Trotz motivierter Therapieversuche gelingt es vielen übergewichtigen Menschen nicht, ihre Bewegungs- und Ernährungsgewohnheiten nachhaltig zu verbessern und das Gewicht zu reduzieren bzw. zu stabilisieren. Es wird angenommen, dass ihnen ein gewisses Maß an Selbststeuerungsfähigkeit (Willensstärke) fehlt. Diese ist notwendig, um ein gefasstes Ziel über eine längere Zeit aufrechtzuerhalten und umzusetzen. Sie steht im Mittelpunkt eines neu konzipierten Selbststeuerungs-, Trainings- und Ernährungs- Programms mit Spaß und wird mittels einer Coaching-Methode individuell gefördert. Durch die Optimierung der mentalen Bedingungen, die das Verhalten determinieren, soll die Voraussetzung für eine dauerhafte Veränderung des Gesundheitsverhaltens geschaffen werden. In einer quasiexperimentellen Studie mit 39 Jugendlichen wurde die Wirksamkeit von S.T.E.P.S. empirisch überprüft. Zudem wurden die Teilnehmer anhand von Erfolgskriterien als Responder bzw. Non-Responder bestimmt und retrospektiv auf Unterschiede untersucht. Daraus wurden Prädiktoren für den Interventionserfolg abgeleitet. Die Ergebnisse deuten auf eine alters- und anwesenheitsabhängige Wirkung des Programms hin. 15-17 Jährige verbesserten signifikant ihre Selbststeuerungskompetenz und reduzierten den Körperfettanteil. Auch die regelmäßig teilnehmenden Jugendlichen optimierten ihre Selbststeuerung bedeutsam. Größtenteils blieben die Effekte nach 8 Monaten bestehen. Responder verfügten über eine signifikant bessere Ausgangslage in den mentalen Prozessen. Bei der Bekämpfung von Übergewicht spielen eine ausgeprägte Handlungsüberzeugung und der Umgang mit negativen Affekten eine entscheidende Rolle. Die Analysen zeigten, dass der BMI zur Abbildung von interventionsbedingten Veränderungen im Körperfettanteil ungeeignet zu sein scheint. Der Einbezug der Eltern und die verwendeten Messinstrumente bezüglich des Verhaltens wurden diskutiert. Letztere wiesen einen dringenden Forschungsbedarf hinsichtlich ihrer Validität auf. / Despite highly motivated attempts at changing their eating and activity habits the majority of overweight people fail to lose weight successfully and over the long term. It is assumed that they lack the willpower necessary to maintain and realize this specific goal and a newly developed intervention program for overweight people (S.T.E.P.S.) is designed to help them with this. Willpower is facilitated through individual coaching. By optimizing the mental conditions which determine an individual’s behaviour, the preconditions for changes to their health behaviour are provided. The efficacy of S.T.E.P.S. has been tested empirically within a quasi-experimental study of 39 adolescents. Based on certain success criteria, participants were defined as responders or non-responders and examined retrospectively for personal differences to deduce which interventions were successful. The efficacy of the program is dependent on the adolescent’s age and frequency of participation. 15-17 year old participants significantly improved their willpower ability and reduced their body fat where they participated in the program frequently. These effects also showed up eight months after finishing the intervention. Responders were disposed to better preconditions in their mental processes. Weight loss requires a high level of volitional self-confidence and being able to deal with negative affects. Analysis seems to show that the BMI is an inadaquate indicator of loss of body fat, based on this intervention. Inclusion of the adolescent’s parents in the program was discussed, as well as the methodological measuring instruments applied in this study. These, however, require further empirical research regarding their validity.

CHDS State/Local / Approved for public release, distribution is unlimited / As the United States improves its collective awareness and emergency preparedness in the face of increased terrorist activity, more efforts are being made to create and enhance community readiness for catastrophic events. There have been substantial efforts to improve the nation's bioterrorism preparedness. Better planning, equipment, training, surveillance, and pharmaceutical caches have elevated the nation's readiness for biological attacks. In order to effectively meet the challenges created by a bioterrorism attack, its first lines of defense, the first responders, must be rapidly prophylaxed to allow the continuance of their mission. Many states and localities have tackled the gigantic undertaking of mass prophylaxis plans to provide chemoprophylaxis to civilians should the need arise. Many cities have developed and tested their plans to provide general public mass prophylaxis. It is assumed, or briefly mentioned, that the mass prophylaxis of first responders will occur, but few plans have been developed. The primary objective of this research is to develop, test, and make recommendations for a straightforward, adaptable mass prophylaxis plan to meet the prophylactic requirements of local first responders in the event of a biological attack. / Paramedic and Disaster Coordinator, Anaheim Memorial Medical Center, CA

