Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

The status quo and influence of self-management behaviors in convalescent stroke patients

Objective： The aims of this study were to investigate the status quo of self-management behaviors in stroke patients at the recovery stage and to explore its influencing factors.Methods： A total of 440 hospitalized convalescent stroke patients were recruited and investigated using the Basic Situation Questionnaire, Self-management Behavior Scale of Stroke, Stroke Prevention Knowledge Questionnaire and Social Support Rating Scale.Results： The mean self-management behavior score was （151.95±23.58）, and dimensions in descending order were as follows： dietary management, drug safety management, social function and interpersonal relationships, life management, emotion management, rehabilitation exercise management and disease management. Five regional self-management behavior scores were statistically significant, and the scores from Minnan and Minzhong of the Fujian province, China, were higher than the others. Gender, age, family income and self-management behavior were significantly correlated （P〈0.05）; educational level, stroke knowledge level, social support level and self-management behavior were positively correlated, and the difference was statistically significant （P〈0.01）. Conclusions： The overall self-management level of convalescent stroke patients should be improved to strengthen health education; focus on the educational level, which is relatively low; strengthen the social support system of patients; stimulate the enthusiasm and initiative of self-management disease patients to promote disease rehabilitation and improve the quality of life.

Microstructure characteristics and solidification behavior of wrought aluminum alloy 2024 rheo-diecast with self-inoculation method

One important problem in casting wrought aluminum alloys is the high tendency to the formation of hot tears in the solidification process.By using semi-solid metal(SSM) processing,the hot tearing tendency of alloys can be minimized during casting.In the present research,the semi-solid slurry of wrought aluminum alloy 2024 was firstly prepared with a novel self-inoculation method(SIM),and then the microstructure characteristics of the semi-solid slurry and the rheo-diecastings cast with the semi-solid slurry were investigated.The results indicate that finer and more uniform globular primary α-Al particles can be obtained when the semi-solid slurry are isothermally held for a short period within the semi-solid temperature range,and the primary α-Al particles without entrapped liquid are uniformly fine,globular grains in the rheo-diecastings.The holding temperature and time affect the solid fraction,particle size,and shape factor.After the semi-solid slurry is held at 625 ℃ for 3 min and 5 min,the optimal values for the average equivalent diameter are 70.80 μm and 74.15 μm,and for the shape factor are 1.32 and 1.42,respectively.The solidification process of the rheo-diecastings is composed of the following two distinct stages:primary solidification process and secondary solidification process.The secondary solidification process consists further of the following three stages:(1) direct growth of secondary primary(α 2) phase from the surface of the primary α-Al phase particles without re-nucleation,(2) independent nucleation and growth of α 3 phase from the residual liquid,and(3) eutectic reaction at the end.

The effect of self-employment on health, access to care, and health behavior

The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.

Influence of dominance rank and affiliation relationships on selfdirected behavior in female Tibetan macaques (Macaca thibetana)

Self-directed behavior(SDB) is characterized as an indicator of anxiety, frustration and stress in nonhuman primates. In this study, we collected self-directed behavior data from one group of free-ranging Tibetan macaques(Macaca thibetana) at Mt. Huangshan, China(September 2012–May 2013) using a combination of behavioral sampling methods including focal animal sampling, behavioral sampling, continuous sampling and instantaneous sampling. Our results showed that females engaged in significantly higher rates of self-directed behavior when they were in proximity to dominant individuals compared to subordinate ones. Conflict losers significantly increased their SDB rates after agonistic episodes, indicating that SDB might also serve as an index of anxiety in M. thibetana. We further found that females significantly increased their SDB rates when focal individual was proximity to weakly affiliation relationship higher rank members than to strongly affiliation relationship higher rank members. If conflicts were not reconciled, the postconflict SDB rates of losers were higher when they stayed with strongly affiliation opponents; if conflicts were reconciled, victims of strongly affiliation relationships opponents engaged in more SDB rates before reconciliation than after reconciliation, while victims of moderately affiliation relationships opponents did not engaged in more SDB rates before reconciliation than after reconciliation. We conclude that both of dominance rank and affiliation relationships might both influence the SDB rates of female Tibetan macaques significantly, suggesting that SDB is not only an index of anxiety in Tibetan macaques, but also can provide a new insight into evaluation of social relationships between individuals.

