论环境变化对医院行为的要求

根据系统论观点,医院是整个社会系统中的子系统。医院不断与外界环境发生着能源、信息、物质、人员等的交换,同时此种交换也在医院内部不同部门之间进行。任何内外环境的变化都会引起医院内部结构与功能发生变化。我国自对外开放以来,医院的内外环境发生了很大的变化。为了生存与发展,医院必须采取一系列适应性应变措施,调整自己的行为。本文就环境变化对医院行为的要求进行分析,提出调节医院行为的一些建议。     

Pre-school children's aggressive and pro-social behaviours in stressful situations

The aim of our research was to investigate social and emotional skills that determine pre-schoolers’ aggressive and pro-social behaviours in stressful situations. The sample of the empirical study consisted of 119 (36–48, 49–60 and 61–72 months) Hungarian children from six pre-schools. Instruments that were used: Coping strategy self-report and teacher-report questionnaires as well as hypothetical social situations interviews with puppets. The statistical analysis of pre-school teachers’ questionnaires showed that verbal and physical aggression as coping strategies were used in a significantly higher proportion (p?<?0.05) by 61–72-month-old children than by the younger age groups. In the oldest age group, boys were rated significantly more aggressive than girls (p?<?0.05). However, significant age or gender effects could not be demonstrated on pro-social behaviour. Self-report questionnaires have not yielded any significant results concerning age and gender differences in either studied dimension. Hypothetical social situations resulted in significantly less-aggressive responses by 36–48-month-old children than by the two other age groups (p?<?0.05). Data obtained by self-report and teacher-report questionnaires on coping strategies and pro-social behaviour showed moderate correlations (r?=?0.325–0.478).     

The role of habit in recurrent pressure ulcers following spinal cord injury

Background: Despite the existence of numerous prevention strategies, pressure ulcers remain highly prevalent in those with spinal cord injury (SCI). The concept of habit, broadly defined, may help understand the persistence of this problem and offer strategies for its mitigation by occupational therapy.

Aim: The aim of this paper is to describe the relationship between habits established prior to sustaining an SCI and post-injury habits that impacted on pressure ulcer risk.

Methods: Secondary analysis of qualitative data collected during an ethnographic study of community-dwelling adults with SCI.

Results: Participants’ habits appeared to substantially affect their risk of developing pressure ulcers. Habits established before incurring the SCI either facilitated or hindered the acquisition of new habits intended to prevent pressure ulcers.

Conclusions: An understanding of the individual’s pre-existing habits may be important when designing a rehabilitation programme intended to minimize risk of pressure ulcer development following SCI. Habit-change strategies could be used to supplement education in pressure ulcer prevention techniques.

Significance: Occupational therapists have a longstanding interest in habit. A more comprehensive understanding of this concept may provide important insights into the persistence and management of pressure ulcers following SCI.     

Illness behaviour: a selective review and synthesis

Sociologists have researched the subject of illness behaviour for more than five decades. Recently the discussion has taken on new importance because of changes in the delivery of health care and the emergence of patients' rights and increased patient knowledge of medicine. Through a selective review of the literature on illness behaviour, the paper aims to show that singular and segmented approaches to illness behaviour have not clearly elucidated the complexity of the phenomenon. A more comprehensive and structured analysis of illness behaviour can be accomplished with mixed qualitative and hierarchical/structural quantitative techniques. Following a discussion of prior research in social psychology, demography, economics, social networks and geographic systems, this paper offers a template for future analysis of illness behaviour.     