One of the most common sources of stress is one's job and the struggle to balance the demands of one's job with those of one's family and/or romantic relationship. Prolonged exposure to stress can lead to burnout, and it can affect various aspects of one's life and one's emotional and cognitive well-being. Firefighters, police officers, and corrections officers are susceptible to burnout. If their well-being is compromised, it can impact their job performance, which can negatively impact society. The purpose of this study was to determine if a relationship exists between work-family conflict (time-based, strain-based, behavior-based), job burnout (exhaustion, depersonalization, accomplishment), and couple burnout in high-stress occupations, using the work-family conflict model. Using standard multiple regressions, strain-based work-family conflict and behavior-based work-family conflict were significant predictors of emotional exhaustion, depersonalization, and couple burnout. Work-family conflict scores predicted levels of personal accomplishment. In addition, emotional exhaustion was a significant predictor of couple burnout. This study provided insight into the aspects of work-family conflict and job burnout and how they predict couple burnout. Future research may include females, spouses, and other variables that may also predict burnout. Increasing education on which aspects of work-family conflict and job burnout predict couple burnout can help to increase awareness and well-being for individuals working in high-stress occupations. It can also lead to social change by encouraging changes in hiring, training, and support services, which can increase occupational retainment and allow employees to deliver the highest level of service to the populations in which they serve.

Made available in DSpace on 2016-06-02T20:30:58Z (GMT). No. of bitstreams: 1 6515.pdf: 2274743 bytes, checksum: 363167ede43e3cae38079ddb2b215fa6 (MD5) Previous issue date: 2014-02-27 / Financiadora de Estudos e Projetos / Exclusion responding is the immediate selection of a comparison indefinite stimulus before a stimulus model also undefined, without a prior history teaching model. The acquisition of vocabulary due to exclusion responding can provide the expansion of verbal repertoire without prior training and accelerating the emergence of new relationships between words and referents. This study aimed to verify if the procedures of teaching conditional discriminations for babies favor the occurrence of exclusion responding and of learning of the relation new name new object, and to check how many trials were needed to check the occurrence of learning the new relation. In all two studies (S1 and S2), the procedure consisted of the establishment of auditory-visual conditional discrimination by matching-to-sample (MTS) with familiar stimuli (baseline), exclusion probes, learning probes and control probes. The difference between the procedures was the use of a cardboard box with masking function (comparison-empty) in S1 and sheets of vellum, with mask function, inserted in a notebook of education in S2. Eight 27-36 month-old babies participated in the first study and the aim was to investigate the emergence of exclusion responding and learning relationships that emerged in a play setting. Blocks of ten trials were performed, with the presentation of four comparison stimuli, one of them inside the box / mask. Four participants learned to baseline after retraining. All participants responded by exclusion and four had learning relations that emerged after retraining LB and the probes. It took six to 11 trials to exclude the occurrence of learning new relationships. A five 15-24 month-old babies participated in the second study. Blocks of six trials were performed, with the presentation of two and three comparison stimuli; consequence turned from the continuous reinforcement (CRF) to variable-ratio 2 (VR2) in baseline trials, and the probes were performed in extinction. The mask (comparison-empty) was inserted through fading in terms of education. All infants learned the conditional discrimination and exclusion responding (in the first or second attempt of each probe); however, none of them responded consistently with the criteria of learning relations new name new object. The need to devise new procedures to foster the learning of relationships that emerged in exclusion responding has been discussed. / O responder por exclusão consiste na seleção imediata de um estímulo de comparação indefinido condicionalmente a um modelo também indefinido, sem uma história prévia de ensino. A aquisição de vocabulário decorrente do responder por exclusão pode proporcionar a ampliação do repertório verbal sem treinamento prévio e a aceleração da emergência de novas relações entre palavras e referentes. Este trabalho visou verificar se os procedimentos de ensino de discriminações condicionais para bebês favorecem a ocorrência do responder por exclusão e a aprendizagem de relações nome novo-objeto novo, além de verificar quantas tentativas de seleção seriam necessárias para a ocorrência da aprendizagem da nova relação. Nos dois estudos (E1 e E2) o procedimento consistiu do estabelecimento das discriminações condicionais auditivovisuais por matching-to-sample (MTS) com estímulos familiares (linha de base), sondas de exclusão, sondas de aprendizagem e sondas controle. A diferença dos procedimentos foi o uso de uma caixa de papelão com função de máscara (comparação-vazio) no E1 e folhas de papel vegetal, com função de máscara, inseridas em um caderno de ensino no E2. No primeiro estudo participaram oito bebês, de 27 a 36 meses e o objetivo foi verificar a emergência do responder por exclusão e da aprendizagem das relações que emergiram, em um contexto de brincadeira. Foram realizados blocos de dez tentativas, com a apresentação de quatro estímulos de comparação, um deles dentro da caixa/máscara. Quatro participantes aprenderam a linha de base após retreino. Todos os participantes responderam por exclusão e quatro apresentaram aprendizagem das relações que emergiram, após retreino de LB e das sondas. Foram necessárias de seis a 11 tentativas de exclusão para a ocorrência da aprendizagem de novas relações. No segundo estudo participaram cinco bebês, de 15 a 24 meses. Foram realizados blocos de seis tentativas, com a apresentação de dois e três estímulos de comparação; a consequência passou de reforçamento contínuo (CRF) para razão variável 2 (VR2) em tentativas de linha de base, e as sondas foram realizadas em extinção. A máscara (comparação-vazio) foi inserida por meio de fading in no caderno de ensino. Todos os bebês aprenderam as discriminações condicionais e responderam por exclusão (na primeira ou segunda tentativa de cada sonda); porém, nenhum deles respondeu consistentemente com os critérios de aprendizagem das relações nome novo-objeto novo. Discutiu-se necessidade de planejar novos procedimentos que propiciem a aprendizagem das relações que emergiram no responder por exclusão.

