Identified or conflicted: a latent class and regression tree analysis explaining how identity constructs cluster within smokers.

Identity, or 'who I am', is important for smoking behaviour. Identity constructs (parts of a person's identity) are typically examined as separate entities, but emerging evidence suggests that the multifaceted nature of identity is relevant in the context of smoking. This cross-sectional study examined how smoking-related self- and group-identity constructs cluster within adult daily smokers (N = 231), whether classes of smokers can be distinguished based on clusters of identity constructs, and which factors explain class membership. Data were collected online in The Netherlands and Belgium, 2017-2018. Latent class and regression tree analyses showed that participants in Class 1 of 'Identified smokers' (estimated population share 54%) reported stronger smoker self- and group-identities, stronger expected identity loss when quitting smoking, and weaker quitter self-identities and non-smoker self- and group-identities (vs. Class 2 of 'Conflicted smokers'). Class membership was explained by the interaction between mental smoking dependence (dominant explanatory variable), consideration of future consequences, age of smoking onset, self-efficacy, and future self thought clarity. Models had good fit. The identity of more dependent smokers is more strongly oriented toward smoking. Smoking is also more strongly embedded in the identity of smokers who started smoking young, are less inclined to think about the future, and have lower self-efficacy.

Development of the Leiden Independence Questionnaire for Support Staff: a measure of staff behaviour regarding promoting independence of people with intellectual disabilities.

BACKGROUND: Support staff of adults with intellectual disability (ID) play an important role in promoting independence in home and community settings. However, little is known about the types of behaviours staff should use to promote independence and instruments that assess such behaviour do not yet exist. The aim of this study was therefore to develop and initially validate a reliable questionnaire that measures the degree to which support staff display behaviours that promote independence in people with ID. METHOD: The Leiden Independence Questionnaire for Support Staff (LIQSS) was constructed to measure the extent to which support staff promote independence in people with ID. The LIQSS was completed by 142 staff members working with people with ID. For the psychometric evaluation of the LIQSS, a principal component analysis was performed with an oblique rotation in all items. Next, the principal component analysis was performed with a forced three-component extraction, and three sub-scales were computed. To assess internal consistency, Cronbach's α was calculated for each of the sub-scales. RESULTS: The LIQSS was found to consist of three internally consistent (Cronbach's α was respectively 0.92, 0.79 and 0.76) and meaningful components: (1) communication, agreements and coordination; (2) positive encouragement and tailoring; and (3) supporting independent performance. The final 22 items had factor loadings between 0.44 and 0.91 on their corresponding component and a minimal difference in loading to the other factors of 0.20. CONCLUSIONS: The LIQSS appears to be an instrument with positive face validity and reliability (internal consistency) that assesses the degree to which support staff promote independence in people with ID. To increase the instrument's value for both scientific research and clinical practice, studies should focus on the further validation of the LIQSS.

A longitudinal study into the reciprocal effects of identities and smoking behaviour: Findings from the ITC Netherlands Survey.

OBJECTIVE: Although it has been found that identity constructs related to smoking are associated with changes in smoking behaviour, the direction of causal associations is as yet unclear. This study aims to clarify the nature and direction of these associations. METHODS: In this longitudinal study we examined the reciprocal relations between identity constructs (i.e., smoker self-identity, quitter self-identity and smoker group-identity), intention to quit and smoking and quitting behaviour among a sample of 1036 smokers and ex-smokers, using cross-lagged structural equation modelling. Moreover, we tested whether these relations differed by socio-economic status (SES). RESULTS: Identity and smoking behaviour were reciprocally related in that in intention to quit and smoking behaviour consistently predicted identity change, and identity predicted (changes in) intentions to quit and smoking behaviour. Behaviour appears more important for identity change than identity for behaviour change. Furthermore, quitter self-identity appears more important than smoker self- and group-identity. Relationships did not differ significantly between SES-groups. The findings were replicated using a cross-validation sample. CONCLUSION: Results imply that changing smoking behaviour may be a vehicle to change smoking-related identity. Moreover, strengthening identification with quitting is more crucial for quit success than decreasing smoker identities. The finding that behaviour may be more important for identity than vice versa, if replicated, may call for additions to identity theories.

