Physical injuries to the upper extremity can have a drastic impact on an individual’s daily functioning affecting their psychological well-being, social participation, and ability to perform valued activities such as self-care, work, and leisure tasks. Due to the wide range of factors affecting a person who is recovering from an upper extremity injury, therapists treating these individuals must understand, help identify, and address the areas impacting function to support and maximize participation in and performance of valued occupations. However, often psychosocial aspects of care go unaddressed when biomechanical interventions are prioritized, which is primarily attributed to therapists’ lack of knowledge, confidence, or skills in this area. Unlocking Biopsychosocial Hand Therapy is a continuing education unit (CEU) course aimed at filling therapist gaps in knowledge and service provision, specifically regarding psychosocial factors, when treating clients with upper extremity injuries or conditions. The long-term goals of this innovative program are to improve client outcomes and to increase therapist prioritization of psychosocial factors on par with biological factors.

Mobility is essential to healthy aging and is closely related to health and overall quality of life. Mobility impairment is an early predictor of disability, and is intimately linked to falling injuries, loss of independence, hospitalization, and mortality. Mobility Assistive Devices (MADs), such as canes, walkers, and wheelchairs, provide support to older adults to improve their balance, coordination, and strength. Despite the acknowledged benefits of MADs for the older adult population research shows that as many as 75% of older adults are non-adherent to prescribed MADs. As non-adherence is a contributing factor to declines in mobility and overall quality of life, it is important to consider the reasoning behind it. Therefore, this doctoral project took a psychosocial perspective and investigated the psychosocial factors that predict non-adherence to MADs among older adults. This study considered a sample of older adult MADs users from long-term care units at the Perley Health Centre in Ottawa with different types of mobility limitations. The study examined the role of psychosocial variables using the Psychosocial Impact of Assistive Devices Scale (PIADS), social support using the Medical Outcomes Study Social Support Survey (MOS-SS), and the demographic variable of sex in the prediction of MADs non-adherence. Predictor variables that were associated with non-adherence in a univariate regression analysis were subsequently entered into a multiple regression analysis. Of the 96 residents invited to participate in the study, 49 gave their consent to participate, and out of this number, 48 completed the study, for a response rate of 51%. The data from the 48 residents (26 females and 22 males), with a mean age of 86.8 (Standard Deviation (SD) = 10.2, age range= 66 - 101), were therefore available for analysis. The most common reported mobility limitations were due to balance problems and leg weakness (29.17% for each). The most common device used was a walker (47.92%), followed by a manual wheelchair (33.33%). No statistical difference was detected between the groups of sexes regarding any of the study variables (P≥0.05). In the univariate regression analysis, the three PIADS subscales, namely, Competence, Adaptability, and Self-esteem, were significantly correlated with non-adherence (p < 0.001). Sex was an insignificant variable, while social support was significantly correlated with Competence, Adaptability, Self-esteem, and non-adherence. In the multiple regression analyses, only Self-esteem showed significant associations (p < 0.05), and the Self-esteem multivariate model explained 43.5 - 54.3% of the variance in non-adherence. This study revealed that the Self-esteem construct, which includes several concepts related to psychological wellbeing, was the only significant predictor of non-adherence among the studied sample of older adults. The theoretical and clinical implications of the findings are subsequently discussed.

