Evaluating the influence of nature connection and values on conservation attitudes at a tropical deforestation frontier.

Inner phenomena, such as personal motivations for pursuing sustainability, may be critical levers for improving conservation outcomes. Most conservation research and policies, however, focus on external phenomena (e.g., ecological change or economic processes). We explored the factors shaping 9 conservation attitudes toward forest and wildlife protection among colonist farmers around an Amazonian deforestation frontier. Our data comprised 241 face-to-face quantitative surveys, complemented with qualitative insights from open-ended questionnaire responses and opportunistic semistructured interviews. To account for the full spectrum of possible inner motivations, we employed measures of nature connection (indicating biospheric motivation) and personal values organized around the traditionalism (traditionalist through to high openness to change) and universalism dimensions (egoistic through to altruistic motivations). We used averaged beta-binomial generalized linear models to assess the role of external factors (socioeconomic, sociodemographic, and environmental) and personal (inner) motivations on the variation in attitudes. Each attitude was modeled separately. The relative importance of each predictor was judged by the proportion of models where it appeared as significant. Proconservation views were expressed by the majority (at least 65%) of the respondents in 7 out of the 9 attitude models. The most consistent predictors were emotional nature connection and personal values (significant in 4-6 out of 9 models), rather than external phenomena (significant in 0-5 models). However, the poorest farmers had lower scores on the agreement with prioritizing nature over development (𝛽 = -0.52, 95% CI: -0.96 to -0.07). Qualitative data also indicated that economic barriers hinder forest conservation on farms. These results suggest that biospheric, traditionalistic, and altruistic motivations promote people's proconservation attitudes, but nurturing these latent motivations is unlikely to improve conservation outcomes if material poverty remains unaddressed. Integrating the inner-outer perspective into conservation thinking and practical interventions could foster environmental stewardship and increase human well-being.

Evaluación de la influencia de la conexión y los valores naturales sobre las actitudes de conservación es una frontera tropical de deforestación Resumen Los fenómenos interiores, como los motivos personales para ser sustentables, pueden ser niveladores importantes para aumentar los resultados de conservación. Sin embargo, la mayor parte de la investigación y las políticas se enfocan en los fenómenos exteriores (cambios ecológicos o procesos económicos, por ejemplo). Exploramos los factores que moldean nueve actitudes de conservación relacionadas con la protección de los bosques y la fauna en un grupo de agricultores colonos cercanos a una frontera de deforestación en la Amazonía. Nuestros datos se obtuvieron de 241 encuestas presenciales cuantitativas complementadas con información cualitativa tomada de las respuestas en cuestionarios de preguntas abiertas y entrevistas oportunistas semiestructuradas. Para considerar el espectro completo de las posibles motivaciones interiores empleamos medidas de la conexión natural (lo que indica motivos relacionados a la biósfera) y valores personales organizados en torno a las dimensiones del tradicionalismo (del tradicionalista hasta una gran apertura al cambio) y el universalismo (del egoísta hasta los motivos altruistas). Usamos modelos lineales generalizados betabinomiales promediados para evaluar el papel que tienen los factores externos (socioeconómicos, sociodemográficos y ambientales) y los motivos personales (interiores) en la variación de las actitudes. Modelamos cada actitud por separado. Juzgamos la importancia relativa de cada predictor mediante la proporción de modelos en los que aparecían como significativos. La mayoría (al menos el 65%) de los respondientes expresó las opiniones en pro de la conservación en siete de los nueve modelos de actitud. Los predictores más uniformes fueron la conexión emocional natural y los valores personales (significativos en cuatro a seis de los nueve modelos), en lugar de los fenómenos externos (significativos en cero a cinco modelos). Sin embargo, los agricultores más pobres tuvieron un puntaje más bajo en cuanto a estar de acuerdo con la priorización de la naturaleza sobre el desarrollo (𝛽 = -0.52, 95% CI -0.96 a -0.07). Los datos cualitativos también indicaron que las barreras económicas impiden la conservación de los bosques en las fincas. Estos resultados sugieren que los motivos tradicionalistas, altruistas y aquellos relacionados con la biósfera promueven las actitudes en pro de la conservación de las personas, pero es poco probable que propiciar estos motivos latentes aumente los resultados de conservación si sigue sin solucionarse la pobreza material. La inclusión de las perspectivas internas y externas dentro del pensamiento de conservación y las intervenciones prácticas podría fomentar la administración ambiental e incrementar el bienestar humano.

Effect of semantics in the study of tolerance for wolves.

As conservation scholars increasingly recognize the critical role of human thought and behavior in determining the persistence of biodiversity across the globe, a growing line of inquiry regarding the validity and comparability of previous applications of core psychological concepts has emerged. Specifically, inconsistent measurement and use of terms, such as attitudes and acceptance, reveal important questions about previous approaches. Given that these concepts differ by definition, yet have been used interchangeably, we explored what drives differences in people's responses when each concept is operationalized in the context of a contested wildlife species, the gray wolf (Canis lupus). To do so, we used data from a 2014 survey of U.S. residents (n = 1287) to test how measures of six concepts (i.e., acceptance, attitudes, benefits, risks, [prior] behavior, and behavioral intentions) often employed in the conservation social sciences were related with a broad set of possible explanatory variables. Despite moderate to strong correlations between all concepts measured (| Pearson's r | = 0.39-0.65, p < 0.001), results revealed considerable variation in their respective relationships with identical explanatory variables. Specifically, although wildlife value orientation (i.e., domination or mutualism) operated fairly consistently across cognitive and behavioral concepts, the relationship between the six concepts and other factors, such as social trust, identification with various interest groups (i.e., hunter, farmer, or rancher, environmentalist, and animal rights advocate), and political ideology (i.e., liberal vs. conservative), varied considerably. Our findings underscore that differences exist in these measures, which could have serious implications for conservationists integrating social science findings in their decision-making processes if they are unaware of the theoretical underpinnings of and distinctions between core psychological concepts.