Bakgrund: Tiden mellan en skadehändelse och innan professionell hjälp anländer är kritisk för den skadade. Under den tiden är det upp till människor på plats, immediate responder, att agera för att rädda liv. Om immediate responder ingriper ökar chansen att de skadade överlever. Desto mer kunskap om livräddande åtgärder och om prehospital akutsjukvård en människa har, desto villigare är de att ingripa vid en skadehändelse. De som besitter mest kunskap om prehospital akutsjukvård är de människor som arbetar inom ambulanssjukvård. Motiv: I dagens forskningsläge utgår forskningen från att immediate responder har liten eller ingen kunskap om livräddande åtgärder. Det saknas beskrivningar om hur professionell personal upplever det att vara först på skadeplats när de inte är tjänst. Syfte: Att beskriva ambulanspersonals upplevelser och erfarenheter av att ingripa på skadeplats utan att vara i tjänst.  Metod: Studien hade en kvalitativ design med semistrukturerade intervjuer och analyserades med kvalitativ innehållsanalys med induktiv ansats. Nio deltagare intervjuades. Resultat: I resultatet framkom två kategorier, självklart att agera och ambivalens att agera, vilka hade sju subkategorier, att känna instinkt, att känna ansvar, att känna trygghet, att samspela och att känna rädsla, att känna obekvämhet, att fundera kring sin egen roll. Slutsats: Genom en ökad kunskap hos befolkningen i enkla livräddande åtgärder, skulle känslan av obekvämhet minska och känslan av trygghet öka vid agerandet. Att specifikt utbilda sjukvårdspersonal, som saknar erfarenhet av prehospital sjukvård, ökar chansen till att fler människor känner sig bekväm med att agera som immediate responder. Personlig kännedom mellan blåljuspersonal och immediate responder är av vikt. Genom samövning kan kännedomen stärkas och blåljuspersonal kan få en djupare kunskap om fenomenet immediate responder. Ytterligare forskning inom området behövs, framför allt hur blåljusorganisationer skall implementera nyttjandet av immediate responder i sin verksamhet.