Self-Management Behaviors of Patients with Hypertension in Daily Life

Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and preventing complications. It is important for patients with hypertension to perform self-management. This improves their lifestyle while controlling their blood pressure to prevent complications and maintain good health. Purpose: This study aimed to examine the actual self-management behavior ability of patients with hypertension and to clarify the factors involved in their self-management behavior. Methods: A total of 150 patients with hypertension were included in this study. The following data were obtained from the patients as background information: sex, age, years with disease, whether they are receiving antihypertensive agents, type of antihypertensive agent, blood test data, heart thoracic ratio, left ventricular ejection fraction, pulse wave, pulse wave velocity, and height. The levels of self-management skills of the patients were also assessed using the “Instrument to Measure the Self-care of patients with Hypertension” developed by Tsuboi et al. Results: The associations among self-management behaviors in daily life, such as diet, exercise, stress, medication, alcohol intake, and smoking, were analyzed in patients with hypertension. The subjects were classified into the following three groups: aged 65 years or below (Group A), early stage elderly individuals (Group B), and late-stage elderly individuals aged 75 years or over (Group C). The results showed that the subjects in Group C had higher self-management scores for diet, exercise, stress, medication, and drinking than the subjects in the other two groups. The scores of smoking and self-management of the subjects in Group A were high but their other self-management scores were low. All the subjects were taking between 1 to 3 types of oral antihypertensive drugs. The rate of achievement of the target blood pressure was 50% or more in all the three groups. However, the pulse wave velocity was high in all the three groups. Conclusion: The results indicate that the risk of developing disorders of the brain and cardiovascular system is high in all the three groups, owing to the high degree of arteriosclerosis. Therefore, increasing the number of nursing interventions is expected to reduce blood pressure, maintain and promote self-management behavior in daily life, and prevent the onset of complications. The results suggest that nursing interventions involving lifestyle guidance for improving the self-management skills of patients are urgently needed by patients under 65 years of age.

Long-term monitoring of the individual self-feeding behavior of rainbow trout Oncorhynchus mykiss

Self-feeding device is extensively used in aquaculture farms, but for salmonids the individual feeding behavior has seldom been continuously observed. In this article, the individual self-feeding behavior of 10 rainbow trout was continuously monitored with a PIT tag record for 50 days with three replicates. The?sh fell into three categories according to their feeding behavior, i.e. high triggering ?sh(trigger behavior more than 25% of the group, HT), low triggering ?sh(1%–25%, LT) and zero triggering ?sh(less than1%). The results showed that in a group of 10 individual 1–2 HT ?sh accounted for most of the self-feeding behavior(78.19%–89.14%), which was far more than they could consume. The trigger frequency of the?sh was signi?cantly correlated with the initial body weight( P <0.01), however, no signi?cant dif ference in growth rate among the HT, LT, and ZT ?sh was observed( P >0.05). Cosinor analysis showed that the two HT ?sh in the same group had similar acrophase. Though some of the HT ?sh could be active for 50 d, there were also HT ?sh decreased triggering behavior around 40 d and the high trigger status was then replaced by other ?sh, which was ?rst discovered in salimonds. Interestingly, the growth of the group was not af fected by the alternation triggering ?sh. These results provide evidence that in the self-feeding system the HT ?sh didn't gain much advantage by their frequent self-feeding behavior, and high trigger status of the HT ?sh is not only an individual character but also driven by the demand of the group. In the self-feeding system, the critical individual should be closely monitored.

The Impact of Self-Efficacy and Work Engagement on Healthcare Professionals’ Proactive Behavior

