökas hos hälso- och sjukvårdspersonal och sjuksköterskestudenter. / Background: Needle fear occurs in all ages and an estimated minimum of 10 percent of the population suffers from it.For the individual, needle fear can involve great discomfort which can lead to that a person with needle fear avoids health care and therefore risks to become ill. The needs of a person with needle fear can be overlooked in health care due to lack of resources and competence which can lead to suffering. It is important to identify effective nursing interventions for health care personnel to alleviate the suffering of persons with needle fear. Aim: To illuminate nursing interventions for adults with needle fear. Methods: A literature review was conducted with a systematic litterature search in the databases Cinahl, PubMed and PsycINFO. The result was based on 12 scientific articles that were viewed regarding scientific quality and ethics. Results: The outcome resulted in five themes that illuminate nursing interventions for adult persons with needle fear: an empathic approach, create distraction, give information and education, adjust room and equipment, give pharmacological and non pharmacological pain relief. The nursing interventions alleviate suffering for persons with needle fear when performed by competent health care personnel through professional care. Implication: The awareness of needle fear and alleviating nursing interventions can be raised among health care professionals and nursing students through dialogue, education and altered working procedures.

Research has shown that antisocial behaviour already develops in early infancy. Insufficiency in attachment has proven to be a prominent factor in those cases a child develops antisocial behaviour. Therefore the purpose of the study is to research how antisocial behaviour in children expresses itself and how professionals approach the complex of problems. The result of this study has shown that work to establish safe relations and trust are accentuated to be one of the most significant components in the treatment of these children and therefore it is essential to as soon as possible detect the complex of problems to be able to prevent that such a development of the behaviour occur. To, in time, take action by adequate interventions has shown to be effective when preventing the problem to accumulate. Also as a professional constantly be observant of which methods and interventions that works and presents good effects, and furthermore to promote an evolvement and betterment of said methods. The conclusion of the study shows that prevention doesn’t have to be a concept connected to the age of a person, but rather a concept connected to the age of a problem. A preventive intervention can therefore happen in the early age of an upcoming problem. To be able to treat and handle antisocial behaviour the study has shown that the most fundamental factor is safe and trustworthy relations and individually adapted interventions. The authors have chosen to use a qualitative interview study with an inductive reasoning. Thereafter a qualitative content analysis has been carried out. This method resulted in the empirics being well anchored in reality. Keywords: Antisocial behavior in children, attachment, prevention, individual interventions

The purpose of this study was to explore regular education student perceptions of the effects of implementing behavioral interventions for seriously emotionally disturbed students (SED) in the regular classroom. Student perceptions of classroom friction or disruptiveness, apathy, and general enjoyment or satisfaction were evaluated. It was predicted that regular education students would report more classroom friction, increased apathy, and less satisfaction when interventions were implemented in the regular classroom for a target SED student.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Background: Behavioral interventions and evidence based guidelines along the cancer control continuum can reduce the burden of cancer. Objectives: This dissertation aims to increase our understanding of colorectal cancer screening (CRCS) decisional conflict and breast cancer survivorship care. This project: 1) assesses CRCS decisional conflict in a general population, 2) uses the Theory of Triadic Influence to model and evaluate direct and indirect associations between CRCS decisional conflict and colonoscopy adherence, 3) assesses post-treatment breast cancer care. Methods: Data from a questionnaire administered to randomly selected adults, 50-75 years, living in six MN communities (N=1,268) and the 2010 Behavioral Risk Factor Surveillance System (BRFSS) (N=1,024, women ages 27-99) were used. Multivariable logistic regression was used to identify characteristics associated with high CRCS decisional conflict; then structural equation modelling (SEM) was performed to assess direct and indirect associations of CRCS decisional conflict and colonoscopy adherence. Using BRFSS data, multivariable logistic regression was performed to assess the association between years since diagnosis and the type of clinician providing the majority of care for breast cancer survivors after treatment completion. Results: Greater colonoscopy barriers (OR=1.04; 95% CI: 1.02-1.05) and CRCS-specific confusion (OR=1.12; 95% CI: 1.10-1.15) as well as a healthcare provider not discussing CRCS options (OR=1.67; 95% CI: 1.18-2.37) were associated with increased odds of high CRCS decisional conflict. A similar relationship was found in the SEM analyses: both greater levels of perceived colonoscopy barriers and CRCS confusion were associated with higher decisional conflict (standardized total effects=0.42 and 0.39, respectively, p-values < 0.01). CRCS decisional conflict was associated with increased non-adherence to colonoscopy. This relationship was mediated by CRCS-specific self-efficacy and intention (standardized total effect=0.14, p-value <0.01). Among breast cancer survivors, women 0–1 and 2–3 years since diagnosis were 2.1-2.6 times more likely to have a cancer-related clinician providing the majority of care compared to women 6+ years since diagnosis (95% CIs: 1.0-4.3; 1.4-4.6). Conclusions: Decreasing colonoscopy barriers and CRCS-specific confusion could decrease CRCS decisional conflict and ultimately increase CRCS uptake. National policies to move breast cancer follow-up care to a primary care provider might be well-received by cancer survivors.

