The centrality of health behaviours: A network analytic approach.

OBJECTIVES: Since behavioural risk factors are the foremost causes of disability and premature mortality, developing new perspectives for understanding them is of utmost importance. This paper describes an innovative approach that conceptualizes health-related behaviours as nodes in a weighted network. DESIGN & METHODS: Using self-reported data from a representative sample (n = 374), a network of 37 health behaviours was analysed, with the aim of identifying 'central' nodes, that is, behaviours that are likely to co-occur with others and potentially influence them. RESULTS: In line with conservation of resources theory, the analysis indicated that behaviours related to basic physiological needs (nutrition and sleep) were most central. Behaviour centrality also varied across subpopulations: Periodic medical examinations, eating meals regularly, and sleep hygiene were more central among high- compared to low-socio-economic status participants; behaviours related to supportive social relationships and sun protection were more central among women compared to men. CONCLUSION: By emphasizing behavioural connectivity, the approach applied herein has identified core health behaviours with potentially high impact on healthy lifestyle behaviours. Statement of Contribution What is already known on this subject? Many health behaviours are related to each other. Engagement in one health behaviour can affect engagement in other behaviours. What does this study add? Health behaviour can be viewed and analysed as a network. Sleep and nutrition behaviours are the most central behaviours in the network. Centrality varies as a function of socio-economic status and gender.

Leadership emergence over time in short-lived groups: Integrating expectations states theory with temporal person-perception and self-serving bias.

Research into leadership emergence typically focuses on the attributes of the emergent leader. By considering also the attributes of perceivers and the passage of time, we develop a more complete theory of leadership emergence in short-lived groups. Using expectation states theory as an overarching theoretical framework, and integrating it with the surface- and deep-level diversity literature and with theories of self-serving biases, we examine the predictors of leadership emergence in short timeframes. We conduct a field study in a military assessment boot camp (a pilot study, n = 60; and a main study, n = 89). We use cross-sectional and longitudinal exponential random graph models to analyze data on participants' abilities and on their perceptions of who, in their respective groups, were "leaders." We find that the criteria by which people perceive leadership in others change over time, from easily noticeable attributes to covert leadership-relevant attributes, and that people also rely on leadership-relevant attributes that they possess at high levels to inform their perceptions of leadership in others. The integration of expectation states theory, attribute salience over time and theories of self-serving bias is needed for a full understanding of leadership emergence in groups, because perceivers' own abilities are instrumental in shaping their perceptions of emergent leadership over time. Theoretical and practical implications are discussed. (PsycINFO Database Record

Till stress do us part: On the interplay between perceived stress and communication network dynamics.

This study of perceived stress and communication networks fills 2 theoretical gaps in the literature: First, drawing predominantly on conservation of resource theory and faultline theory, we demonstrate the role of stress as an "engine of action" in network evolution. Second, we extend the stress literature to the interpersonal domain by arguing that others' levels of stress influence the individual's communication network, and this, in turn, changes his or her stress level. At 3 time points, we evaluated the communication ties and perceived stress in a unique field setting comprising 115 male participants (in 6 groups) performing group-based tasks. We introduce stochastic actor-based models for the coevolution of network ties and actor attributes, statistical models that enable causal inferences to be drawn regarding the interplay between dynamic networks and individual attributes. Using these models, we find that over time, individuals experiencing higher levels of perceived stress were less likely to create new communication ties and were more likely to maintain existing ties to others. Participants also tended to communicate with similarly stressed others. Such communication network dynamics further increased individuals' levels of perceived stress over time, leading to stress-related vicious cycles. We discuss organizational implications that relate to stress and network-related interventions.

Relations between social support and psychological and parental distress for lesbian, single heterosexual by choice, and two-parent heterosexual mothers.

Relations between family type and psychological and parental distress and the moderating role of social support were studied for 90 Israeli lesbian mothers, single heterosexual mothers by choice and 2-parent heterosexual mothers who completed measures of psychological distress, well-being, parental distress, and direct and indirect social support. Findings indicated differences on psychological and parental outcome between mothers from the two heterosexual groups. Social support was higher for lesbian than single heterosexual mothers and was correlated with psychological and parental indices. Unique because of the distinctive demographics of Israeli society (especially in relation to Western Europe and North America), this study highlights ways in which social and individual processes affect psychological outcomes among minority groups.

Israeli norms for the Stanford hypnotic susceptibility scale, Form C.

A Hebrew version of the 12-item Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) was administered to 169 subjects in Israel. The authors compared the results with those obtained for the English original administered in the USA and with an additional group of 38 English-speaking subjects in Israel, as well as with versions translated into Spanish (2 versions, for Spain and for Mexico), Italian, German, and Dutch. Mean scores and pair-wise rank-order correlations between item pass rates were comparable across the different samples. Item reliability was somewhat lower in the Hebrew version; however, if testing was discontinued after failure to comply with 3 consecutive items, reliability was similar to that obtained for the other samples. We conclude that the Hebrew version of the SHSS:C can be used for the assessment of hypnotizability and recommend that the discontinuation criterion be applied.