A daily diary study on the independent and interactive effects of headache and self-regulatory factors on daily affect among adolescents.

OBJECTIVE: The relationship between recurrent headache and reduced psychological well-being among adolescents has been well documented. Evidence also suggests that headache is associated with greater impediment to successful goal pursuits, which in turn is related to reduced well-being. The aim of this study was to investigate both the independent and interactive effects of headache and self-regulatory processes on daily positive and negative affect. DESIGN AND METHODS: In order to be able to investigate both concurrent and prospective relationships a daily diary design was employed. Independent variables were headache occurrence, daily goal frustration, and strategies to cope with these setbacks. Dependent variables were daily negative and positive affect. Eighty-nine adolescents from the general population aged 13-21 completed an on-line diary for 3 weeks. Data were analysed using multi-level modelling. RESULTS: Negative affect was related to same day headache occurrence, high daily goal frustration, rumination, catastrophizing, other blame, and low coping efficacy beliefs. Furthermore, in the context of headache, coping efficacy appears to buffer the effects of goal frustration on same day negative affect. Negative affect on the next day was predicted by high daily goal frustration, rumination, catastrophizing, and low coping efficacy. In contrast, positive affect was related to no same day headache occurrence; low daily goal frustration, and high acceptance, positive refocusing, and coping efficacy. Positive affect on the following day was related to low daily goal frustration, rumination, and high positive refocusing. CONCLUSIONS: Daily goal frustration and cognitive coping strategies may provide important targets for interventions aimed at adolescent with reduced well-being due to headache.

Biological wastewater treatment followed by physicochemical treatment for the removal of fluorinated surfactants.

Perfluorinated surfactants (PFS) have become compounds of high concern during the last decade. While "conventional surfactants" are degraded to a great extent in the biological wastewater treatment process, partly or perfluorinated surfactants are not only stable against biodegradation but also against oxidizing agents, they even resist OH-radical attacks. Our objectives were to eliminate the fluorinated surfactants perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) by adsorption, separation or degradation with a balance of precursor compounds and follow-up of degradation products. Therefore, municipal wastewater was spiked with these fluorinated surfactants before membrane bioreactor (MBR) treatment-applying microfiltration membranes--was performed and before permeates were treated using ozone (O3) or different advanced oxidation treatment (AOP) techniques. O3 or hydrogen peroxide (H2O2), both in combination with UV radiation or in combination with catalysts, was applied. Removal by adsorption or membrane separation as well as degradation were monitored by substance specific determination and identification. High resolution mass spectrometry after high performance liquid chromatography (HPLC/HRMS and -MS(n)) was used for analysis. Contact to Teflon and/or glass during all analytical procedures was avoided.

Goal commitment to finding a partner and satisfaction with life among female singles: the mediating role of rumination.

In this cross-sectional study among 1502 female singles between the ages of 18 and 50, commitment to the goal of finding a partner was negatively related to satisfaction with life. In line with our expectations, this relationship was fully mediated by ruminating about being and remaining single. The relationship between rumination and lower satisfaction with life was stronger in the older age groups. The findings support the notion that rumination is an important mechanism through which goal commitment may negatively influence well-being, and that reducing one's level of commitment to the pursuit of stage-specific life goals may be beneficial when reaching a new developmental stage.

Predicting preparatory behaviours for condom use in female undergraduate students: a one-year follow-up study.

The objective of this study is to investigate whether the Theory of Planned Behaviour (i.e. attitude, subjective norm, perceived behavioural control and intention), fluctuations in motivation over time, and variables from the Prototype-Willingness Model (i.e. behavioural expectation and behavioural willingness to have unprotected sex) predict preparatory behaviours for condom use. Sixty-two female undergraduates completed baseline and one-year follow-up questionnaires. Having condoms at home and carrying condoms were predicted by behavioural willingness to have unsafe sex at baseline. Having bought condoms was predicted by the behavioural expectation to use condoms with new partners at baseline. Intention and fluctuations in motivation did not emerge as significant predictors of preparatory actions. Female undergraduates, who are more willing to have unprotected sex under risk-conducive circumstances, are also less likely to prepare adequately for condom use, and thereby increase their chances of encountering such situations. Overall, the findings are in support of the Prototype-Willingness Model.