Efectos de la semántica en los estudios de tolerancia a los lobos Resumen Los académicos dedicados a la conservación reconocen cada vez más lo importantes que son el pensamiento y el comportamiento humano para definir la persistencia de la biodiversidad a nivel mundial, por lo que ha emergido una creciente línea de indagación con respecto a la validez y la comparabilidad de las aplicaciones previas de conceptos psicológicos fundamentales. Más específicamente, las medidas incompatibles y el uso de términos como actitudes y aceptación revelan preguntas importantes sobre las estrategias anteriores. Ya que estos conceptos difieren por definición y aun así se han usado indistintamente, decidimos explorar qué impulsa las diferencias en las respuestas de las personas cuando cada concepto opera en el contexto de una especie de fauna controvertida: el lobo gris (Canis lupus). Para lograr esto, usamos datos de un censo de 2014 aplicado a residentes estadunidenses (n = 1,287) para analizar cómo la medida de seis conceptos usados frecuentemente en las ciencias sociales de la conservación (aceptación, actitudes, beneficios, riesgos comportamiento [previo] e intenciones conductuales) se relacionan con un amplio conjunto de variables explicativas posibles. A pesar de las correlaciones moderadas y fuertes entre todos los conceptos medidos (| Pearson's r | = 0.39 a 0.65, p < 0.001), los resultados revelaron una variación considerable en sus respectivas relaciones con las variables explicativas idénticas. De manera más precisa, aunque la orientación del valor de la fauna (es decir, dominancia y mutualismo) operó uniformemente en los conceptos cognitivos y conductuales, la relación entre los seis conceptos y otros factores, como la confianza social, identificación con varios grupos de interés (cazador, agricultor o ranchero, ambientalista, defensor de los derechos animales) e ideología política (liberal vs conservador) variaron considerablemente. Nuestros resultados destacan las diferencias que existen en estas medidas, las cuales podrían tener repercusiones serias para los conservacionistas que integran los resultados de las ciencias sociales dentro de sus procesos de toma de decisiones si no están concientes de las teorías fundamentales y las distinciones entre los conceptos psicológicos fundamentales.

Reframing caring for parents who struggle with substance-use disorders.

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent-child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.

Nancy Suchman y los colegas sobre quienes ella ha ejercido influencia han producido un trabajo innovador y de reto a las actitudes sobre la comprensión de cómo la crianza y el uso de sustancias conviven juntas. La doctora Suchman y sus colegas insisten en el hecho de que no hay nada acerca del trastorno de uso de sustancias que no permita el cuidado eficaz y sensible para niños, especialmente con intervenciones que se enfocan en la relación progenitor-niño. El legado de Suchman es enfatizar cómo el uso de sustancias como enfermedad aleja a los individuos de relaciones importantes y afectuosas y les limita en el proceso de entregarse a tales relaciones. Restaurar la importancia de relaciones afectuosas y de la habilidad del individuo para mantener una relación afectuosa pudiera ser tan impactante en su uso de sustancias como un enfoque estricto para reducir el uso de drogas y lograr el estado de abstinencia.

Nancy Suchman, et les collègues qu'elle a influencés, a fait un travail novateur et généreusement combatif pour la compréhension de la manière dont le parentage et la toxicomanie se rassemblent. Le docteur Suchman et ses collègues soutiennent qu'il n'y a rien dans un trouble lié à l'usage d'une substance qui empêche le soin efficace et sensible aux enfants, surtout avec des interventions qui se focalisent sur la relation parent-enfant. L'héritage légué par Suchman consiste à mettre en lumière la façon dont la toxicomanie en tant que maladie détache les individus de relations importantes et attentionnées et limite le don qu'ils font d'eux-mêmes à ces relations. Le fait de restaurer la prépondérance de relations attentionnées et la capacité de l'individu à prendre soin peut avoir autant d'impact sur leur toxicomanie qu'une attention stricte à la réduction d'utilisation des drogues et l'atteinte de l'abstinence.

Couples Therapists' Attitudes Toward Online Therapy During the COVID-19 Crisis.

The measures adopted by governments around the world to control the spread of the COVID-19 virus (e.g., social distancing) have propelled a rapid transition from face-to-face to online therapy. Studies on online individual therapy indicate that therapists often have favorable attitudes toward this modality. To date, there is scant work on couples therapists' attitudes, despite the fact that the provision of online couples' therapy poses unique challenges (e.g., dealing with escalating conflict remotely). To provide a snapshot, in real time, as to how therapists experience the transition to online therapy, we surveyed 166 Israeli couples' therapists during April 2020, when lockdown orders prevented therapists from seeing couples face-to-face. A few weeks later, when the stay-at-home policy was lifted, a subsample (N = 60) of these therapists completed a follow-up assessment. The results suggest that couples therapists had limited experience using the online modality prior to COVID. The therapists reported experiencing online couples' therapy as somewhat successful and that their experience of providing therapy during the COVID-19 crisis had an overall positive impact on their attitudes toward online work. Establishing a strong therapeutic bond with both partners, dealing with escalating conflict, and treatment dropout were identified as the issues of most concern when conducting online couples therapy. The perceived difficulties with online therapy prospectively predicted lower usage of online couples' therapy, as well as less intention to continue online treatment once the crisis is over.

