Background
Although fetal alcohol spectrum disorders (FASD) affect communities worldwide, little is known about its prevalence. The objective of this study was to provide an overview of the global ...FASD prevalence.
Methods
We performed a search in multiple electronic bibliographic databases up to August 2015, supplemented with the ascendancy and descendancy approach. Studies were considered when published in English, included human participants, and reported empirical data on prevalence or incidence estimates of FASD. Raw prevalence estimates were transformed using the Freeman–Tukey double arcsine transformation so that the data followed an approximately normal distribution. Once the pooled prevalence estimates, 95% confidence intervals and prediction intervals were calculated based on multiple meta‐analyses with transformed proportions using random effects models, these estimates were transformed back to regular prevalence rates. Heterogeneity was tested using Cochran's Q and described using the I2 statistic.
Results
Among studies that estimated prevalence in general population samples, considerable differences in prevalence rates between countries were found and therefore separate meta‐analyses for country were conducted. Particularly high‐prevalence rates were observed in South Africa for fetal alcohol syndrome (55.42 per 1,000), for alcohol‐related neurodevelopmental disorder (20.25 per 1,000), and FASD (113.22 per 1,000), For partial fetal alcohol syndrome high rates were found in Croatia (43.01 per 1,000), Italy (36.89 per 1,000), and South Africa (28.29 per 1,000). In the case of alcohol‐related birth defects, a prevalence of 10.82 per 1,000 was found in Australia. However, studies into FASD exhibited substantial heterogeneity, which could only partly be explained by moderators, most notably geography and descent, in meta‐regressions. In addition, the moderators were confounded, making conclusions as to each moderator's relevance tentative at best.
Conclusions
The worldwide pooled prevalence estimates are higher than assumed so far, but this was largely explained by geography and descent. Furthermore, prevalence studies varied considerably in terms of used methodology and methodological quality. The pooled estimates must therefore be interpreted with caution and for future research it is highly recommended to report methodology in a more comprehensive way. Finally, clear guidelines on assessing FASD prevalence are urgently needed, and a first step toward these guidelines is presented.
Fetal Alcohol Spectrum Disorders form a considerable burden to every society. Although FASD affect communities worldwide, until now our knowledge about its prevalence is limited. A clear overview of FASD prevalence is not available. This is the first study providing an overview of this problem worldwide. Meta‐analysis reveals that cautious interpretation is warranted and guidelines on assessing FASD prevalence are urgently needed.
Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the ...current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks—protection motivation theory and the extended parallel process model—the findings of six meta‐analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self‐efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered.
Quality indicators (QIs) are used to monitor quality of care and adherence to osteoarthritis (OA) standards of care. Patient reported QIs can identify the most important gaps in quality of care and ...the most vulnerable patient groups. The aim of this study was to capture the perspective of people with knee OA (KOA) in the Netherlands on the quality of care received, and explore determinants related to lower achievement rates.
We sent an online survey to all members of The Dutch Knee Panel (n = 622) of the Sint Maartenskliniek Nijmegen, the Netherlands between September and October 2019. The survey consisted of a slightly adapted version of the "OsteoArthritis Quality Indicator" (OA-QI) questionnaire (18 items; yes, no, N/A); a rating of quality of KOA care on a 10-point scale; a question on whether or not one wanted to see change in the care for KOA; and an open-ended question asking recommendations for improvement of OA care. Furthermore, sociodemographic and disease related characteristics were collected. Pass rates for separate QIs and pass rates on patient level were calculated by dividing the number of times the indicator was achieved by the number of eligible persons for that particular indicator.
A total of 434 participants (70%) completed the survey. The mean (SD) pass rate (those answering "Yes") for separate QIs was 49% (20%); ranging from 15% for receiving referral for weight reduction to 75% for patient education on how to manage knee OA. The mean (SD) pass rate on patient level was 52% (23%). Presence of OA in other joints, comorbidities, and having a knee replacement were associated with higher pass rates. On average, a score of 6.5 (1.6) was given for the quality of care received, and the majority of respondents (59%) wanted change in the care for KOA. Of 231 recommendations made, most often mentioned were the need for tailoring of care (14%), more education (13%), and more empathy and support from healthcare providers (12%).