Background: Overuse injuries (OI) account for a substantial part of sport injury incidence among athletes of various sports and levels. They lead to serious consequences for athletes’ physical and mental health, as well as athletic performance. Despite the gradual onset of symptoms, athletes often persevere in training and competing. The present study aimed to identify psychological risk profiles suggested to explain maladaptive behaviors prior or in response to first signs of overuse injuries. Design: Prospective cohort study. Methods: 149 athletes representing 10 individual and team sports responded to a range of questionnaires regarding personal (athletic identity, perfectionistic concerns, grit and negative life stress) and interpersonal (coach-athlete relationship) psychological traits. By using the mobile application Briteback®, participants subsequently answered the OSTRC Overuse Injury Questionnaire on a weekly basis during a 10 weeks period. A latent profile analysis was used in order to identify different psychological profiles. Results: Athletes were classified into 3 latent profiles regarding their psychological characteristics: profile 1 was labelled a “perfectionistic OI risk profile”, profile 2 a “negative stress OI risk profile” whereas profile 3 was called a “low risk profile for OI”. Indeed, athletes in profile 1 and 2 were found to be significantly more often affected by overuse problems than individuals in profile 3 (71% of the time, χ² (2) = 9.62, Hedges’ g = (0.71), p &lt; .01 and 70% of the time χ² (2) = 9.13, Hedges’ g = (0.68), p &lt; .01 vs 45% of the time), with athletes in profile 1 also experiencing more substantial overuse problems than for profile 3 (35% vs 21% of the time; χ² (2) = 4.12, Hedges’ g = (0.50), p &lt; .05). Conclusions: Our findings support the existence of two “risk profiles” in which athletes are characterized either by elevated perfectionistic concerns or by high negative stress. These findings could be explained by the perseverative and rigid personality of perfectionistic concerns individuals and by the hypothesis of a synergy between psychological and physiological stress for negative stressed athletes. Coaches should pay particular attention to the psychological characteristics of their athletes in order to prevent overuse injury occurrence and worsening, especially those with high perfectionistic concerns and negative life stress. Cognitive behavioral interventions supporting at-risk athletes in reframing their rule-governed behaviors might decrease the risk of overuse problems.

The objective of this thesis is to advance our understanding of how consumers use date labels and the implications of date-label use for household dairy product waste. It does this by investigating the effect of psychological, social, and contextual factors on date-label use and willingness to consume dairy products in relation to the expiry date. These effects are tested using structural equation models and survey data gathered from 548 Scottish consumers. The results of this study make two contributions to the literature on date-labelling and food waste. The first contribution is primarily theoretical. By improving our understanding of how consumers use date labels and the implications of date-label use for household dairy product waste, it supports the contention that food waste is best understood, not as a behaviour, but as the outcome of multiple behaviours. It argues that in order to understand why food waste is created, it is important to identify the factors that affect the individual behaviours that lead to it, such as date-label use, and how these behaviours relate to one another. These results also have implications for communications and campaigning around food waste reduction. The second contribution has policy relevance. It provides evidence of the likely limited effect of increasing the number of dairy products labelled with a best-before date rather than a use-by date on food waste. This is an approach recently proposed to reduce household food waste. It finds that better knowledge of the best-before date is associated with a higher willingness to consume products after the best-before date has passed. However, perceived risks about consuming products beyond their best-before date, including not just safety but quality, freshness, and social acceptability, appear to interact with date-label knowledge and dampen its influence. It argues that to be effective, any changes in date-labelling should be accompanied by communication that goes beyond improving date-label knowledge, and addresses the multifaceted nature of related risk perceptions and conceptions of date-label trust.

Risk factors for psychological insult following deployment to Operation Enduring Freedom or Operation Iraqi Freedom among veterans: A systematic review: The systematic review aimed to establish more clearly the risk factors for mental health problems in the veteran population. Five databases were searched. Included studies (n = 10) required that veterans served in Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) and included risk factors of mental health problems among the veteran population. Data from included studies were extracted and critically appraised based on critical appraisal tools following a narrative approach to synthesise data. All of the studies reviewed identified risk factors, although due to their heterogeneous nature key findings varied considerably. However, it was consistently reported that combat exposure and deployment experiences were associated with emergence of post operational mental health problems. The current review provides preliminary evidence that there are a number of specific risk factors that may increase susceptibility to mental health problems subsequent to military deployment. It is suggested that interventions are needed in order to mitigate risk factors and bolster protective factors. A cross-sectional study investigating the impact of disease activity and disease related cognitions on adjustment in Inflammatory Bowel Disease: The research journal aimed to investigate the degree to which psychological illness related cognitions will mediate the effect of disease activity on Quality of Life (QoL). In addition, to assess the impact of disease activity, and several psychological factors, in several adjustments outcomes in IBD to see whether the adjustment variables are significant predictors of multiple outcomes. Mediation was used followed by an exploratory cross-sectional correlational design. Three hundred and thirty eight participants were recruited through an IBD charity and invited to respond to a self-report questionnaire online. Measures targeted different aspects of the IBD profile to give an indication of adjustment associated with IBD diagnosis, psychological factors and Quality of Life (QoL). Mediation analysis found support for significant indirect effects on the relationship between disease activity and QoL through Gastrointestinal (GI) anxiety, perceived disability and illness representations. The subsidiary analysis indicated that pain catastrophising, disease activity, stigma, illness representations and GI anxiety were found to be significant predictors of adjustment in IBD. The results indicate that there is an important relationship with the adjustment factors, QoL, and psychological functioning. In addition, stress, depression, anxiety and QoL were found to be predicted by the adjustment factors. The current study has provided insight into psychological factors and adjustment indicators from a multi-faceted perspective, which will facilitate advancement of managing IBD from a biopsychosocial framework with a view to enable more effective disease management.