Las medidas adoptadas por los gobiernos de todo el mundo para controlar la propagación del virus de la COVID-19 (p. ej.: el distanciamiento social) han impulsado una transición rápida de la terapia presencial a la terapia virtual. Los estudios sobre la terapia individual virtual indican que los terapeutas con frecuencia tienen actitudes favorables hacia esta modalidad. Hasta la fecha, los trabajos sobre las actitudes de los terapeutas de pareja son escasos, a pesar del hecho de que la práctica de la terapia de pareja virtual plantea desafíos únicos (p. ej.: manejar la intensificación del conflicto distancia). Para ofrecer un panorama en tiempo real sobre cómo viven los terapeutas la transición a la terapia virtual, encuestamos a 166 terapeutas de pareja israelíes durante abril de 2020, cuando las órdenes de confinamiento impidieron a los terapeutas ver a las parejas en persona. Algunas semanas después, cuando se levantó la orden de quedarse en casa, una submuestra (N=60) de estos terapeutas completó una evaluación de seguimiento. Los resultados sugieren que los terapeutas de pareja tenían poca experiencia en el uso de la modalidad virtual antes de la COVID-19. Los terapeutas informaron que vivieron la terapia de pareja virtual como bastante favorable y que su experiencia de ofrecer terapia durante la crisis de la COVID-19 tuvo un efecto general positivo en sus actitudes hacia el trabajo virtual. Los problemas identificados como los de mayor preocupación a la hora de ofrecer terapia de pareja virtual fueron los siguientes: la construcción de un vínculo terapéutico sólido con ambos integrantes de la pareja, el manejo de la intensificación del conflicto y el abandono del tratamiento. Las dificultades percibidas con la terapia virtual predijeron prospectivamente un menor uso de la terapia de pareja virtual, así como menos intenciones de continuar el tratamiento virtual una vez que termine la crisis.

Knowledge and attitudes towards organ donation in a sample of physicians from two hospitals in Mexico.

INTRODUCTION: For many patients, organ transplantation is the only life-saving treatment. There is a severe shortage of organs for transplantation, and Mexico has one of the lowest organ donation rates. Health professionals are the link between society and the health system, and can promote and increase organ donation. OBJECTIVE: To explore general knowledge and attitudes of Mexican physicians with regard to cadaveric organ donation. METHODS: Cross-sectional, observational study. Two questionnaires were applied to 219 physicians either from an institution where transplants are carried out or from a hospital where the procedure is not performed. RESULTS: Most participants had not received any training on organ donation. The main deficits in their knowledge were related to the criteria for being a donor and to the position of the Church on organ donation. Knowledge predicted attitudes towards organ donation: it was negatively associated with unfavorable and mistrust attitudes, whereas it was positively associated with favorable attitudes and willingness to be a donor. CONCLUSION: It is necessary to implement programs aimed at physicians in order to provide them with tools that help promote organ donation culture.

INTRODUCCIÓN: Para numerosos pacientes, el trasplante de órganos es el único tratamiento para sobrevivir. Hay una grave escasez de órganos para trasplantes y México tiene una de las tasas más bajas de donación de órganos. Los profesionales de la salud son el vínculo entre la sociedad y el sistema de salud, y pueden promover e incrementar la donación de órganos. OBJETIVO: Explorar los conocimientos generales y las actitudes de médicos mexicanos respecto a la donación de órganos provenientes de cadáveres. MÉTODOS: Estudio observacional transversal. Se aplicaron dos cuestionarios a 219 médicos de una institución donde se realizan trasplantes y de un hospital en donde no se llevan a cabo. RESULTADOS: La mayoría de los participantes no había recibido entrenamiento sobre donación de órganos. Las principales deficiencias en sus conocimientos estuvieron relacionadas con los criterios para ser donador y la postura de la iglesia sobre la donación de órganos. El conocimiento predijo las actitudes hacia la donación de órganos; este se asoció negativamente a actitudes desfavorables y de desconfianza, mientras que se asoció positivamente a actitudes favorables y la disposición a ser donador. CONCLUSIÓN: Es necesario implementar programas dirigidos a los médicos para dotarlos de herramientas que ayuden a fomentar la cultura de donación de órganos.

The importance of tangible and intangible factors in human-carnivore coexistence.