Job crafting (JC) is a form of proactive behavior and refers to the initiatives employees that could take to change their tasks or other job characteristics to achieve the best person-job fit. JC consists of six dimensions: seeking structural and social job resources, as well as challenges, hindering job demands, optimizing job demands, and delegating tasks. The aim of the present study was to explore the impact of self-efficacy and work engagement on healthcare professionals’ (HP) proactive behavior. A convenience sample of 295 HP working in Primary and Secondary healthcare structures of Northern Greece completed a questionnaire that included: 1) demographic/occupational characteristics, 2) the Job Crafting Scale, 3) the Generalized Self-Efficacy Scale (GSE) and 4) the Utrecht Work Engagement Scale (UWES). Increased age was found to be associated with decreased levels of seeking social job resources (p < 0.01). Education level was positively associated with increased levels of seeking structural job resources (p < 0.01), seeking challenges (p < 0.05), and optimizing job demands (p < 0.05), while job position was found to be negatively related to delegating tasks (p < 0.01). Self-efficacy was positively associated with increased levels of seeking structural resources (p < 0.001), challenges (p < 0.001), and increased levels of optimizing job demands (p < 0.001), while it was positively associated with decreased levels of delegating tasks (p < 0.05). In addition, increased work engagement was found to be associated with increased levels of seeking social job resources (p < 0.05), challenges (p < 0.01), and optimizing job demands (p < 0.01). Findings highlight the importance of self-efficacy, work engagement and individual characteristics in the realization of a resourceful work environment and HP’ adjustment in the organization. Thus, interventions that promote HP’ JC proactive behaviors should be encouraged.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Status of Understanding of the Disease and Self-Management Behavior among Patients with Hypertension

Background: Hypertension is a lifestyle-related disease that has no subjective symptoms but could lead to severe complications. The goals of treatment for hypertension are to maintain blood pressure with medications and prevent complications. Measuring blood pressure at home regularly is critical for patients with hypertension. Purpose: This study aimed to 1) clarify the status of patients’ understanding of hypertension and self-management, 2) identify nursing practices that could support patients with hypertension in making them aware of the need for understanding hypertension, monitoring blood pressure at home, and engaging in self-management. Method: A questionnaire survey on understanding of the disease and self-management behavior was conducted among patients with hypertension who regularly visited outpatient clinics. As for data analysis, descriptive statistics were computed for patients’ attributes, clinical findings, understanding of the disease, and self-management behavior. Cross-tabulation and the chi-square test were used for each item on understanding of the disease and self-management behaviors. Results: Data were obtained from 150 participants (93 males and 57 females) with a mean age of 70 years. Patients with a higher understanding of the disease and those who were aware of the target blood pressure were more likely to engage in self-management behavior, including monitoring blood pressure at home, ensuring regular outpatient visits, and consulting with nurses or physicians. In addition, the percentage of patients who recognized the need to achieve their target blood pressure was higher among those who had a spouse and lived with their family. Discussion: Regular monitoring and recording of blood pressure at home are the most important self-management behaviors. Understanding of the disease and self-management behavior and support from the family are critical for maintaining appropriate self-management. Therefore, in cooperation with physicians, nurses should provide health education to patients and their families to enable them to perform appropriate self-management. Health expenditures increase with age, especially in those aged 65 years and over. The prevalence of hypertension increases with age;patients aged 65 years and over need to engage in self-management to maintain their target blood pressure. Nurses should provide patients with hypertension aged 65 years and over with appropriate nursing care to enable them to measure and record their blood pressure at home appropriately and regularly. Appropriate nursing care may help reduce the health expenditure. This may help reduce the health expenditure.

Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice

AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.

Comparison of time-restricted and ad libitum self-feeding on the growth,feeding behavior and daily digestive enzyme profiles of Atlantic salmon

Although it has been hypothesized that a predictable feeding regime in animals allows physiological variables to be adjusted to maximize nutrient utilization and,hence,better growth performance,the assumption has rarely been tested.This study compares the effects of time-restricted versus free access self-feeding on the growth,feeding behavior and daily digestive enzyme rhythms of Atlantic salmon(Salmo salar).In an experiment that lasted 6 weeks,fish(109.9 g) were divided into two groups:group 1 had free access to a self-feeder(FA);group 2 received three meals per day(2 h per meal) at dawn,midday and dusk via a time-restricted self-feeder(TR).At the end of the experiment,the fish were sampled every 3 h over a24-h period.The results showed that the TR fish quickly synchronized their feeding behavior to the feeding window and their blood glucose showed a significant postprandial increase,while FA fish displayed no statistically significant rhythms(P>0.05).Pepsin activity of TR fish also showed a significant daily rhythm(P<0.05) with the acrophase at the second feed and a decrease over the next 12 h.Average daily trypsin,lipase and amylase levels of FA fish were significantly lower than those of TR fish(P<0.01);however,the growth performance of both groups was similar(P>0.05).In conclusion,the study failed to confirm a link between the entrainment of daily digestive enzyme profiles and growth performance,with the TR group showing comparatively poor blood glucose regulation.