缺锌大鼠对光电刺激的不同反应及相关机理的探讨

目的：研究缺锌对大鼠光和电敏感性的影响及其可能的机制。方法：以Ｗｉｓｔａｒ大鼠建立缺锌模型，用避暗箱观察其对光和电的敏感性，并分别测定其脑组织５－羟色胺及外围血液中乙酰胆碱和皮质醇的含量。结果：缺锌使大鼠对光的敏感性明显降低，而对电的敏感性增强，同时其脑组织５－羟色胺及外周血液中乙酰胆碱和皮质醇含量升高。结论：上述神经递质和激素的变化可能是缺锌大鼠对光和电敏感性发生变化的机理。     

Challenges to changing health behaviours in developing countries: a critical overview

This overview of recent research on health behaviour change in developing countries shows progress as well as pitfalls. In order to provide guidance to health and social scientists seeking to change common practices that contribute to illness and death, there needs to be a common approach to developing interventions and evaluating their outcomes. Strategies forming the basis of interventions and programs to change behaviour need to focus on three sources: theories of behaviour change, evidence for the success and failure of past attempts, and an in-depth understanding of one's audience. Common pitfalls are a lack of attention to the wisdom of theories that address strategies of change at the individual, interpersonal, and community levels. Instead, programs are often developed solely from a logic model, formative qualitative research, or a case-control study of determinants. These are relevant, but limited in scope. Also limited is the focus solely on one's specific behaviour; regardless of whether the practice concerns feeding children or seeking skilled birth attendants or using a latrine, commonalities among behaviours allow generalizability. What we aim for is a set of guidelines for best practices in interventions and programs, as well as a metric to assess whether the program includes these practices. Some fields have approached closer to this goal than others. This special issue of behaviour change interventions in developing countries adds to our understanding of where we are now and what we need to do to realize more gains in the future.     

Child care and social support modify the association between maternal depressive symptoms and early childhood behaviour problems: a US national study

OBJECTIVE: To investigate the presence and patterns of modification effects of the sex of the child, social support, and childcare on the relation between maternal depressive symptoms and child behaviour problems at two developmental stages. DESIGN: Analyses are based on prospective longitudinal data from the study of early child care. PARTICIPANTS: A total of 1216 families were drawn from 10 locations across the USA. Mothers were age 18 or older at the time of the study child's birth and had completed outcome measures for at least one follow up time point (24 months, 36 months). MAIN OUTCOME MEASURES: Child internalising and externalising behaviour problems assessed at the child's age of 24 months and 36 months, as reported by the mother. RESULTS: Results from generalised estimating equation analyses showed that the association between child externalising behaviour problems and maternal depressive symptoms varied according to the social support received by the mother (p<0.05). Overall, social support mitigated the relation, but protective effects diminished at increasing levels of depressive symptoms. Associations between child internalising behaviour problems and maternal depressive symptoms varied according to whether or not the child received care from caregivers other than the mother (p<0.05). CONCLUSIONS: Health providers who are working with mothers with depressive symptoms may want to examine social support that is available to mothers, especially if mothers are not severely depressed. Furthermore, recommendations to begin, continue, or perhaps increase provision of childcare from other caregivers can provide respite for mothers and opportunities for children to engage in protective interactions with others.     

Managing challenging behaviour in the community: methods and results of interactive staff training

A necessary condition for a high quality of community care in relation to challenging behaviour is staff training in appropriate methods. This paper describes the application of a practical 'interactive staff training' approach with n = 101 staff, featuring the use of focused and experiential learning in teams. The findings indicated that the course was socially acceptable to the participants, led to a significant improvement in their knowledge of nonphysical methods, and resulted in written guidelines for managing their own clients' challenging behaviour. Furthermore, agreements were clarified on how these guidelines would be implemented by each team following training. Implications are drawn for improved evaluation of this promising training programme, including developing the measures of learning and adding a generalisation assessment.     