Conflict with humans is one of the major threats facing the world's remaining large carnivore populations, and understanding human attitudes is key to improving coexistence. We surveyed people living near Hwange National Park about their attitudes toward coexisting with lions. We used ordinal regression models with the results of the survey to investigate the importance of a range of tangible and intangible factors on attitudes. The variables investigated included the costs and benefits of wildlife presence, emotion, culture, religion, vulnerability, risk perception, notions of responsibility, and personal value orientations. This was for the purpose of effectively tailoring conservation efforts but also for ethical policy making. Intangible factors (e.g., fear and ecocentric values) were as important as, if not more important than, tangible factors (such as livestock losses) for understanding attitudes, based on the effect sizes of these variables. The degree to which participants' fear of lions interfered with their daily activities was the most influential variable. The degree to which benefits accrue to households from the nearby protected area was also highly influential, as was number of livestock lost, number of dependents, ecocentric value orientation, and participation in conflict mitigation programs. Contrary to what is often assumed, metrics of livestock loss did not dominate attitudes to coexistence with lions. Furthermore, we found that socioeconomic variables may appear important when studied in isolation, but their effect may disappear when controlling for variables related to beliefs, perceptions, and past experiences. This raises questions about the widespread reliance on socioeconomic variables in the field of human-wildlife conflict and coexistence. To facilitate coexistence with large carnivores, we recommend measures that reduce fear (through education and through protective measures that reduce the need to be fearful), reduction of livestock losses, and ensuring local communities benefit from conservation. Ecocentric values also emerged as influential, highlighting the need to develop conservation initiatives tailored to local values.

Importancia de los Factores Tangibles e Intangibles en la Coexistencia Humanos-Carnívoros Resumen Los conflictos con humanos son una de las principales amenazas que enfrentan las poblaciones permanentes de grandes carnívoros del planeta y el entendimiento de las actitudes humanas es importante para mejorar la coexistencia. Preguntamos a las personas que viven cerca del Parque Nacional Hwange sobre su postura hacia la coexistencia con leones. Usamos modelos de regresión ordinal en los resultados del cuestionario para investigar la importancia de una gama de factores tangibles e intangibles para estas posturas. Las variables investigadas incluyeron el costo y beneficio de la presencia de fauna, emociones, cultura, religión, vulnerabilidad, percepción de riesgos, nociones de la responsabilidad y orientaciones de valor personal. Realizamos esto con el propósito de diseñar efectivamente los esfuerzos de conservación pero también para la generación de políticas éticas. Los factores intangibles (p. ej.: el miedo y los valores ecocéntricos) fueron tan importantes, si no es que más importantes, como los factores tangibles (como la pérdida de cabezas de ganado) para el entendimiento de las actitudes, con base en los tamaños del efecto de estas variables. El grado al que el miedo que los participantes sienten por los leones interfiere con sus actividades diarias fue la variable con mayor influencia. El grado al que los hogares del área protegida cercana devengan beneficios también tuvo una influencia alta, como lo tuvo el número de cabezas de ganado perdidas, el número de dependientes, la orientación de los valores ecocéntricos y la participación en programas de mitigación del conflicto. Contrario a lo que frecuentemente se asume, las medidas de la pérdida de cabezas de ganado no dominó sobre las actitudes por la coexistencia con leones. Más allá, encontramos que las variables socioeconómicas pueden parecer importantes cuando se estudian de manera aislada pero su efecto puede desaparecer cuando se controlan las variables relacionadas con las creencias, percepciones y experiencias pasadas. Esto genera preguntas sobre la dependencia hacia las variables socioeconómicas en el área de estudios de conflictos y coexistencia entre humanos y fauna. Para facilitar la coexistencia con carnívoros mayores recomendamos tomar medidas que reduzcan el miedo (por medio de la educación y medidas de protección que reduzcan la necesidad de vivir con miedo), la disminución de la pérdida de cabezas de ganado y garantizarles a las comunidades locales los beneficios que proporciona la conservación. Los valores ecocéntricos también surgieron como influyentes, lo que resalta la necesidad de desarrollar iniciativas de conservación adaptadas a los valores locales.

Convergence of stakeholders' environmental threat perceptions following mass coral bleaching of the Great Barrier Reef.

Managing human use of ecosystems in an era of rapid environmental change requires an understanding of diverse stakeholders' behaviors and perceptions to enable effective prioritization of actions to mitigate multiple threats. Specifically, research examining how threat perceptions are shared or diverge among stakeholder groups and how these can evolve through time is increasingly important. We investigated environmental threat perceptions related to Australia's Great Barrier Reef and explored their associations before and after consecutive years of mass coral bleaching. We used data from surveys of commercial fishers, tourism operators, and coastal residents (n = 5254) conducted in 2013 and 2017. Threats perceived as most serious differed substantially among groups before bleaching but were strongly aligned after bleaching. Climate change became the most frequently reported threat by all stakeholder groups following the coral bleaching events, and perceptions of fishing and poor water quality as threats also ranked high. Within each of the 3 stakeholder groups, fishers, tourism operators, and coastal residents, the prioritization of these 3 threats tended to diverge in 2013, but convergence occurred after bleaching. These results indicate an emergence of areas of agreement both within and across stakeholder groups. Changes in perceptions were likely influenced by high-profile environmental-disturbance events and media representations of threats. Our results provide insights into the plasticity of environmental-threat perceptions and highlight how their convergence in response to major events may create new opportunities for strategic public engagement and increasing support for management.