Qatar is rapidly becoming an internationally renowned art hub not only through the construction of numerous museums and galleries, but also through the development of public art projects. I strongly believe that Qatar can be more than a place to work; it can be a space where art is part of public spaces. But how can we fully and effectively integrate art into public space in Qatar? How can Qatar be more than a place where we work, eat, sleep, and go to the mall from time to time? How can public art involve / benefit the community and local artists? Can it shift behaviors from less of an exclusive to more of an inclusive community? This research is an investigation on public art in order to enhance its development. Instead of commissioning internationally renowned public artworks that are massive and monumental, the objective of this research is to encourage social interaction between communities and local artists through participatory public art projects. This type of art engages users directly in the creative process, permitting them to be both co-actors and observers of the work. The outcomes tackle social engagement through public art interventions that trigger conversations and interactions among communities

Abstract EFFECTIVENESS OF SENSORY INTEGRATION AND BEHAVIORAL INTERVENTIONS ON NONENGAGEMENT IN PRESCHOOL AGED CHILDREN By Tiffany Ann Kuyper, OTR/L A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy at Virginia Commonwealth University Virginia Commonwealth University, 2012 Director: Marie Anzalone ScD, OTR, FAOTA This single subject pilot study explored a combination of sensory-based interventions and behavioral interventions in a preschool aged child identified with Sensory Over-Responsivity (SOR). Children often display nonengagement associated with escaping and avoiding tactile and/or vestibular information because they perceive sensory input as negative or aversive. The subject was a 3-year old child who engaged in alternating treatments over the course of six weeks of occupational therapy. The first condition was a sensory-based intervention (SB), a widely used intervention approach for sensory over-responsivity. The alternating condition was a sensory-based intervention combined with behavioral interventions (SBB). The behavioral intervention used tangible reinforcement as the primary technique to facilitate engagement in sensory intensive play that was part of the sensory-based interventions. It was hypothesized that nonengagement behaviors would decrease during the SBB condition and play engagement behaviors would increase during the SBB condition. It was also hypothesized that the subject would demonstrate an improvement in perceived performance and satisfaction of daily living activities. The outcomes of this study included frequencies of nonengagement, play engagement and the family’s perceived performance and satisfaction of a child’s performance of occupations. The frequency of nonengagement behaviors was assessed when the subject was presented with sensory intensive play that was part of sensory-based interventions in each condition. The frequencies of nonengagement and play engagement were coded over each session to determine if there was any change between and within conditions. Also, performance and satisfaction with occupations were compared from the initial evaluation and the last intervention session. Results of this study revealed that the subject’s nonengagement behaviors actually increased throughout the interventions. This finding did not support the first hypothesis that nonengagement behaviors would decrease in the condition using a combination of sensory-based interventions and behavioral interventions. It was also found that the subject’s number of play engagement behaviors decreased within both conditions. This finding did not support the second hypothesis that play engagement behaviors would improve as result of participating in a combination of sensory-based interventions and behavioral interventions over time. However, the qualitative improvements as identified by the subject’s mother when using the Canadian Occupational Performance Measure (COPM; Law, Baptiste, McColl, Polatajko, & Pollock, 2005) improved significantly across both interventions in the home and community settings. As a result of participation in this study, the subject made improvements with regard to all occupational performance areas as initially collaborated upon in the initial evaluation.