The views of carers about support for their family member with an intellectual disability: With a focus on positive behavioural approaches

This qualitative study explored the views of family carers about the support that their adult children with an intellectual disability had received in relation to their behaviour that challenged. There was a particular focus on positive behavioural support (PBS), although some participants spoke more generally in terms of positive approaches. Semi‐structured interviews with eight family carers were analysed using inductive thematic analysis. Four key themes were identified. Good support, of which PBS was an example, was seen as both having reduced behaviours that challenged and having a wider positive impact on the quality of life of the individual and their families. Key features highlighted were: technical knowledge and skill; a strong value base of warmth, acceptance and respect; a collaborative, consistent approach; open communication; and the extension of support to the family carer when needed. It was recognised that there is a need for broad systemic change and for the application of a workforce development model that takes account of the needs of staff, carers and those working in wider systems that have contact with people with an intellectual disability.     

Consumers' attitudes towards GM Free products in a European Region. The case of the Prefecture of Drama-Kavala-Xanthi in Greece

This study aims to identify the factors that affect consumers purchasing behaviour towards food products that are free from Genetic Modified Organism (GM Free) in a European Region and more precisely in the Prefecture of Drama-Kavala-Xanthi. Field interviews conducted in a random selected sample consisted of 337 consumers in the cities of Drama, Kavala, Xanthi, in November and December of 2009. Principal components analysis (PCA) was conducted in order to identify the factors that affect people in preferring consuming products that are GM Free. The factors that influence people in the study area to buy GM Free products are: (a) products’ certification as GM Free or organic products, (b) interest about the protection of the environment and nutrition value, (c) marketing issues, and (d) price and quality. Furthermore, cluster and discriminant analysis identified two groups of consumers: (a) those are influenced by the product price, quality and marketing aspects and (b) those are interested in product's certification and environmental protection. Non parametric statistical bivariate techniques were performed to profile the identified groups of consumers regarding their personal characteristics and some other factors affecting their buying behaviour.     

Strategies to influence nutrition behaviour

An attempt is made in this paper to consider first the current nutritional scene with its problems, and then to suggest strategies for improvement. As the quality of people's diets everywhere is influenced by many different factors, not least by availability of food, ability to pay for it, and some (however basic) understanding of its effects upon health, a strong plea is made for consideration to be given to those most in need of nutritional help–the least advantaged and least motivated groups in the developed countries, as well as the poor in the Third World. Some strategies aimed at improving nutrition behaviour are outlined.
Having given some considerable thought to the exact meaning of the title, I decided it is best understood as 'ways and means of bringing about beneficial changes in food habits from the health point of view'. The more I considered what such changes might entail, the less appropriate it seemed to think merely in terms of one's own immediate area, or even of the developed parts of the world. Thus, although many of the examples offered are taken either from my native Scotland or from the UK as a whole, I have attempted to aim for a wider view.     

Attention to infants in the first year

The time spent by 158 infants in contact with their carers at 6, 13, 26 and 52 weeks was reviewed prospectively. Periods of contact in the categories of (1) physical care, (2) holding the crying or sleeping infant, and (3) playing and interacting with the infant were recorded using 24-h log diaries completed by the mother. The mean total carer contact time over a 24-h day did not change significantly in the first year, varying between 6.5 and 73 h. Between 6 and 52 weeks, time spent by the mother in physical care declined significantly from 207 to 143 min and in holding the crying or sleeping infant from 61 to 17 min (P < 0.05 and 0.0001 respectively). There were no significant changes in the amount of time spent in playing and interacting with the infant over the first year by the mother and father, the time being on average 52.7 and 25.0 min respectively. Play and interaction with a non-parental carer increased significantly from 14 to 69 min (P < 0.0001). Relationships between infant size and holding became weaker as the infant became older. Infant gender, socioeconomic status and duration of breast-feeding did not influence infant contact time.     