Convergencia de la Percepción de las Amenazas Ambientales por los Actores Sociales después del Blanqueamiento Masivo del Coral de la Gran Barrera Arrecifal Resumen La administración del uso que las personas dan a los ecosistemas en una época de cambios ambientales rápidos requiere un entendimiento del comportamiento de diferentes actores sociales y sus percepciones para facilitar la priorización de las acciones que mitigan a las múltiples amenazas. Específicamente, las investigaciones que examinan cómo se comparten o difieren las percepciones de las amenazas entre los grupos de actores y cómo estas percepciones pueden evolucionar con el tiempo son cada vez más importantes. Investigamos las percepciones de las amenazas ambientales relacionadas con la Gran Barrera Arrecifal en Australia y exploramos sus asociaciones antes y después de varios años consecutivos de blanqueamiento masivo del coral. Usamos datos tomados de encuestas realizadas a pescadores comerciales, operadores turísticos y residentes de la costa (n = 5,254) en 2013 y 2017. Las amenazas percibidas como las más serias difirieron sustancialmente entre los tres grupos antes del blanqueamiento, pero se alinearon marcadamente después del blanqueamiento. El cambio climático se convirtió en la amenaza reportada con mayor frecuencia por todos los grupos de actores después de los eventos de blanqueamiento del coral. Las percepciones de la pesca y la baja calidad del agua como amenazas también tuvieron una clasificación alta. Dentro de cada uno de los tres grupos de actores (pescadores, operadores turísticos y residentes de la costa) la priorización de estas tres amenazas tendió a diferir en 2013 pero la convergencia ocurrió después del blanqueamiento. Estos resultados indican un surgimiento de áreas de acuerdo dentro y entre los grupos de actores. Los cambios en las percepciones probablemente estuvieron influenciados por eventos de perturbación ambiental de alto perfil y la representación mediática de las amenazas. Nuestros resultados proporcionaron conocimiento sobre la plasticidad de las percepciones de las amenazas ambientales y resalta cómo su convergencia en la respuesta a los eventos más importantes puede crear nuevas oportunidades para la participación estratégica del público e incrementar el apoyo para su manejo.

Eating disorders in patients with irritable bowel syndrome.

INTRODUCTION: Eating disorders (ED) constitute an important group of conditions that commonly occur in adolescents. Gastrointestinal complaints are frequently reported in ED patients. Few studies assessed the association of irritable bowel syndrome (IBS) with ED. The aim of the current study is to determine the prevalence of ED in a group of IBS patients and compare it with a healthy control group and assess the relationship of IBS sub-types, it's duration and severity with ED. PATIENTS AND METHODS: 100 IBS patients diagnosed according to the Rome-IV criteria and a control group consisting of 100 healthy adults, between 18 and 65 years old, were enrolled in this study. Sub-type, duration and severity of IBS were determined. All participants were requested to fill questionnaires to screen for ED. RESULTS: 200 subjects participated in the study. 118(59%) were female and 92(41%) were male. The Eating Attitudes Test (EAT) score was significantly higher in the IBS group (Odds ratio: 5.3 CI 95%:4.3-9.3; p<0.001). The number of subjects with EAT score >30 was significantly higher in the IBS group (p<0.001). EAT scores were significantly higher in female IBS patients and in younger patients (p=0.013 and p=0.043; respectively). No significant association between the IBS sub-type and EAT score was found (p>0.05). However, IBS severity and duration positively correlated with EAT scores. DISCUSSION: ED should be considered in the management of IBS patients. Since many psychological factors can exacerbate IBS symptoms a multidisciplinary approach consisting of medical and behavioral therapeutic modalities should be employed for a better management of these patients.

[Opinion of doctors and users on e-health advances in primary care]. / Opinión de los facultativos y usuarios sobre avances de la e-salud en atención primaria.

OBJECTIVE: To find out the opinions of users and primary care doctors on the progress of e-health in primary care. DESIGN: Focus groups set up between 1st May and 25th September 2018. LOCATION: Primary care level in regional online health services. PARTICIPANTS: A total of 29 users and 33 primary care doctors linked to primary care that were contacted, through user associations and regional public health services, respectively. METHOD: Inductive analysis of transcripts from focus groups about the following issues: accessibility and security; efficiency; information and technical problems; potentialities. RESULTS: Online health services are positively valued in terms of cost savings both by users and doctors of primary care. Nevertheless, face-to-face interaction is still considered a key factor in the quality of service. When it comes to the access and provision of e-health services, there is shared concern for the security of the data and for the training deficiencies of users and doctors. An adequate design of the applications becomes a condition for the acceptance and diffusion of technologies that support online health. CONCLUSIONS: Health authorities should intensify the use of new technologies oriented towards easing the work of doctors, simplifying bureaucratic tasks, providing diagnostic and prescription security, and protecting data. As long as systems generate failures and mistrust, new technologies will remain to be perceived as a complement, but not as an alternative to the traditional care model.

A landscape of conservation philanthropy for U.S. land trusts.

Finding ways to increase financial support is critical to conservation efforts. We used conservation fundraising data, unprecedented in their resolution, to reveal spatial patterns in philanthropic giving to a major land protection organization in the United States. We also quantified the relationship between the amount of effort devoted to fundraising and donations received. Around 40% of the variation in the propensity to give and overall value of gifts was explained by sociodemographic and other predictors. For example, education level had greater predictive capacity than income, political views, and other factors often considered important. Fundraising effort was strongly predictive of the amount donated in an area. Our model estimated a doubling of funds raised with a 5-fold increase of effort. Conservation organizations could use our statistical framework to inform efforts aimed at increasing philanthropic giving by identifying locations with large model residuals. An example application of our framework showed an almost 40% increase (US$200 million) in fundraising revenue for the case-study conservation organization.

Public perception of river fish biodiversity in four European countries.