Made available in DSpace on 2015-07-22T20:50:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24 / Este estudo teve por objetivo explorar como a resiliência e alguns de seus aspectos se relacionam aos diferentes padrões de uso de drogas por adolescentes. Foi composta uma amostra representativa de estudantes de escolas particulares de São Paulo (Brasil), selecionada por estratos e conglomerados. Os dados foram coletados através de questionário de auto-preenchimento aplicado em sala de aula. Para mensurar o uso no mês de álcool, binge de álcool, tabaco e outras drogas (maconha, inalantes, ansiolíticos, estimulantes, cocaína, ecstasy e crack) foi utilizado um questionário proposto pela OMS. Para avaliar resiliência, foi aplicada a Escala de Resiliência. O principal fator da escala, encontrado na validação brasileira, foi nomeado “resolução de ações e valores”. As classes econômicas foram mensuradas pela escala da ABEP. Os dados foram analisados por estatística descritiva, bivariada (GLM), análise de cluster e regressão logística. O nível de significância adotado foi de 5%. Os 2691 estudantes que participaram da amostra apresentaram média de 16 anos (IC=15,9-16,1) e 95,5% eram de classes mais favorecidas (A e B). A droga mais consumida foi o álcool (50,2%), seguida do tabaco (14,1%) e outras drogas (11,6%). O consumo binge de álcool foi relatado por 31,8%. A análise de cluster definiu quatro grupos quanto ao uso de drogas no mês: não usou drogas, álcool, álcool/binge/tabaco, álcool/binge/tabaco/outras drogas. A resiliência não se relacionou aos padrões de uso de drogas avaliados nessa população. Apesar disso, o fator de “resolução de ações e valores”, que avaliou auto-estima, determinação, disciplina, bom humor, prontidão para ajuda e adaptabilidade, contribuiu para uma menor chance de uso de álcool, binge, uso de tabaco e de outras drogas. Para esse padrão de uso, os principais aspectos protetores foram a disciplina e a determinação. A disciplina também diminuiu as chances do uso de álcool, associado a episódios de binge e uso de tabaco. Esses resultados ressaltam a relevância de aspectos relacionados a ações e valores, especialmente disciplina e determinação, para prevenção ao uso de drogas na adolescência, cuja prática tem sido um grande desafio. / The aim was assess how resilience and its factors are related to different drug use patterns in adolescents. Private school students from São Paulo (Brazil) were selected by a representative, stratified and cluster sample. It was applied a self-report questionnaire proposed by WHO measuring alcohol, binge drinking, tobacco and other drugs (marijuana, inhalants, tranquilizers, stimulants, cocaine, ecstasy and crack) 30-day use. The resilience was assessed by Resilience Scale, which in Brazilian validation the main factor was named “capacity to act based on ones values”. The economic class was measured by ABEP scale. Weighted data were analyzed by descriptive, bivariate (GLM), cluster analysis and logistic regression statistics. Significance level was set at 5%. The sample was comprised of 2691 students with mean age 16 (CI=15.9-16.1), 52% were female and 95.5% were from upper economic classes. The most prevalent drug consumption was alcohol (50.2%), followed by tobacco (14.1%) and other drugs (11.6%). Binge drinking was related by 31.8%.Cluster analysis identified four groups according to 30-day drug use: do not use drugs, alcohol, alcohol/ binge drinking/ tobacco, alcohol/ binge drinking/ tobacco/ other drugs. The resilience was not associated with different drug use patterns in this population. However, the factor “capacity to act based on ones values” that evaluate self-steam, determination, self-discipline, good mood, readiness to help and adaptability, contribute to decrease the odds of alcohol use, binge drinking and other drug use. The main protect factors for this drug use pattern was self-discipline and determination. Self-discipline also decreased the odds of alcohol associated with binge drinking and tobacco use. These results highlight the relevance of aspects related to “capacity to act based on ones values”, especially self-discipline and determination, to drug use prevention in adolescence. / TEDE / BV UNIFESP: Teses e dissertações