Detection and identification of degradation products of sulfamethoxazole by means of LC/MS and -MSn after ozone treatment.

The ozonation of the antibiotic sulfamethoxazole has been studied, in order to elucidate the structures of some of the degradation products generated throughout the process. Under the conditions applied, a complete destruction of sulfamethoxazole was achieved after 10 minutes of reaction. The biodegradability of the resulting solution has been also determined, and this parameter undergoes a gradual increase along during the reaction time. The acute toxicity of the reaction mixture, on the contrary, is only decreased during the first 5 minutes of reaction while it increases subsequently. Some of the intermediates resulting during ozonation seem to be more toxic to Daphnia magna than the untreated sulfamethoxazole. The structures of selected degradation products found in the solution are determined and identified. Ozone predominantly attacks sulfamethoxazole via the amine group of the aniline ring in some cases giving rise to nitro-aromatic compounds.

Medical care-seeking and health-risk behavior in patients with head and neck cancer: the role of health value, control beliefs and psychological distress.

Health behavior plays an important role in the development, detection and course of cancer of the head and neck. Relevant health behavior includes prompt medical care seeking, and smoking and drinking cessation after diagnosis. This study examines the relationship between these health behaviors and health value and control beliefs, as well as psychological distress. Two hundred and sixty-four recently diagnosed head and neck cancer patients were interviewed about their health behavior, and they filled in a questionnaire on health beliefs and psychological distress. The results showed that one-quarter (25%) of the patients had waited more than 3 months before seeking medical care, 50% had continued to smoke and 80% had continued to drink after the diagnosis. The patients, particularly those who smoked and drank before diagnosis, reported lower levels of health value and perceived health competence than a general population sample with which they were compared. Patients who engaged in patient delay reported a lack of perceived health competence. Psychological distress and lack of perceived health competence were found to be more common among patients who continued to smoke. The implications of these findings are discussed with regard to interventions aimed at promoting these specific health behaviors.

Integrating social-psychological frameworks for health behavior research.

OBJECTIVE: To review the social-cognitive theories that have predominated in research on determinants of healthbehaviors. METHODS: Based on a literaturesearch,the theorieswere compared and critically analyzed. RESULTS: Although the theories are somewhat successful in predicting health behaviors, the social-cognitive perspective is restricted to a unidirectional, nondynamic view of behavioral change and neglects the fact that individuals may differ with respect to the life goals they pursue. CONCLUSION: Health behavior research should adopt a more integrative approach, including insights from stage and goal theories. The health behavior goal model is described as an example of such an approach.

The Revised Health Hardiness Inventory (RRHI-24): psychometric properties and relationship with self-reported health and health behavior in two Dutch samples.

Our objective was to examine the psychometric properties of a Dutch translation of the Health Hardiness Inventory (HHI), and to determine relationships between health hardiness scales and self-reported health and preventive health behavior. Data from a cross-sectional study with two samples [a general population sample (n = 205) and a student sample (n = 286)] were analyzed. The Revised Health Hardiness Inventory (RHHI-24) was found to consist of four stable and reliable scales: (1) Health Value, (2) Internal Health Locus of Control, (3) External Health Locus of Control and (4) Perceived Health Competence. Women valued their health more than men, older individuals (> 45 years) valued their health more than younger individuals (< or = 45 years) and elderly people (> 65 years) were more externally orientated with respect to health locus of control. Preventive health behavior was related to a higher value placed on health, a lower external health locus of control and a higher perceived health competence. Better self-reported health was related to a higher perceived health competence and a more internally orientated health locus of control. We conclude that the RHHI-24 is a theoretically sound instrument for the measurement of health cognitions.

Social cognitive determinants of drinking in young adults: beyond the alcohol expectancies paradigm.