Public support for biodiversity conservation is shaped by people's values and their knowledge, beliefs, and attitudes toward the environment. We conducted the first multinational representative survey of the general public's perceptions of river fish biodiversity in France, Germany, Norway, and Sweden. For the online survey, 1000 respondents per country were randomly selected from large panels following country-specific quotas set on age, gender, and educational level. Questions covered people's level of knowledge, beliefs, values, and attitudes toward river fish, environmental threats, and conservation measures. We found that the public had limited knowledge of freshwater fishes. Two non-native species, rainbow trout (Oncorhynchus mykiss) and brook trout (Salvelinus fontinalis), were widely perceived as native, whereas native Atlantic salmon (Salmo salar) was mostly classified as native in Scandinavia and largely as non-native in central Europe. These results suggest an extinction of experience paralleling the extirpation or decline of salmon stocks in countries such as Germany and France. Respondents thought pollution was the dominant threat to riverine fish biodiversity. In reality, habitat loss, dams, and the spread of non-native fishes are equally important. Despite limited biological knowledge, respondents from all countries held an overwhelmingly proecological worldview, supported conservation stocking, and appreciated native fishes, although only a minority interacted with them directly. Differences among the 4 countries related to several conservation issues. For example, threats to biodiversity stemming from aquaculture were perceived as more prevalent in Norway compared with the other 3 countries. Promoting fish conservation based on charismatic species and use values of fishes may work well in countries with a strong economic and cultural link to the freshwater environment, such as Norway. In countries where people rather abstractly care for nature, focusing conservation messaging on broader ecosystem traits and non-use values of fishes is likely to win more support.

Marital Processes Linking Gender Role Attitudes and Marital Satisfaction Among Mexican-Origin Couples: Application of an Actor-Partner Interdependence Mediation Model.

Informed by dyadic approaches and culturally informed, ecological perspectives of marriage, we applied an actor-partner interdependence mediation model (APIMeM) in a sample of 120 Mexican-origin couples to examine (a) the associations linking Mexican immigrant husbands' and wives' gender role attitudes to marital satisfaction directly and indirectly through marital processes (i.e., warmth and negativity) and (b) whether the associations between spouses' gender role attitudes and marital processes were moderated by wives' employment. Although previous research has identified spouses' gender role attitudes as potential predictors of spouses' marital satisfaction, no study has examined these links in a dyadic model that elucidates how gender role attitudes may operate through processes to shape marital satisfaction and conditions under which associations may differ. We found that when spouses reported less sex-typed attitudes, their partners reported feeling more connected to them and more satisfied with the marriage, regardless of whether wives were employed. Our results suggest that marital satisfaction was highest for those Mexican-origin couples in which marital partners were less sex-typed in their attitudes about marital roles to the extent that partners' attitudinal role flexibility promoted spouses' feelings of warmth and connection to their partner.

Sobre la base de enfoques diádicos y perspectivas de matrimonio ecológicas y culturalmente fundamentadas, aplicamos un modelo de mediación e interdependencia actor-pareja en una muestra de 120 parejas de origen mexicano para examinar (a) las asociaciones que conectan las actitudes hacia los roles de género de los esposos y las esposas inmigrantes mexicanos con la satisfacción conyugal directamente e indirectamente mediante procesos conyugales (p. ej.: calidez y negatividad) y (b) si las asociaciones entre las actitudes hacia los roles de género de los cónyuges y los procesos conyugales estuvieron moderados por el empleo de las esposas. Aunque en investigaciones anteriores se han reconocido las actitudes hacia los roles de género de los cónyuges como posibles predictores de su satisfacción conyugal, ningún estudio ha analizado estas conexiones en un modelo diádico que aclare cómo las actitudes hacia los roles de género pueden funcionar mediante procesos para determinar la satisfacción conyugal y las condiciones en las cuales las asociaciones pueden diferir. Descubrimos que cuando los cónyuges informaron menos actitudes consideradas adecuadas para cada género, sus parejas informaron sentirse más conectadas con ellos y más satisfechas con el matrimonio, independientemente de si las esposas estaban empleadas o no. Nuestros resultados sugieren que la satisfacción conyugal fue mayor para las parejas de origen mexicano en las cuales los cónyuges tuvieron actitudes menos típicas de cada género con respecto a los roles conyugales hasta el punto de que la flexibilidad actitudinal hacia los roles de los integrantes de la pareja fomentó sentimientos de calidez y conexión con su pareja.

[Heart failure in primary care: Attitudes, knowledge and self-care]. / Insuficiencia cardiaca en atención primaria: actitudes, conocimientos y autocuidado.

OBJECTIVE: To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. DESIGN: Cross-sectional and multicentre study. SETTING: Primary Care. PARTICIPANTS: Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. MAIN MEASUREMENTS: Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. RESULTS: A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n=282; R2 conditional=0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46). CONCLUSION: Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care.

Sickle cell disease in western Sudan: genetic epidemiology and predictors of knowledge attitude and practices.

