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\"In spite of improved access to psychosocial interventions, many people with psychosis continue to experience persistent problems which act as significant barriers to their recovery. This book investigates risk and problem behaviours in psychosis including staff and service factors that can impede the delivery of effective care. Working with Problematic Behaviour in Psychosis provides a new approach for assessment formulation and intervention with such problem behaviours in a team context. Of particular interest will be: an outline of the SAFE (Shared Assessment, Formulation and Education) approach an integrative model for understanding risk and problematic behaviour shared risk assessment and management processes the use of CBT in day-to-day interactions with clients a set of formulation driven strategies for managing problematic behaviours case studies and vignettes providing guidance and highlighting the benefits of the approach. This book will have particular appeal to professionals working in residential care for those with complex mental health problems as well as those working in intensive community based services. It is also an excellent resource for those training in psychological therapies for complex mental health problems, risk assessment and management\"--Provided by publisher.

INTRODUCTION Amyloid beta (Aβ) can be detected in vivo years before Alzheimer's disease (AD) symptom onset and, according to recent criteria, is sufficient for a biological diagnosis. This study evaluates emotional responses to Aβ status disclosure in cognitively normal individuals. METHODS Questionnaires were given before and 6 months after Aβ positron emission tomography results disclosure to assess anxiety and depression related to the possibility of an elevated result, subjective memory complaints, and motivation for risk‐reduction behavior. RESULTS One hundred ninety‐nine cognitively normal adults were included. Non‐elevated Aβ status disclosure was associated with reductions in all emotional parameters compared to baseline (p < 0.001). Elevated Aβ disclosure was associated with no changes in depression or memory complaints and a modest decrease in anxiety and motivation to change lifestyle (p < 0.048). DISCUSSION No negative psychological effects were observed after Aβ status disclosure. Decreased motivation for lifestyle changes was seen after disclosure of both elevated and non‐elevated amyloid status and should be targeted. Highlights No negative psychological effects were observed after amyloid beta (Aβ) status disclosure. Motivation for lifestyle changes decreased after Aβ disclosure. Lower education may predict “unfavorable” response to non‐elevated Aβ disclosure. Results support personalized communication strategies for Aβ disclosure.

Tracing the Sudden Infant Death Syndrome (SIDS) diagnosis from its mid-century origins through the late 1900s,Rest Uneasyinvestigates the processes by which SIDS became both a discrete medical enigma and a source of social anxiety construed differently over time and according to varying perspectives. American medicine reinterpreted and reconceived of the problem of sudden infant death multiple times over the course of the twentieth century. Its various approaches linked sudden infant deaths to all kinds of different causes-biological, anatomical, environmental, and social. In the context of a nation increasingly skeptical, yet increasingly expectant, of medicine, Americans struggled to cope with the paradoxes of sudden infant death; they worked to admit their powerlessness to prevent SIDS even while they tried to overcome it. Brittany Cowgill chronicles and assesses Americans' fraught but consequential efforts to explain and conquer SIDS, illuminating how and why SIDS has continued to cast a shadow over doctors and parents.

Purpose: To explore the effect of providing lymphedema information on breast cancer survivors' symptoms and practice of risk‐reduction behaviors. Design: A cross‐sectional design was used to obtain data from 136 breast‐cancer survivors in New York City from August 2006 to May 2007. Descriptive statistics, t tests, chi‐square tests, and correlations were calculated. Methods: Data were collected using a demographic and medical information interview tool, two questions regarding status of receiving lymphedema information, the Lymphedema and Breast Cancer Questionnaire, and Lymphedema Risk‐Reduction Behavior Checklist. Findings: Fifty‐seven percent of the participants reported that they received lymphedema information. On average, participants had three lymphedema‐related symptoms. Only 18% of participants were free of symptoms. Participants who received information reported significantly fewer symptoms (t=3.03; p<0.00) and practicing more risk‐reduction behaviors (t=2.42; p=0.01). Conclusions: Providing lymphedema information has an effect on symptom reduction and more risk‐reduction behaviors being practiced among breast cancer survivors. Clinical Relevance: In clinical practice, nurses and other healthcare professionals could consider taking the initiative to provide adequate and accurate information and engage breast‐cancer survivors in supportive dialogues concerning lymphedema risk‐reduction.

Three causes have been identified for the spiraling cost of wildfire suppression in the United States: climate change, fuel accumulation from past wildfire suppression, and development in fire-prone areas. Because little is likely to be performed to halt the effects of climate on wildfire risk, and because fuel-management budgets cannot keep pace with fuel accumulation let alone reverse it, changing the behaviors of existing and potential homeowners in fire-prone areas is the most promising approach to decreasing the cost of suppressing wildfires in the wildland–urban interface and increasing the odds of homes surviving wildfire events. Wildfire education efforts encourage homeowners to manage their property to decrease wildfire risk. Such programs may be more effective with a better understanding of the factors related to homeowners’ decisions to undertake wildfire risk–reduction actions. In this study, we measured whether homeowners had implemented 12 wildfire risk–mitigation measures in 2 Colorado Front Range counties. We found that wildfire information received from local volunteer fire departments and county wildfire specialists, as well as talking with neighbors about wildfire, were positively associated with higher levels of mitigation. Firsthand experience in the form of preparing for or undertaking an evacuation was also associated with a higher level of mitigation. Finally, homeowners who perceived higher levels of wildfire risk on their property had undertaken higher levels of wildfire-risk mitigation on their property.