Puberty as a risk factor for less favorable visual outcome in idiopathic intracranial hypertension.

PURPOSE: To test the hypothesis that puberty is a risk factor for poorer visual outcome in idiopathic intracranial hypertension (IIH). DESIGN: Retrospective chart review case series. SETTING: Tertiary referral center, neuro-ophthalmology unit. PATIENT POPULATION: Ninety-six patients with IIH followed for a minimum of one year. OBSERVATION: Age (grouped into prepubertal, pubertal, teenage, or adult), obesity, initial intracranial pressure (ICP), measurements and presence of hypertension, anemia, or renal failure were correlated with final visual outcome using chi(2), stepwise logistic regression, and model-selection log linear analyses. MAIN OUTCOME MEASURES: Visual outcome was graded into "excellent" -- no evidence of an optic neuropathy or any permanent visual field defect in either eye, "moderate"-- evidence of an optic neuropathy and/or a mild (nasal constriction) visual field defect, or "poor outcome" (peripheral constriction) -- permanent visual field defect. RESULTS: Outcome data were complete for 96 patients. Moderate to poor visual outcome, as opposed to excellent, was significantly associated with puberty (P = .007 using the gender-specific definition of puberty, .0002 using the broad definition). Moderate-poor visual outcome occurred in none of seven IIH patients of prepubertal age (<9 years), in 15 of 26 patients presenting between nine to 16 years, in two of six patients aged 17 to 22 years, and in seven of 57 adult patients over the age of 23 years. CONCLUSIONS: In this series of 96 patients with IIH, visual outcome was less favorable in pubertal patients than in prepubertal, teenage, and adult patients. We recommend that clinicians maintain a high index of awareness when caring for pubescent children with IIH.

Presentation, natural history, and management of carotid cavernous aneurysms.

OBJECTIVE: We present the largest reported cohort of carotid cavernous aneurysms (CCA), comparing the neuro-ophthalmic presentation, complications, and outcome with and without endovascular treatment. METHODS: Retrospective review of 185 patients with 206 CCAs examined between 1980 and 2001 at a tertiary neuro-ophthalmology and neurovascular service. Patients' symptoms and findings at presentation were recorded and compared with those at outcome. The effect of treatment on outcome and on complication rate was analyzed using the chi test, multivariate analysis of covariance, model-selection log-linear analysis, and multinomial logistic regression. RESULTS: Long-term follow-up was available for 189 of 206 CCAs. Seventy-four CCAs underwent treatment (endovascular, 67 [91%]; surgical treatment, 6 [9%]), and 115 were followed for an average of 4 years, two of which required later treatment. Treatment reduced the incidence and severity of pain, even after adjusting for the severity of initial pain (F(1,192 = 9.59, P = 0.002). Treatment did not significantly affect the patient's final diplopia after adjusting for their initial diplopia (F(1, 182 = 2.01, P = 0.158). Statistical examination revealed that the treated group had a higher proportion of neurological and visual complications than people who were not treated (2(2). = 25.26, P = 0.0003). CONCLUSION: Endovascular treatment of carotid cavernous aneurysms leads to a significantly higher rate of pain resolution compared with untreated patients, even after adjusting for initial pain severity. Diplopia may not resolve after treatment. The results of this study underscore our approach indicating treatment only in cases of debilitating pain, visual loss from compression, or diplopia in primary gaze or in patients with risk factors for major complications such as pre-existing coagulopathy or sphenoid sinus erosion.

Swedish interactive thresholding algorithm fast for following visual fields in prepubertal idiopathic intracranial hypertension.

OBJECTIVE: To examine the reliability of Swedish Interactive Thresholding Algorithm Fast (SITA Fast) visual fields (VFs) in prepubertal idiopathic intracranial hypertension (IIH) and to compare whether age, gender, or severity of visual outcome influenced the reliability of VF tests. DESIGN: Prospective, longitudinal cohort study. PARTICIPANTS: Twenty-six prepubertal children (<11 years of age; mean age, 7.2 years) with IIH. TESTING: Children were prospectively followed up using a child-oriented program, which included SITA Fast VF tests. Age, gender, and severity of visual outcome were correlated with reliability of performance on SITA Fast VFs using a 1-way analysis of variance, point-biserial correlation, and the chi-square test for independence of observation. MAIN OUTCOME MEASURES: Statistical analyses results that correlated the reliability of SITA Fast VFs with age, gender, and visual outcome. RESULTS: Three children were treated at the age of 2 years and were unable to perform automated VF tests. Four children were treated at the age of 4 years, 3 of whom were able to perform repeatable reliable SITA Fast VF tests. Forty-two eyes of 21 children had an average SITA Fast test time of 4.5 minutes for each eye, compared with 8 minutes using the Fastpac strategy. Age was not associated with reliability scores of SITA Fast tests (F = 0.971, not significant [ns]). Gender did not influence the reliability of SITA Fast VF tests (chi-square((1)) = 0.669, ns), nor did severity of visual outcome (chi-square((2)) = 3.348, ns). Visual deficits were observed in 55% of patients at presentation and in 27% of patients after resolution of papilledema. CONCLUSIONS: The SITA Fast VF tests can be performed from age 4 years and offer a reliable method for shortening test time. A child-oriented follow-up program, which entails a shortened testing time, may improve outcome in prepubertal IIH.