OBJECTIVE: To investigate the epidemiology of sickle cell disease (SCD) and determinants of knowledge, attitudes and practices (KAP) towards SCD in western Kordofan State, Sudan. METHODS: A community-based, descriptive, cross-sectional study was conducted in three towns. Three hundred and seventy-two households were polled, and blood samples for haemoglobin phenotyping were collected from 1116 individuals. Sociodemographic, socio-economic and KAP data were collected using investigator-administered questionnaires. Descriptive, frequency distribution and multiple regression analyses were performed. RESULTS: About 50.9% of the study population were Misseriya tribes. Consanguineous marriages were reported by 67.5% of the households. The highest percentage of homozygous SCD was 2.8% among children under 5 years of age. About 24.9% were carriers of HbS allele (HbAS). HbS allele frequency was highest in children aged 5-11 years (18.3%, CI: 13.7-22.9%) and lowest in males >15 years old (12.0%, CI: 6.1-17.9%). The average HbS frequency across all age groups was 14.5% (95% CI: 12.2-16.8%). The most frequent ß-globin gene cluster haplotype was the Cameroon (30.8%), followed by the Benin (21.8%), the Senegal (12.8%) and the Bantu (2.2%) haplotypes. About 17.0% of all-cause child deaths were due to SCD. The estimated change in log odds of having the SS genotype per year increase in age was (-) 0.0058 (95% CI -0.0359, 0.0242). This represents a non-statistically significant 2.9% increase in 5-year mortality for individuals with the SS genotype relative to those with AS and AA genotypes. About 46.9% of the households had poor knowledge, 26.1% had satisfactory knowledge, and 26.9% had good knowledge about sickle cell disease. Mothers' and fathers' educational levels were significant predictors of good knowledge about SCD (P < 0.05). About 48.0% had a satisfactory attitude towards sickle cell disease while 30.7% had poor attitude and only 21.3 showed good attitudes. Poor knowledge about SCD and low socio-economic status were the strongest positive predictors of poor attitude and practices towards SCD (P < 0.01). CONCLUSIONS: Sickle cell disease is a major health problem in West Kordofan, Sudan. Knowledge, attitude and practices towards the disease are not satisfactory. The development of public health programs is highly recommended to control and manage SCD in western parts of Sudan.

Implications of human value shift and persistence for biodiversity conservation.

Large-scale change in human values and associated behavior change is believed by some to be the ultimate solution to achieve global biodiversity conservation. Yet little is known about the dynamics of values. We contribute to this area of inquiry by examining the trajectory of values affecting views of wildlife in North America. Using data from a 19-state study in the United States and global data from the Schwartz Value Survey, we explored questions of value persistence and change and the nature of attitudinal responses regarding wildlife conservation issues. We found support, based on subjects' ancestry, for the supposition that domination is a prevalent American value orientation toward wildlife that has origins in European Judeo-Christian traditions. Independent of that effect, we also found indications of change. Modernization is contributing to a shift from domination to mutualism value orientations, which is fostering attitudes less centered on human interests and seemingly more consistent with a biocentric philosophy. Our findings suggest that if value shift could be achieved in a purposeful way, then significant and widespread behavior change believed necessary for long-term conservation success may indeed be possible. In particular, greater emphasis on mutualism values may help provide the context for more collaborative approaches to support future conservation efforts. However, given the societal forces at play, it is not at all clear that human-engineered value shift is tenable. Instead of developing strategies aimed at altering values, it may be more productive to create strategies that recognize and work within the boundaries of existing values. Whereas values appear to be in a period of flux, it will be difficult to predict future trends without a better understanding of value formation and shift, particularly under conditions of rapid social-ecological change.

Community motivations to engage in conservation behavior to conserve the Sumatran orangutan.

Community-based conservation programs in developing countries are often based on the assumption that heteronomous motivation (e.g., extrinsic incentives such as economic rewards and pressure or coercion to act) will incite local communities to adopt conservation behaviors. However, this may not be as effective or sustainable as autonomous motivations (e.g., an intrinsic desire to act due to inherent enjoyment or self-identification with a behavior and through freedom of choice). We analyzed the comparative effectiveness of heteronomous versus autonomous approaches to community-based conservation programs through a case study of Sumatran orangutan (Pongo abelii) conservation in 3 villages in Indonesia. Each village had a different conservation program design. We surveyed people (n = 240) to determine their motivations for and behavior changes relative to orangutan and orangutan habitat (forest) protection. Heteronomous motivations (e.g., income from tourism) led to greater self-reporting of behavior change toward orangutan protection. However, they did not change self-reported behavior toward forest (i.e., orangutan habitat) protection. The most effective approach to creating self-reported behavior change throughout the community was a combination of autonomous and heteronomous motivations. Individuals who were heteronomously motivated to protect the orangutan were more likely to have changed attitudes than to have changed their self-reported behavior. These findings demonstrate that the current paradigm of motivating communities in developing countries to adopt conservation behaviors primarily through monetary incentives and rewards should consider integrating autonomous motivational techniques that promote the intrinsic values of conservation. Such a combination has a greater potential to achieve sustainable and cost-effective conservation outcomes. Our results highlight the importance of using in-depth sociopsychological analyses to inform the design and implementation of community-based conservation programs.

Understanding public perceptions of risk regarding outdoor pet cats to inform conservation action.

Free-ranging domestic cats (Felis catus) incur and impose risks on ecosystems and represent a complex issue of critical importance to biodiversity conservation and cat and human health globally. Prior social science research on this topic is limited and has emphasized feral cats even though owned cats often comprise a large proportion of the outdoor cat population, particularly in urban areas. To address this gap, we examined public risk perceptions and attitudes toward outdoor pet cats across varying levels of urbanization, including along the wildland-urban interface, in Colorado (U.S.A.), through a mail survey of 1397 residents. Residents did not view all types of risks uniformly. They viewed risks of cat predation on wildlife and carnivore predation on cats as more likely than disease-related risks. Additionally, risk perceptions were related to attitudes, prior experiences with cats and cat-wildlife interactions, and cat-owner behavior. Our findings suggest that changes in risk perceptions may result in behavior change. Therefore, knowledge of cat-related risk perceptions and attitudes could be used to develop communication programs aimed at promoting risk-aversive behaviors among cat owners and cat-management strategies that are acceptable to the public and that directly advance the conservation of native species.