To identify significant predictors of the adoption of more than one tick-exposure and tick-borne disease risk reduction behavior among a cross-section of Indiana residents. Study participants were recruited through quota sampling, before completing an online self-administered questionnaire in Qualtrics. The most adopted tick exposure risk reduction behavior (TERRB) (was ‘Walking on established trails and avoiding contact with adjacent vegetation’ (83%, n = 2418). This was followed by ‘Conducting a thorough check of clothing and the body soon after returning from the outdoors’ (81%, n = 2373). The two least adopted TERRBs were,’ Treating outdoor clothing with special insect repellent (e.g. Permethrin)’ (48%, n = 1409) and ‘Wearing appropriate clothing’ (‘Tucking shirt into pants, and the pants into socks when outdoors’) respectively (52%, n = 1524). Study participants who engaged in residential tick control practices (i.e. ‘three-foot wide barrier of wood chips/gravel between lawn and woodland’, ‘yard pesticide application’, ‘shrub & tree-branch trimming’, ‘yard fencing’, ‘fixed time lawn mowing’, and ‘leaf litter removal’) were significantly more likely to adopt nearly all the assessed TERRBs. Higher scores on TERRB efficacy index were associated with engaging in multiple TERRBs. Higher degree of worry about safety/health because of ticks was also associated with adoption of multiple TERRBs. In conclusion, increased risk perceptions, among Indiana residents is significantly associated with adoption of multiple TERRBs. Identifying the predictors of the adoption of more than one TERRB is vital for the prevention of tick-borne diseases.

This integrative review aims to provide a consolidated evidence-based appraisal of the most up-to-date guidelines and recommendations of international public and professional health regulatory bodies in relation to preparedness framework for restructuring safe delivery of dental services amid and beyond the coronavirus disease-2019 (COVID-19) pandemic. Most recent updated guidelines for dental professionals from major international health regulatory bodies were reviewed. PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, WHO COVID-19 and LILACS databases, along with relevant preprints were searched, and citations were checked up to January 23, 2021. The search was performed by one author. Shortlisted articles were read and brought to consensus to be included in the study by at least two co-authors. In case of any disagreement between the judgements, an independent co-author’s decision was taken as final. Of 849 records searched, 61 articles were included in the study. Following content analysis of the global guidelines and the collected prevailing evidence, the common themes and recommendations of different guidance documents were collated and summarized into seven domains. Most guidelines have a consensus regarding implementation of rigorous administrative, engineering and environmental infection control strategies. However, variations do exist with regard to the use of respirators in non-aerosol-generating procedure (non-AGP) settings, employment of airborne precautions during non-AGPs, use of supplemental air-handling systems, and preoperative use of mouthwashes. This evidence-based analysis can serve as a useful reopening resource tool and facilitate effective restructuring for delivery of optimal, equitable and safe dental practices globally, during and while emerging from the pandemic.

This report reviews the outcomes of a project to better understand as well as develop a methodology to study the factors associated with sexual risk behaviour among alcohol users in diverse cultural settings. The project focused on eight countries from four continents (Belarus, India, Mexico, Kenya, Romania, the Russian Federation, South Africa and Zambia).

We present the results of a clinical trial that tested the efficacy of using motivational interviewing (MI) in a group format to promote adherence to antiretroviral medications and risk reduction behaviors (RRB) in 203 predominately African American HIV infected women. It was compared to a group health promotion program. Participants were followed for 9 months. Adherence was measured by MEMS ® ; and RRB by self-report. Controlling for recruitment site and years on ART, no significant group by time effects were observed. Attendance (≥7/8 sessions) modified the effects. Higher MI attendees had better adherence at all follow-ups, a borderline significant group by time effect ( p  = 0.1) for % Doses Taken on Schedule, a significantly larger proportion who reported abstinence at 2 weeks, 6, and 9 months, and always used protection during sex at 6 and 9 months. Though not conclusive, the findings offer some support for using MI in a group format to promote adherence and some risk reduction behaviors when adequate attendance is maintained.

BackgroundHealth risk assessment tools compute an individual’s risk of developing a disease. Routine use of such tools by primary care physicians (PCPs) is potentially useful in chronic disease prevention. We sought physicians’ awareness and perceptions of the usefulness, usability and feasibility of performing assessments with computer-based risk assessment tools in primary care settings.MethodsFocus groups and usability testing with a computer-based risk assessment tool were conducted with PCPs from both university-affiliated and community-based practices. Analysis was derived from grounded theory methodology.ResultsPCPs (n = 30) were aware of several risk assessment tools although only select tools were used routinely. The decision to use a tool depended on how use impacted practice workflow and whether the tool had credibility. Participants felt that embedding tools in the electronic medical records (EMRs) system might allow for health information from the medical record to auto-populate into the tool. User comprehension of risk could also be improved with computer-based interfaces that present risk in different formats.ConclusionsIn this study, PCPs chose to use certain tools more regularly because of usability and credibility. Despite there being differences in the particular tools a clinical practice used, there was general appreciation for the usefulness of tools for different clinical situations. Participants characterised particular features of an ideal tool, feeling strongly that embedding risk assessment tools in the EMR would maximise accessibility and use of the tool for chronic disease management. However, appropriate practice workflow integration and features that facilitate patient understanding at point-of-care are also essential.Where this study fits inThis is a qualitative study determining the perspectives of primary care physicians on health risk assessment tools.Participants observed that computerisation of primary care practices offers scope to increase the routine use of health risk assessment tools.EMRs can facilitate the administration of risk assessment tools as well as convey risk to patients in a meaningful manner.The design and functionality of computer-based risk assessment tools should be expanded to improve the ease of use, display of results, and integration with clinical workflow.