This doctoral thesis describes a clinical, prospective, single-center pilot study, investigating the feasibility and the outcome of a novel optimization concept for heart failure patients who are not responding to a device-based therapy, so called Cardiac Resynchronization Therapy (CRT).

The hallmark of HIV/AIDS is a gradual depletion of CD4 T cells. Despite effective control by antiretroviral therapy (ART), a significant subgroup of people living with HIV (PLHIV) fails to achieve complete immune reconstitution, deemed as immune non-responders (INRs). The mechanisms underlying incomplete CD4 T cell recovery in PLHIV remain unclear. In this study, CD4 T cells from PLHIV were phenotyped and functionally characterized, focusing on their mitochondrial functions. The results show that while total CD4 T cells are diminished, cycling cells are expanded in PLHIV, especially in INRs. HIV-INR CD4 T cells are more activated, displaying exhausted and senescent phenotypes with compromised mitochondrial functions. Transcriptional profiling and flow cytometry analysis showed remarkable repression of mitochondrial transcription factor A (mtTFA) in CD4 T cells from PLHIV, leading to abnormal mitochondrial and T cell homeostasis. These results demonstrate a sequential cellular paradigm of T cell over-activation, proliferation, exhaustion, senescence, apoptosis, and depletion, which correlates with compromised mitochondrial functions. Therefore, reconstituting the mtTFA pathway may provide an adjunctive immunological approach to revitalizing CD4 T cells in ART-treated PLHIV, especially in INRs.

This ethnographic and phenomenological study examined the relationship between the benefits and compensation afforded to emergency responders; their perceptions of work equity, equality, justice, and risk management; and the effect of perceived equity, equality, justice, and risk management on the execution of an emergency responder's duties. The data was collected through interviews with members of the culture group, including law enforcement officers, firefighters, and emergency medical responder's (n = 24). The interviews were audio recorded, then manually transcribed by the researcher. The raw data was coded for reoccurring themes and commonalities. The reoccurring themes were organized and displayed in tables based on subcategory of the culture group. The results of the study indicate that the benefits and compensation afforded to professionals working in this field have an impact on their perception of work equity, justice, and risk management. It was further found that these benefits do not have an impact on the perception of work equality among members of this culture group. Understanding how to effectively motivate these professionals can have many positive effects regarding social change. These effects could be seen at the local and individual level for these responder's, at the community level for those that they serve, and at the policy level.

Army first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet® (CAT® ) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee Trauma Trainer™ (MATT™) simulator provides tourniquet training using a lifelike bilateral lower limb amputee. In addition, MATT™ combines movement and resistance while the first responder applies the tourniquet, mimicking conditions one would see in a real situation. This research describes tourniquet history, appropriate usage, field tourniquet review, surgical tourniquet, CAT® bleeding intervention procedures, bleeding physiology and complications, prehospital tourniquet use in recent conflicts, medical simulation fidelity, and a review of the value of animatronic movement during tourniquet simulation-based training. I then evaluate the effectiveness of animatronic movement during tourniquet training using the Advanced MATT in an experiment using Army first responders. The control group experienced no movement while the experimental group experienced movement when applying a tourniquet during the lab-training. Each group then alternately experienced Advanced MATT movement during an immersive scenario along with fog, strobe lights, and battle sounds. It was hypothesized that 1) In the immersive scenario, the experimental groups (i.e., those who were trained on a moving simulator) would have a faster reaction time as compared to those participants who did not receive training on the moving Advanced MATT simulator; 2) In the iv lab-based training, the experimental groups would have a slower reaction time; 3) In the immersive scenario, the experimental groups would have a faster tourniquet application time when subjected to movement while in the lab-based training, but the experimental groups would also have a slower tourniquet application time when initially subjected to movement in the laboratory-based training; finally, 4, 5, and 6) Participants who completed lab-based tourniquet training on the Advanced MATT simulation with animatronic movement would report higher perceived realism scores than participants who complete the training on a static version of the Advanced MATT and participants who completed a tourniquet training immersive scenario on the Advanced MATT simulation with movement would report higher perceived realism, presence, and self-efficacy scores than participants who complete the training on a static version of the Advanced MATT. The empirical results show a significant overall training effect of the Advanced MATT simulator (with or without movement). For reaction time and tourniquet application time, involving simulator movement was significant over varying scenarios. A small reduction in reaction and tourniquet application time on the battlefield may be extremely beneficial on the battlefield. Participants who received movement generally gave more positive reactions than those who did not received movement, although these results failed to reach statistical significance. Participants who received movement, followed by a scenario without movement rated the subjective ratings the lowest, suggestive of the lack of movement. Furthermore, despite the order movement was received, no large drops in performance occurred in any condition, indicating that negative training was avoided