Social values and biodiversity conservation in a dynamic world.

Understanding what shape values (which ultimately shape human behavior) will help improve the effectiveness of conservation solutions that depend on public support. To contribute to this understanding, we investigated the influence of societal-level changes, such as modernization, on values in a multilevel framework. We collected survey responses (n = 4183) to questionnaires mailed to a random selection of households within each county in Washington (U.S.A.) (response rate 32%). We used multilevel modeling to determine the relationship between modernization (e.g., county-level urbanization, wealth, and education) and wildlife value orientations (values that shape thought about wildlife) while controlling for individual-level sociodemographics. We then explored how values influence conservation support at different levels (e.g., individual and county) and how values explain conservation support in a case study of public responses to wolf (Canis lupis) recovery. We found positive associations between county-level examples of modernization and mutualism (a wildlife value orientation that prioritizes the perceived needs of wildlife) independent of a respondent's sociodemographics, and negative associations between modernization and domination (a wildlife value orientation that prioritizes human needs). Our results suggest that context has an additive impact on one's values; certain locations exhibited domination values, whereas others exhibited a mix of value types. This finding is important because actions that restrict human interests to promote biodiversity were negatively associated with domination and positively associated with mutualism. In the wolf case study, mutualism was strongly correlated with less social conflict over wolf recovery in many, but not all, counties (e.g., Pearson's r correlation = 0.59 in one county and a nonsignificant correlation in another). Our findings suggest that modernization operates on values within a state with implications for biodiversity, but other factors in addition to values must be investigated to fully understand what leads to proconservation behavior.

[Gender violence: Knowledge and attitudes of nurses in Primary Care]. / Violencia de género: conocimientos y actitudes de las enfermeras en atención primaria.

AIM: To determine the knowledge and attitudes of nurses in Primary Care as regards gender violence and their relationship with socio-demographic factors and cases detected. DESIGN: Cross-sectional, descriptive study. LOCATION: Urban health centres. PARTICIPANTS: A total of 167 nurses working in Primary Care. MAIN MEASUREMENTS: A questionnaire was used that included questions related to knowledge, knowledge perception and attitudes to gender violence attitudes. Variables such as age, gender, marital status, work place and health area were also analysed. RESULTS: The response rate was 114 (68.26%). The percentage of correct responses in the knowledge questions was 62.2%, with a medium level of knowledge being observed. Married nurses or couples living in a stable relationship obtained a higher score (95.2%, P=.077). The low detection (29%) is associated with marital status (P=.004), low knowledge (P=0,008), low knowledge perception (P=.001), lack of training (P=.03) and non-implementation of the gender violence protocol (P=.001). Nurses with low self-perception of their knowledge implement the protocol less often (OR=0.26; 95% CI: 0.1-0.7), and they consider that the lack of training is the main problem in determining the diagnosis (OR=11.24; 95% CI: 1.5-81.1). CONCLUSIONS: The level of knowledge was adequate. Nurses have a lack of confidence in terms of their knowledge about gender violence. The detection and diagnosis attitudes are more related to self-perception of levels of knowledge than their real knowledge. Marital status influences the level of knowledge. Professionals state that the lack of training is the main problem to give an efficient healthcare response.

[Knowledge and attitudes of citizens in the Basque Country (Spain) towards cardiopulmonary resuscitation and automatic external defibrillators]. / Conocimientos y actitudes de los ciudadanos del País Vasco sobre la resucitación cardiopulmonar y los desfibriladores externos automatizados.

AIM: To explore the training, ability and attitudes towards cardiopulmonary resuscitation and the use of automatic defibrillators among the population of the Basque Country (Spain). DESIGN: A face-to-face survey. SCOPE: Capital cities of the Basque Country. PARTICIPANTS: A total of 605 people between 15-64 years of age were randomly selected. MAIN VARIABLES OF INTEREST: Information about the knowledge, perceptions and self-perceived ability to identify and assist cardiopulmonary arrest was requested. RESULTS: A total of 56.4% of the responders were women, 61.8% were occupationally active, and 48.3% had higher education. Thirty-seven percent of the responders claimed to be trained in resuscitation techniques, but only 20.2% considered themselves able to apply such techniques. Public servants were almost 4 times more likely of being trained in defibrillation compared to the rest of workers (OR 3.7; P<.001), while people with elementary studies or no studies were almost 3 times more likely of not being trained in cardiopulmonary resuscitation, in comparison with the rest (OR 2.7; P=.001). A total of 94.7% of the responders considered it "quite or very important" for the general population to be able to apply resuscitation, though 55% considered themselves unable to identify an eye witnessed cardiac arrest, and 40.3% would not recognize a public-access defibrillator. CONCLUSIONS: Citizens of the Basque Country consider the early identification and treatment of cardiorespiratory arrest victims to be important, though their knowledge in cardiopulmonary resuscitation and defibrillation is limited.