With the support of four vegetarian and vegan companies established on the Swedish market, Astrid och Aporna, Ekko Gourmet, Tzay and Quorn, the objective of this study is to understand why companies produce vegan and vegetarian products imitated with real meat products as well as how these companies market these products. The data was collected through interviews with suitable representatives from respective company. The empirical data collected from the interviews have further been analysed together with theories from past researches. The research approaches of this study has been a mixture of inductive and deductive when handling our data. The results from this thesis enlightens that there are contrasting strategies behind the products’ visual appearance, chosen target group and marketing among the different vegetarian and vegan companies on the Swedish market. We have discovered patterns between the companies’ target audiences and how these companies have designed their products depending of target audience Due to time limitations and companies’ unwillingness to participate in interviews, a broader perspective on the topic could not be given. Also, this study only looks at vegan and vegetarian companies operating in Sweden. A suggestion for future research is to investigate the consumer’s perspective and perceptions of vegan and vegetarian products by conducting a quantitative research to distinguish if the companies’ strategies are consistent with the perceptions of consumers on the Swedish market.

Bakgrund: Personer med diabetes typ ett och typ två utsätts för stor psykologisk och känslomässig påfrestning som påverkar hanteringen av att leva med sjukdomen. Vården lägger stora resurser på den medicinska specialiteten vilket gör att psykologiska och känslomässiga faktorer inte värdesätts i samma utsträckning. Som följd av detta kan personer med diabetes uppleva sämre hälsa. Syfte: Att beskriva forskningsbaserad kunskap om hur hälsa hos personer med diabetes påverkas av psykologiska och känslomässiga faktorer. Metod: Litteraturöversikt med sju kvalitativa och åtta kvantitativa studier. Resultat: Erfarenheten av att leva med diabetes är individuell. Vissa psykologiska och känslomässiga faktorer var mer framträdande och resulterade i kategorierna: hur personer med diabetes hälsa påverkas, acceptansens betydelse, sociala relationer och stigmas inverkan på hälsa, riskfaktorer för psykologiskt välbefinnande och hälsa, rädsla och oro, frustration och ilska, känslomässig stress kopplat till HbA1c- och glukosvärden samt egenvård för god hälsa. Slutsats: Psykologiska och känslomässiga faktorer har i olika utsträckning en inverkan på personer med diabetes hälsa. Dessa faktorer bidrar till förändrade beteenden som kan ge hinder för en god egenvård som sedan är en grundpelare för en god hälsa. Att leva med diabetes är en komplex situation som påverkar personen på många plan. Sjuksköterskan bör utifrån ett personcentrerat förhållningssätt ta hänsyn till personen som en helhet i vård och behandling. / Background: People with diabetes type one and type two are exposed to severe psychological and emotional burdens that affect the management of living with the disease. Health care adds great resources on the medical specialty, instead of meeting the psychological and emotional factors. This could lead to a lower experience of health for people with diabetes. Aim: Describe research-based knowledge about how psychological and emotional factors affects health of people with diabetes. Methods: A literature review with seven qualitative and eight quantitative studies. Results: The experience of living with diabetes is individual. Certain psychological and emotional factors were prominent and resulted in categories: how persons with diabetes health are affected, the importance of acceptance, social relationships and stigma's impact on health, risk factors for psychological wellbeing and health, fear and concern, frustration and anger, emotional stress associated with HbA1c- and glucose values and self-care for good health. Conclusion: Psychological and emotional factors have a varying impact on people with diabetes. These factors contribute to changing behaviors that may prevent good self-care, which is important for good health. Living with diabetes is a complex situation that affects the person on many levels. The nurse should look at the whole person when caring, based on a person-centered approach.