Made available in DSpace on 2016-04-29T13:18:17Z (GMT). No. of bitstreams: 1 Monica Milharezi Mendonca.pdf: 1227656 bytes, checksum: e4408bd029458b28b9a5b7d2bf8dbf72 (MD5) Previous issue date: 2010-05-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Variables that influence rule control are important to be known because the control by rules seems to be a distinctive characteristic of humans. Some of these variables are the specification of deadlines and consequences in rules that also state immediate (OIR) or delayed (OAR) opportunity to respond, investigated by Bram & Malott (1990), Mistr & Glenn (1992) e Hupp & Reitman (1999) and replicated in this experiment. Two experiments have been conducted; the first one, due to unpredictable variables interference, it was used as a preparatory for the second one. Four children, between 3 years and 11 months and 5 years and 6 months old participated in the experiment and were divided in 2 groups. The 2 children in Group I were exposed to conditions PI (in which rules specified an immediate deadline), CA (rules specified delayed consequence) and CA-PI (rules specified delayed consequence and immediate deadline) with OIR, and children in Group II, to the same conditions, but with OAR. Results suggested that the specification of immediate deadline or delayed consequence could be enough to evoke the response specified by the rule in OIR, however, the variables manipulated could have had their effect modulated by the presence of the variable history of rule following, and therefore, the interaction between them is still to be investigated. In conditions with OAR, the variable specification of delayed consequence and immediate deadline had a subtle effect and Mistr & Glenn (1992)‟s suggestion that the declaration of immediate consequence could be critical in OAR condition, couldn‟t be discarded. The variable type of opportunity to respond showed to be critical, although could have also been in interaction with the history of rule following to produce some of the results. It was also found verbalizations of the participants, which we called rule related responses, which seemed to differ between groups and thus deserve a greater investigation. The long-lasting function-altering effect of rules was observed in the preparatory experiment / Variáveis que influenciam o controle por regras são importantes de serem conhecidas, pois o controle por regras parece ser uma característica distintiva de humanos. Algumas destas variáveis são as especificações de prazos e consequências em regras que declaram oportunidade imediata (OIR) e atrasada para responder (OAR), investigadas por Bram & Malott (1990), Mistr & Glenn (1992) e Hupp & Reitman (1999) e replicadas no presente experimento. Foram realizados 2 experimentos, o 1°, devido à interferência de variáveis não previstas, serviu como preparatório para o 2° experimento (experimento principal). Do experimento principal participaram 4 crianças, com idades entre 3 anos e 11 meses e 5 anos e 6 meses, divididas em 2 grupos. As 2 crianças do Grupo I passaram pelas condições PI (em que regras especificavam prazo imediato), CA (especificavam consequência atrasada) e CA-PI (consequência atrasada e prazo imediato) em OIR e as 2 crianças do Grupo II, pelas mesmas condições, porém em OAR. Os resultaram sugeriram que a especificação de prazo imediato ou de consequência atrasada poderia ser suficiente para evocar a resposta especificada pela regra em OIR, entretanto, as variáveis manipuladas podem ter tido seu efeito modulado pela presença da variável história de seguimento de regras e, portanto, a interação entre elas ainda deve ser investigada. Nas condições em OAR, a variável especificação de consequência atrasada e prazo imediato teve um efeito sutil, e a hipótese de Mistr & Glenn (1992) de que a declaração de consequência imediata seria crítica em OAR não pôde ser descartada. A variável tipo de oportunidade para responder se mostrou crítica, embora também possa ter estado em interação com a história de seguimento de regras para produzir alguns dos resultados. Foram encontradas também verbalizações dos participantes, a que chamamos respostas relacionadas à regra, que pareceram diferir entre os grupos e merecem, portanto, maior investigação. O efeito duradouro da função alteradora de função das regras pôde ser observado no experimento preparatório