Evolution of oculomotor nerve paresis after endovascular coiling of posterior communicating artery aneurysms: a neuro-ophthalmological perspective.

OBJECTIVE: Guglielmi detachable coil treatment is becoming an accepted alternative to microsurgical clipping for select intracerebral aneurysms. Resolution of oculomotor nerve paresis (ONP) after endovascular packing was claimed to be complete in two prior series, with three and six cases. We describe the evolution of ONP after Guglielmi detachable coil treatment of posterior communicating artery aneurysms, and we search for endovascular and patient factors correlated with the degree of functional nerve recovery. METHODS: Twelve cases of ONP attributable to posterior communicating artery aneurysms were treated with Guglielmi detachable coils between 1999 and 2002. Eleven patients were available for follow-up monitoring. The degree of ONP was recorded at admission, at discharge, after 3 months, and at yearly intervals thereafter. The size of the aneurysm, the duration of ONP before coiling, the degree of coiling, age, and the presence of other microvascular risk factors were correlated with the degree of nerve recovery. RESULTS: Complete resolution of ONP did not occur in any of the 11 cases in this series. However, residual oculomotor nerve deficits did not cause diplopia with primary gaze for 10 of 11 patients. Clinically significant ptosis did not persist for any of the patients. The pupil remained minimally affected in all cases. CONCLUSION: Although mass effect remains after endovascular packing, oculomotor nerve dysfunction improves comparably to the recovery observed after surgical clipping. Contrary to previous reports, typical residual oculomotor nerve deficits persist. Older age and the presence of microvascular risk factors seem to be detrimental to ONP recovery.

Cavernous sinus dural arteriovenous malformations: patterns of venous drainage are related to clinical signs and symptoms.

OBJECTIVE: To provide evidence that venous congestion and drainage patterns are responsible for the manifestations of cavernous sinus area dural arteriovenous malformations (CSdAVMs). DESIGN: Retrospective observational case series. PARTICIPANTS: Records of 85 patients with complete clinical and angiographic evaluations of CSdAVMs were evaluated for the clinical features of the disorder. A neuroradiologist analyzed patterns of venous drainage to and from the cavernous sinus without knowledge of the clinical features. Four venous drainage patterns (reversal of flow from the CSdAVMs into the anterior cavernous sinus, ophthalmic vein thrombosis, drainage into the inferior petrosal sinus or drainage into the superior petrosal sinus) were statistically tested for their predictive value of signs and symptoms using logistic regression. MAIN OUTCOME MEASURES: The power of prediction of orbital congestion, elevated IOP, extraocular muscle dysfunction, optic neuropathy, venous-stasis retinopathy, choroidal effusion, anterior chamber shallowing, bruits, cranial nerve paresis, and central nervous system dysfunction from four patterns of venous drainage. RESULTS: Reversal of drainage into the anterior cavernous sinus and ophthalmic veins was highly predictive (P = 0) of orbital congestion, which was seen in 77 (91%) patients. In contrast, eight (9%) patients without orbital congestion had shunts that did not drain into the anterior cavernous sinus and ophthalmic veins. Cavernous sinus dural arteriovenous malformation drainage into the anterior cavernous sinus and ophthalmic veins also predicted elevated IOP (P = 0.0023) and optic neuropathy (P = 0.047). Ophthalmic vein thrombosis significantly predicted cases with choroidal effusion (P = 0.002) and anterior chamber shallowing (P = 0.01). Third nerve paresis could be predicted from flow toward the inferior petrosal sinuses (P = 0.017). Central nervous system symptoms or dysfunction, occurring in 7 (8%) patients, was predicted by venous drainage into the superior petrosal sinus (P = 0.0008). CONCLUSIONS: The clinical features found in patients with CSdVAMs are related to the abnormal venous drainage and can be predicted by these venous drainage patterns. Venous congestion and hypertension seem to cause the clinical dysfunction in this disorder.