In prior investigations of the psychology of drinking behavior, drinkers' positive expectancies regarding the effects of alcohol have been studied extensively. From a social cognitive point of view, however, several additional psychological factors also deserve attention, namely negative expectancies, social influence, and self-efficacy expectations. In a representative sample of 161 university students, this study examined to what extent inclusion of these additional social cognitive factors enhanced the predictive power of the predominant alcohol-expectancies model of drinking behavior, and to what extent all four social cognitive factors were related to the uptake and cessation of drinking behavior. The three additional social cognitive factors contributed 17% to the explained variance in drinking behavior, in addition to the 18% accounted for by positive expectancies. The constructs with the greatest predictive strength all pertained to the social effects and social context of drinking. The most important predictors of drinking behavior were found to differ for male versus female students, and for students living with their parents versus those living on their own. The data on drinking acquisition and cessation suggest that in this sample little change in drinking behavior could be expected. The social cognitive factors were strongly related to acquisition stages but only weakly to cessation stages. Recommendations for interventions aimed at lowering alcohol intake are given.

Measuring transitions through stages of exercise: application of latent transition analysis.

In this longitudinal study of 504 nursing staff members from seven Dutch nursing homes, which transitions in exercise behaviour had occurred over a 12-mo. period were investigated. For this purpose, latent transition analyses were employed. Latent transition analysis is an extension of Markov chain modelling and of Latent class analysis and has been especially developed to study dynamic latent variables. The data supported the notion that natural change in exercise occurs through various stages and that these are sequential in nature. Latent transition analysis was an effective method for the comparison of various models describing possible transitions over time and for estimation of the likelihood of the occurrence of such transitions.

Conflicting activities for exercise.

190 nonexercisers foresaw regular exercise (> or = 3 times a week) as interfering with day-to-day activities. Most frequently mentioned were various social activities, doing household chores, and watching TV. The impediment of all activities, except watching TV, was expected to be at least rather bothersome. Interventions should focus on these particular barriers to action.

Use of wide-diameter and standard-diameter implants to replace single molars: two case presentations.

PURPOSE: The ultimate goal in modern esthetic dentistry is the restoration of lost hard and soft tissues by imitating nature as closely as possible. With the increasing esthetic awareness of patients, surgical and technical developments, and dentists' enhanced skills and knowledge, optimal function and esthetics are achievable even with implant-supported restorations in molar regions. Anatomic and morphologic factors and poor bone quantity and quality might reduce success rates of dental implants in the posterior jaw. Today, there are two options to replace a single missing molar by an implant-supported crown: the single wide-diameter implant or two standard-diameter implants. These two approaches are described and their advantages and disadvantages discussed in two exemplary clinical cases. MATERIALS AND METHODS: In one case, the edentulous ridge in the area of the mandibular right first molar (FDI tooth 46) provided sufficient mesiodistal space to restore tooth 46 with a porcelain-fused-to-metal crown on two standard-diameter implants, placed in a root-analog manner. In the other case, the manibular first molars (FDI teeth 36 and 46) were replaced by porcelain-fused-to-metal crowns on wide-diameter implants. RESULTS: It can be concluded that both options to replace a single molar provide more surface area and better biomechanical properties than one standard implant. CONCLUSION: Long-term data are needed before these treatment modalities can be recommended for the private practitioner.

Competing personal goals and exercise behaviour.

Research on the determinants of exercise behaviour has not assessed the role of personal goals which may be in conflict with exercising. A cross-sectional study showed that 312 nonexercisers, 466 people who exercised once or twice a week, and 202 people who exercised at the norm of at least three times a week differed significantly with respect to the number of important personal goals expected to be hampered by exercising at the norm. To be specific, the number of competing activities in the home was higher for the sedentary group than for those who exercised. Further, those who exercised at the norm reported fewer competing social activities than all other subjects and fewer competing self-developmental activities than the non-exercisers. Scores on the scale for activities outside the home did not differ significantly among the three groups. It is argued that any theoretical model of exercise behaviour should take into account the influence of competing personal goals on the initiation and continuation of exercise during leisure time.

Effectiveness of training to prevent job-related back pain: a meta-analysis.

Data from a meta-analysis, involving six experimental studies, revealed a modest relationship between training of employees and a decrease in the occurrence of back pain or sick leave associated with this disorder. The implications for prevention of job-related back pain, and future research within this field are discussed.