This study found patients are only moderately satisfied with the OA care received, and showed substantial gaps between perceived quality of care for OA and internationally accepted standards. Future research should focus on the underlying reasons and provide strategies to bridge these gaps.
A review of empirical studies on proenvironmental behaviors in organizational contexts is presented. Twenty‐one studies met the inclusion criteria. Quantitative effect sizes were compared where ...statistics were available and research designs were comparable. Characteristics of the dependent variable and the targeted organizational (sub)populations were systematically examined. With respect to individual‐specific determinants, the results show relatively consistent effects for attitudinal determinants and past behavior. For organization‐specific influences, management and physical facilitation were frequently significant. Findings related to other factors are less conclusive. Given the available evidence and feasibility considerations, it is recommended that interventions focus on physical facilitation, tailored persuasive communication, and active engagement of middle management. It is further recommended that future research integrates the analysis of individual and organizational determinants.
Use of fear appeals assumes that when people are emotionally confronted with the negative effects of their behaviour they will change that behaviour. That reasoning is simple and intuitive, but only ...true under specific, rare circumstances. Risk perception theories predict that if people will experience a threat, they want to counter that threat. However, how they do so is determined by their coping efficacy level: if efficacy is high, they may change their behaviour in the suggested direction; if efficacy is low, they react defensively. Research on fear appeals should be methodologically sound, comparing a threatening to a non-threatening intervention under high and low efficacy levels, random assignment and measuring behaviour as outcome. We critically review extant empirical evidence and conclude that it does not support positive effects of fear appeals. Nonetheless, their use persists and is even promoted by health psychology researchers, causing scientific insights to be ignored or misinterpreted.
Abstract Purpose The aim of this study was to investigate if and how an artificially intelligent chat agent (chatbot) that answers questions about sex, drugs, and alcohol is used and evaluated by ...adolescents, especially in comparison with information lines and search engines. Methods A sample of 929 adolescents (64% girls, mean age = 15), varying in urbanization level and educational level, participated in this study. Use of the chatbot was objectively tracked through server registrations (e.g., frequency and duration of conversations with the chatbot, the number and topics of queries), and a web-based questionnaire was used to evaluate the chatbot (e.g., the perception of anonymity, conciseness, ease of use, fun, quality and quantity of information, and speed) and to compare it with information lines and search engines. Results The chatbot reached high school attendees in general and not only adolescents with previous experience related to sex, drugs, or alcohol; this is promising from an informed decision-making point of view. Frequency (M = 11) and duration of conversations (3:57 minutes) was high and the chatbot was evaluated positively, especially in comparison with information lines and search engines. Conclusion The use of chatbots within the field of health promotion has a large potential to reach a varied group of adolescents and to provide them with answers to their questions related to sex, drugs, and alcohol.
An analysis of individual and organisational determinants of energy‐related behaviors in office buildings and the interplay between the two is presented. Interviews and focus groups were conducted ...with office workers from four organisations in two Dutch provinces. The results indicate that, overall, work efficiency and productivity was prioritised over energy conservation. In general, self‐efficacy was the most salient individual determinant, and social norm the least discussed determinant of current office energy‐related behaviors. Nevertheless, both self‐efficacy and social norm elements were encountered in employees' proposed strategies to achieve future office energy‐saving. Formal and informal aspects of the organisational context were found to equally affect individual determinants and their related behaviors. Facility managers' and general office workers' views differed in a few but important ways. Interorganisational comparisons showed that differences in organisational foci were linked to the relative salience of normative, gain, and hedonic motivations.
This paper examines whether short-term cross-cultural study tours enhance the four factors of cultural intelligence (CQ): metacognition, cognition, motivation and behavior. CQ has exhibited high ...correlations between higher levels of CQ and positive attitudinal and behavioral outcomes. As a capability, CQ appears malleable and, thus, open to change and improvement. Data were collected from working professionals in an MBA program both before and after participating in an experientially oriented 11- or 12-day short-term cross-cultural study tour. Results supported three of the four hypotheses, suggesting that short-term cross-cultural study tours exhibited a significant relationship with enhanced metacognitive CQ, cognitive CQ and motivational CQ. The results did not reveal a significant relationship between the study tours and behavioral CQ.
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