Long term behavior of self-compacting reinforced concrete beams

Tests were carried out on 8 self-compacting reinforced concrete(SCC) beams and 4 normal reinforced concrete beams. The effects of mode of consolidation,load level,reinforcing ratio and structural type on long term behavior of SCC were investigated. Under the same environmental conditions,the shrinkage-time curve of self-compacting concrete beam is very similar to that of normal concrete beam. For both self-compacting reinforced concrete beams and normal reinforced concrete beams,the rate of shrinkage at early stages is higher,the shrinkage strain at 2 months is about 60% of the maximum value at one year. The shrinkage strain of self-compacting reinforced concrete beam after one year is about 450×10-6. Creep deflection of self-compacting reinforced concrete beam decreases as the tensile reinforcing ratio increases. The deflection creep coefficient of self-compacting reinforced concrete beam after one and a half year is about 1.6,which is very close to that of normal reinforced concrete beams cast with vibration. Extra cautions considering shrinkage and creep behavior are not needed for the use of SCC in engineering practices.

Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review

Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.

The Channel Behavior of Gramicidin D in the Self-assembled Monolayer

It was found for the first time that gramicidin D (GD) molecules can be incorporated into the ODM monolayer which is self-assembled on the surface of the gold electrode and form monovalent cation channels.

Density behaviors of Ge nanodots self-assembled by ion beam sputtering deposition

Self-assembled Ge nanodots with areal number density up to 2.33× 1010 cm-2 and aspect ratio larger than 0.12 are prepared by ion beam sputtering deposition. The dot density, a function of deposition rate and Ge coverage, is observed to be limited mainly by the transformation from two-dimensional precursors to three-dimensional islands, and to be associated with the adatom behaviors of attachment and detachment from the islands. An unusual increasing temperature dependence of nanodot density is also revealed when a high ion energy is employed in sputtering deposition, and is shown to be related to the breaking down of the superstrained wetting layer. This result is attributed to the interaction between energetic atoms and the growth surface, which mediates the island nucleation.

The Impact of Eating Disorders and Self-Disorders on Women’s Behavior in Kuwait

The purpose of this study is to examine the impact of eating disorders and self-disorders (self-esteem, selflessness, self-efficacy, self-concept clarity, and self-compassion) on women’s behavior in Kuwait. This study used a quantitative approach based on a survey questionnaire by the online survey has been used as the main technique for data collection. The survey was sent to a group of 500 women in Kuwait. The survey was administrated through an online survey tool. 212 women completed the full questionnaire, resulting in a response rate of 42.2 percent. The results indicated that eating disorders have a direct effect on women’s behavior in Kuwait. Moreover, self-disorders (self-esteem, selflessness, self-efficacy, self-concept clarity, and self-compassion) have a direct effect on women’s behavior in Kuwait.

The Influence of Social Desirability on Self-Reported Sexual Behavior in HIV Survey in Rural Ethiopia

Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15-24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher’s exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also examined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.

Development of a Self-Assessment Questionnaire for Nurses’ Risk-Taking Behavior in Medication

Purpose: The purpose of this study was to prepare a self-assessment questionnaire for nurses’ risk-taking behavior (RTB) in medication and to develop a reliable and valid questionnaire. Method: In the first study, a draft of the self-evaluation questionnaire for nurses’ RTB in medication was prepared based on the literature study and qualitative analysis of important case information included in the Project to Collect Medical Near-miss/Adverse Event Information Annual Report of the Ministry of Health, Labor and Welfare. Following the studies, face validity was confirmed, and a questionnaire survey was conducted for nurses who oversee medication nationwide to verify the reliability and validity. Result: The number of subjects was 586 (valid response rate: 94.1%). Item analysis and exploratory factor analysis showed that 4 factors and 12 items for the RTBs in daily life and 4 factors and 20 items for RTBs in medication could be extracted. Confirmatory factor analysis confirmed the fit of the hypothetical model obtained by exploratory factor analysis. In addition, Cronbach’s α coefficient was 0.888. Thus, high reliability and validity were obtained. A correlation was found by comparing the total scores of each RTB factor with the incident/accident group, and a standard for self-evaluation value could be established (p < 0.01). Conclusions: We were able to develop a self-assessment questionnaire for nurses’ risk-taking behavior in medication. This questionnaire will be used by nurses to find out their trends.