Regular physical activity is associated with improved physiological and psychological wellbeing, by reducing the risk of chronic illnesses such as cardiovascular disease, cancer, obesity, diabetes, osteoporosis and depression. There is a common perception that physical activity levels in the population are declining, and one of the biggest changes affecting this is occupational based activity. Since adults spend on average over 50% of their waking hours at work, work sites have the potential to be an important setting for health promotion initiatives. Cognitions and behaviours are key causal factors behind many of today s most widespread health problems and illnesses. The stage of change model has been highlighted as having intuitive appeal because it considers the dynamic nature of attitudes and behaviour change. This thesis is concerned with the application of the stage of change model to an occupational health intervention promoting physical activity. Several research studies were undertaken to explore the experiences of employees with workplace health initiatives and investigate the strategies and practices used by occupational health to promote healthy behaviours. These research studies highlighted the barriers and facilitators to successful health interventions and contributed towards the design, development and implementation of an activity promotion intervention. Additional research was also conducted to develop information materials based on the stage of change model. The stage approach was simplified and intervention materials were classified based on whether employees were thinking about making a change or not thinking about making a change to their activity levels. In order to test the materials, a twelve month intervention was implemented in ten work sites across the UK that were allocated to one of three groups. Two groups received information materials and one group received no information during the intervention period (control group). The difference between the two groups who received information was that one group received standard activity promotion information (standard group) and the second group received tailored information based on their stage of change construct (staged group). Participants in the staged intervention group demonstrated significant decreases in body mass index, fat percentage, waist circumference, blood pressure and resting heart rate following the twelve month intervention. In contrast, reductions were identified for the standard intervention group for waist circumference and diastolic blood pressure. Finally, there were no long-term significant improvements identified for the control group. However, group comparisons revealed there were no significant differences between the intervention conditions. The intervention also recorded self-reported psychological outcomes, which demonstrated variations throughout the intervention period for all groups. The potential reasons for these inconsistent outcomes are discussed. A process evaluation following the intervention demonstrated employees valued the health screenings and identified issues relating to knowledge, behaviour change and health implications that were important outputs of the intervention. Based on these findings, the research concludes there is scope to make physical activity interventions in the workplace more effective by applying the stage of change approach. Using the process of simplifying the stages and focusing on whether employees want to change their behaviours or not allows occupational health to deliver information that could be more meaningful and have a significant impact on behaviour change. By understanding employees readiness to change their activity behaviours and targeting information based on their beliefs, attitudes and intentions to change may produce significant improvements in health outcome measures compared to standard information. The results also suggest there is potential for this type of tailored intervention to be extended to other occupational health issues.

Considering serious health, social and subsequently economic impacts which are rising due to the heavy alcohol consumption in the Czech Republic and the whole of Europe, the WHO proposed scientifically based tools, the aim of which is to minimize damage caused by alcohol. Health service is, therefore, highly recommended to establish Screening and brief interventions (SBI). The SBI method belongs to behavioural and cognitive-behavioural therapies. The goal is to identify people with risk or harmful alcohol consumption, to stop its usage, to diminish risks and get a motivation to seek specialized assistance. The majority of recommendations to establish SBI for risk and harmful drinking are especially aimed at primary care, mostly at doctors. Nurses with their broad competence in a lot of medical fields are left behind even though their activity including direct contact with patients involves analysing the levels of risk factors which alcohol is a part of. The purpose of the study is to clarify under which circumstances it is possible to effectively apply the SBI methodology into nursing practice in a selected Czech district, to describe the current engagement and extent of nurses' motivation to deal with alcohol prevention, to look for possibilities of SBI integration into real nursing practice and...

1 ABSTRACT PATIENTS' ATTITUDES TO PHARMACOTHERAPY OF OSTEOPOROSIS Author: Hana Theimerová Supervisor: Magda Vytřísalová Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy INTRODUCTION: Patients' attitudes to treatment might be affected by various factors. These may vary in different generations as well as in different populations. The patients' attitudes to the treatment along with the illness may affect decision concerning the beginning, interruption or end of the treatment. That implies that the interaction between these factors and attitudes to the treatment is comprehensive. AIMS: The study aim was to evaluate the patients' attitudes to the treatment of osteoporosis based on the perception of necessity and concerns of treatment with oral bisphosphonates (BIS). METHODS: Data for the analysis were obtained using an anonymous questionnaire in five outpatient centres in the Czech Republic from November 2012 to March 2013. The patients' opinions concerning the BIS treatment were identified (necessity vs. concerns) using the Czech version of the "Beliefs about Medicines Questionnaire Specific" (BMQ-CZ). RESULTS: A total of 363 patients were involved in the analysis (mean age 68.9 years). Patients were treated with once a week dosing forms of BIS -...