Talking to primary care patients about weight: a study of GPs and practice nurses in the UK

Evidence-based guidance recommends that primary care health practitioners should deliver brief interventions to their patients to change behaviours to reduce overweight and obesity. This cross-sectional study investigates UK general practitioners' (GPs) and practice nurses' communication about overweight with their overweight and obese patients. Forty general practitioners and 47 practice nurses in two inner-London primary care organizations completed a questionnaire about past practice and concerns. When there was no identified medical problem, 38% of GPs and 14% of practice nurses reported raising the issue on less than 50% of occasions. Practice nurses were more likely than GPs to raise the issue of weight, both when there was no medical problem and when there was a medical problem. When they did raise the issue of overweight, only 9% did so in the context of presenting possible solutions to weight loss or in discussions about health promotion. Fifty two per cent of GPs and 28% of practice nurses had concerns about raising the issue of overweight; the most common being that patients would react emotionally to the message. These results suggest that there is considerable room for improvement in the frequency with which primary care practitioners address the questions of weight in their overweight patients, especially amongst doctors. Training to increase skills and confidence in communicating about weight is recommended.     

Health education and agency: a comprehensive program for young women in the Mixteca region of Mexico

The Si yo estoy bien, mi familia también ("If I am OK then so is my family") is a health and agency education program that was provided over a period of 3 years to 39,000 rural women in Oaxaca, Mexico. The purpose of the article is to describe the development, implementation and evaluation of the program. The theoretical rationale and strategy of this intervention are described, as well as the construction of the program and the implementation. Moreover, an evaluation of the various stages of the program is provided, to enable an assessment of its efficacy, and the scope for dissemination and scaling up.     

Nursing specialty and burnout

We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest burnout, whereas nurse practitioners had the most control and the least burnout. Mediational analyses showed that expected control, hostility, and stressor frequency explained differences between specialties in burnout. The implications of these findings for interventions that reduce burnout and promote nursing retention are discussed.     

The attribution of attention: 9-month-olds' interpretation of gaze as goal-directed action

The current study distinguishes between attributions of goal-directed perception (i.e. attention) and non-goal-directed perception to examine 9-month-olds' interpretation of others' head and eye turns. In a looking time task, 9-month-olds encoded the relationship between an actor's head and eye turns and a target object if the head and eye turns were embedded in a sequence of multiple, variable actions with equifinal outcomes, but not otherwise. This evidence supports the claim that infants of this age may attribute perception, at least goal-directed perception, to others and undermines arguments that gaze-following at this age consists only of uninterpreted reflexes. The evidence also suggests alternative interpretations of the typical errors infants make in standard gaze-following procedures. Implications for infants' understanding of perception and attention in both human and non-human agents are discussed.     

Age Differences in Affective Well-Being: Context Matters

The study of emotion across the adult lifespan requires an understanding of how life circumstances change with age. With this knowledge, we can predict when age is related to increases in affective well-being and when age no longer confers such benefits. In the current paper, we review research that finds age-related stability and even increases in affective well-being, as well as age-related strengths in several emotion regulation strategies. We introduce the theory of Strength and Vulnerability Integration to predict age-related patterns in emotional experience across the adult lifespan, and to identify situations when age will no longer be related to improved emotion-related outcomes. We suggest that only by understanding the context of daily life can we predict when and how age is related to affective well-being.     

Body checking behaviors in men

Males have been facing increasing pressure from the media to attain a lean, muscular physique, and are at risk for body dissatisfaction, disturbed eating and exercise behaviors, and abuse of appearance- and performance-enhancing drugs (APEDs). The aim of the current study was to examine the relationship between body checking and mood, symptoms of muscle dysmorphia, importance of shape and weight, and APED use in undergraduate males. Body checking in males was correlated with weight and shape concern, symptoms of muscle dysmorphia, depression, negative affect, and APED use. Body checking predicted APED use and uniquely accounted for the largest amount of variance in Muscle Dysmorphic Disorder Inventory (MDDI) scores (16%). Findings support the view that body checking is an important construct in male body image, muscle dysmorphia, and body change strategies and suggest a need for further research.     

Transient convergence and relational sensibility: Beyond the modern constitution of nature

The paper builds on the critique of what Latour (1993) terms the ‘modern constitution’ and its configuration of nature as an independent and external entity to human culture and politics. The paper suggests that, firstly, moving beyond the modern constitution to a world of amodern or postnature (Braun, 2004, Hayles, 1999) marks a shift from ontological stability to ontological instability, where ‘nature’ is now constituted by merging and emerging ontologies. In this unstable new world order, the paper argues that postnature should be understood as a transient convergence in a context of flow, union, and divergence. This perspective emphasises the role that emotions play in this relationship, arguing that they are both part and product of the transient convergence of postnature. ‘Humans’ are now constituted in and with the temporary coincidences that form ‘nature’, and the relational sensibility that is produced through this convergence is vital to fully understand the post-natural world. The paper concludes by suggesting that this postnature can provide new premises for protecting the world of which we are a part.     

Flexible working memory representation of the relationship between an object and its location as revealed by interactions with attention

Working memory (WM) selectively maintains a limited amount of currently relevant information in an active state to influence future perceptual processing, thought, and behavior. The representation of the information held in WM is unknown, particularly the degree of separation between the representation of an object’s identity and its location. The present experiments examined the flexibility of object and location WM representations by measuring reaction times on a visual discrimination task during the delay period of a WM recognition task for object identities, locations, or both. The results demonstrate that during WM delay periods, attention is biased toward information that matches the current contents of WM. Attention is not biased toward information that was present in the encoded memory sample but not relevant for the memory recognition test. This specificity of the interaction between WM and attention applies to both the identity and the location of the remembered stimulus and to the relationship between an object and its location. The results suggest that when this relationship is necessary for task performance, WM represents an object and its identity in an integrated manner. However, if this relationship is not task relevant, the object and location information are represented in WM separately.     

The effects of wording on the understanding and use of uncertainty information in a threshold forecasting decision

Many believe that information about small chances of severe weather would be useful to the general public for precautionary action. What is the best way to explain this kind of information to a non‐expert audience? The studies reported here investigated effects of framing (negative vs. positive), format (frequency vs. probability), likelihood (low vs. high) and compatibility (task‐match) on interpretation of verbal expressions of forecast uncertainty and on subsequent forecasting decisions. The crucial factor was the match between the verbal expression and the overall task goal. Errors increased when there was a mismatch between the expression (e.g. winds less than 20 knots) and the task (e.g. post an advisory when winds will exceed 20 knots). However, framing and format had little impact. We conclude that consideration of user expectations arising from the overall task goal is crucial in explaining uncertainty information to a naïve audience. Global expectations overpower other potential effects. Copyright © 2008 John Wiley & Sons, Ltd.