No description available.

Bakgrund: I Sverige är fotboll den idrott där flest personer skadar sig under idrottsutövning. Oavsett skada kan fotbollsspelaren behöva komma i kontakt med fysioterapeut för rehabilitering. Biopsykosociala faktorer är viktiga under rehabiliteringen då de kommer påverka individens möjlighet att återgå till fotboll. Det råder dock en oklarhet bland fysioterapeuter vad psykosociala interventioner innebär och hur de ska användas. Syfte: Syftet med studien är att undersöka rehabiliterade fotbollsspelares upplevelse av psykosociala faktorer av betydelse för återgång till fotboll, samt deras upplevelse av hur fysioterapeuter beaktat dessa psykosociala faktorer under rehabiliteringen. Metod: En deskriptiv kvalitativ design med induktiv och deduktiv ansats har använts för att svara på studiens syfte. Urvalet skedde genom ett ändamålsenligt urval. Kvalitativa semistrukturerade intervjuer genomfördes. Data analyserades genom kvalitativ innehållsanalys. Resultat: Dataanalysen resulterade i sex kategorier som var av vikt för återgång till fotboll. Tre som berör psykologiska faktorer: negativa känslor, motivation och känna sig sedd. Tre som berör sociala faktorer: samhörighet med laget, förväntningar från familjen och stöd från tränare. Enligt fotbollsspelarnas upplevelser beaktade inte fysioterapeuterna psykosociala faktorer så mycket som fotbollsspelarna uppgav att de behövde. Slutsats: Psykosociala faktorer var av betydelse för spelarnas återgång till fotboll och upplevelsen kring hur fysioterapeuterna beaktade faktorerna påverkade rehabiliteringen. De spelare som hade ett behov av psykisk och social stöttning upplevde också att de saknade frågor om psykosociala faktorer från fysioterapeuten. Nyckelord: Fysioterapi, socialkognitiv teori, fotboll, psykiska faktorer, sociala faktorer. / Background: Soccer is the sport where most people injure themselves during sports in Sweden. Regardless of the injury, the soccer player may need to get in contact with a physiotherapist for rehabilitation. Biopsychosocial factors are important during rehabilitation as they will affect the individual's ability to return to sports. However, there is a lack of clarity among physiotherapists what psychosocial interventions means and how they should be used. Aim: The aim of the study is to investigate rehabilitated soccer players' experiences of psychosocial factors of importance for returning to soccer, as well as their experiences of how physiotherapists have taken these psychosocial factors into account during rehabilitation. Method: A descriptive qualitative design with an inductive and deductive approach has been used. A purposive sampling technique was applied. Qualitative semi-structured interviews were conducted. The data was analyzed with qualitative content analysis.  Result: The data analysis resulted in six categories which were experienced as important for returning to soccer. Three involving psychological factors: negative emotions, motivation, and the feeling of being seen. Three involving social factors: affiliation with the team, expectations from the family and support from coaches. According to the soccer players experiences the physiotherapists did not take psychosocial factors into account as much as the soccer players stated that they needed. Conclusion: Psychosocial factors was of importance for the players return to soccer and the experience of how physiotherapists took the factors into account affected the rehabilitation. The players who had a need for psychological and social support also experienced that they lacked questions about psychosocial factors from the physiotherapist. Keywords: Physiotherapy, social cognitive theory, soccer, psychological factors, social factors.