Health behaviours, risk-taking and conceptual changes among schoolchildren aged 7 to 19 years in semi-rural Sweden

Background This study covers a broad age group (7–19 years) and includes a wide range of themes. The aim is to describe how various behaviours, complaints and conceptual changes come into play and to discuss the factors that might support or hamper the happiness and well‐being of growing children and adolescents. We also discuss the implications of our findings for future prevention programmes. Methods This cross‐sectional study included all schoolchildren in a semi‐rural district in Sweden (2181 pupils). A structured classroom questionnaire was used but the children were also given the opportunity to describe in their own words what was important for their happiness and well‐being. Results Mean response rate was 85%. Most changes in behaviour occurred between 11 and 14 years of age. Girls had a more rapid process of change than boys. Both girls and boys experienced stress in their relations with peers, parents and teachers. Gender differences in emotional support were prominent. Regardless of age and sex, all schoolchildren asked for a richer choice of leisure time activities, a place where they could meet with friends and caring teachers, parents and adults in the surrounding community. Conclusions Adolescence was perceived as a risky and problematic period not only by adults but also by the adolescents themselves. However, the perceived risks and the worries differed. While the adults mainly worried about the early onset of smoking and drug use, the schoolchildren worried about their social situation and their personal relationships. After decades of preventive programmes in Swedish schools, only modest results are seen. To be effective, future preventive programmes probably have to focus more on the conceptual world of the growing child.     

Breaking the speed of the sound of loneliness: Sexual partner change and the fear of intimacy

Following a thematic analysis of responses, a qualitative study of sexuality and alcohol use was undertaken in three bars/clubs in Oslo. Interviews with two persons (one male, one female) with high rates of sexual partner change were selected for detailed interpretative and contextual analysis, the aim being to examine the underlying motives for this mode of action. The principal motivations underpinning the man's behaviour linked to sex drive, impulsivity, and opportunity. He expressed cynicism, distance, loneliness and an element of narcissism. The woman's sexual activity on the other hand was motivated by intoxication, chance, the desire to offer care, arousal, and love. The data suggest that much more than sexual pleasure is being sought in the kinds of encounters described. A basic motive underpinning this behaviour appears to be a fear of intimacy mixed with the search for a sense of self-worth.     

Associations between perceived teaching behaviours and affect in upper elementary school students

We explored the associations between student-perceived teaching behaviours and negative affect (NA) and positive affect (PA) in upper elementary age students, both before and after controlling for perceived parenting behaviours. The Teaching Behaviour Questionnaire, the Alabama Parenting Questionnaire, and the Positive and Negative Affect Schedule for Children were completed by 777 third to fifth graders in nine elementary schools. Using two-level hierarchical linear model analyses, we found that (a) perceived instructional teaching behaviour was negatively associated with NA and positively associated with PA; (b) perceived organizational behaviour was not associated with either; (c) perceived socio-emotional teaching behaviour was positively associated with both; (d) perceived negative teaching behaviour was positively associated with NA but not associated with PA. When parenting behaviours were controlled for, the associations with NA but not with PA held up. We discuss the implications of the findings for education and mental health personnel.     

Weathering the preschool environment: affect moderates the relations between meteorology and preschool behaviors

The goal of this study was to examine the relations among various meteorological conditions, affective states and behavior in young children. Results from past research have revealed many weather effects on behavior and emotions with adult samples. However, there is a paucity of empirical evidence to support this link with children. Thirty‐three mothers were asked to rate their children (age 36–70 months) for a one‐month period to assess positive and negative affect. Teachers completed questionnaires for the same period to assess internalizing (e.g. anxious), externalizing (e.g. aggressive) and prosocial (e.g. helping) behavior, and data were collected for various weather conditions. Pearson correlation analyses revealed many associations between weather and children’s internalizing, externalizing and prosocial behavior. Furthermore, using a moderated model approach, the interactions between weather (temperature, humidity and amount of sunshine) and children’s affect (positive and negative) were examined in the prediction of social adjustment in preschool. The overall pattern of results revealed that favorable temperature and an increased amount of sunshine promote positive social behaviors in children who are prone to higher levels of negative affect. However, the results also suggest that higher humidity is associated with decreases in prosocial behavior and increases in externalizing behavior in children who typically exhibit positive social adjustment. Findings are related to issues surrounding family functioning, classroom management and peer relations.