Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology.

Neurocritical patients (NCPs) in the intensive care unit (ICU) rapidly progress to respiratory and peripheral muscle dysfunctions, which significantly impact morbidity and death. Early mobilization in NCPs to decrease the incidence of ICU-acquired weakness has been showing rapid growth, although pertinent literature is still scarce. With this review, we summarize and discuss current concepts in early mobilization of critically ill patients within the context of neurologic pathology in NCPs. A narrative synthesis of literature was undertaken trying to answer the following questions: How do the respiratory and musculoskeletal systems in NCPs behave? Which metabolic biomarkers influence physiological responses in NCPs? Which considerations should be taken when prescribing exercises in neurocritically ill patients? The present review detected safety, feasibility, and beneficial response for early mobilization in NCPs, given successes in other critically ill populations and many smaller intervention trials in neurocritical care. However, precautions should be taken to elect the patient for early care, as well as monitoring signs that indicate interruption for intervention, as worse outcomes were associated with very early mobilization in acute stroke trials.

Examining the Role of Mononormative Beliefs, Stigma, and Internalized Consensual Non-Monogamy Negativity for Dehumanization.

Interest in consensually non-monogamous (CNM) relationships has been increasing in the general population in recent years. However, given the cultural dominance of monogamy and the normative expectations often imposed through socialization (i.e., mononormativity), people in CNM relationships may experience negativity, which can become internalized and harm their individual and relationship health. The present study investigated if mononormativity beliefs and CNM relationship stigma were associated with more dehumanization and if internalized CNM negativity was an underlying mechanism for these associations. Results showed that participants who endorsed more mononormative beliefs and CNM relationship stigma also reported more internalized CNM negativity. In turn, participants who experienced more internalized CNM negativity attributed more negative (vs. positive) emotions to themselves and treated their partners as more immature, unrefined, exploitable, and emotionless. These results show that mononormativity and internalized negativity can shape the attitudes, perceptions, and behaviors of CNM individuals toward themselves and their partners.

Condom Use Beliefs Differ According to Regulatory Focus: A Mixed-Methods Study in Portugal and Spain.

Reports worldwide have been showing increasing rates of sexually transmitted infections (STIs) and condomless sex in recent years. Research has identified several individual and situational variables that can determine the decision to use condoms or forgo their use. We argue that such a decision can also be shaped by motives related to pleasure and safety (i.e., regulatory focus in sexuality). Using open ended questions, we asked 742 Portuguese and Spanish adults to indicate situations and reasons that could inform the decision making process with casual partners and the functions/attributes related to condoms. Using thematic analyses, we coded the drivers of condomless sex and condom use into themes and subthemes, and computed their frequencies. Using quantitative measures, we also asked participants to indicate their condom use expectancies and perceived barriers. Comparing participants according to regulatory focus revealed some differences. Pleasure promotion participants were more likely to consider that condom use decision making is driven by unexpectedness, pleasure, and intimacy pursuit, attached more pleasure reduction functions to condoms, expected more negative outcomes in condom use, and endorsed more sensation and partner barriers in condom use. In contrast, disease prevention participants were more likely to consider that condom use decision making is driven by adequate sexual education, responsibility, and behavioral control, and attached more health protective functions to condoms. These differences can inform the development of tailored intervention and awareness campaigns aimed at helping people to use condoms more consistently with casual partners and to avoid behaviors that put them at risk of STI transmission.

Prevent2Protect Project: Regulatory Focus Differences in Sexual Health Knowledge and Practices.

The way people perceive risks and make decisions about their health is regulated by two motivational systems-prevention of harm or promotion of pleasure. People more focused on prevention strive to avoid negative outcomes and enact more health-protective behaviors. In contrast, people more focused on promotion strive to attain positive outcomes and take more risks with their health. Building upon recent evidence extending this framework to sexual behaviors and health, we conducted a pre-registered online survey ( OSF ) with Portuguese and Spanish adults (N = 742; Mage = 31.42, SD = 9.16) to examine whether self-reported STI knowledge and sexual health practices differ based on predominant regulatory focus. This study was part of the Prevent2Protect project ( OSF ). Results showed that prevention-focused participants had heard about more STIs and retrieved more of their knowledge from scientific sources but had been tested for fewer STIs in the past. In contrast, promotion-focused participants indicated they had specific knowledge about more STIs, retrieved more of their knowledge from medical and peer sources, and had been tested for more STIs in the past. They also reported more frequent STI testing, using free testing facilities or asking their family practice doctor to get tested, more routine sexual health check-ups, and more use of other contraceptive methods, such as birth control pills. These results remained unchanged after controlling for demographic differences. Overall, our findings showed that different motives in sexuality shape sexual health knowledge and sexual health practices.

Stigmatization of Consensual Non-Monogamous Partners: Perceived Endorsement of Conservation or Openness to Change Values Vary According to Personal Attitudes.

Studies have shown that romantic partners in consensual non-monogamous (CNM) relationships are targets of stigmatization. However, little is known about the underlying mechanisms and the conditions under which such stigmatization occurs. In two experimental studies (combined N = 772), we asked participants to read the description of two partners in a relationship (monogamous vs. open relationship vs. polyamorous) and make a series of judgments about those partners. Overall results showed that CNM (vs. monogamous) partners were perceived as less trustworthy and as having more sexual health concerns (Studies 1 and 2), and as being less committed and less sexually satisfied (Study 2). Results from a conditional mediation analysis (Study 2) further showed that participants with negative attitudes toward consensual non-monogamy perceived CNM (vs. monogamous) partners as having less conservation and more openness to change values, which was then associated with more stigmatization. In contrast, participants with positive attitudes toward consensual non-monogamy perceived CNM (vs. monogamous) partners as having more openness to change values, which was then associated with less stigmatization. Taken together, these results extended the literature focused on prejudice, discrimination, and stigmatization of minority groups and highlighted key elements that can be used to buffer stigmatization.

Perceived Associations between Excessive Sugar Intake and Health Conditions.

Excessive sugar intake represents an increased risk of developing non-communicable diseases (e.g., obesity, cardiometabolic diseases, and dental diseases). Still, it is unclear whether people are aware of these adverse health outcomes. The current study systematically examined the extent to which people associate health conditions with excessive sugar intake. Participants (N = 1010 Portuguese volunteers) freely reported all health conditions they associated with excessive sugar consumption and rated the strength of these associations for eight specific health conditions. All participants reported health conditions associated with excessive sugar intake, with the most frequent being risk factors for cardiometabolic diseases (e.g., diabetes), cardiovascular diseases, oral problems, oncological and mental health conditions. Moreover, participants considered diabetes, overweight/obesity, and oral problems as being the conditions most related to excessive sugar intake. Women, participants with children in the household, and experts in health/nutrition rated excessive sugar intake as being more strongly linked to some of the health conditions. The identification of the health conditions that people associate with excessive sugar consumption may inform policymakers, educators, and health professionals and support interventions targeting the general public or specific groups (e.g., overweight people) in raising awareness of potential adverse health outcomes and, ultimately, contribute to reducing sugar intake.

Having a prevention regulatory focus longitudinally predicted distress and health-protective behaviours during the COVID-19 pandemic.

People focussed on prevention (vs. promotion) are motivated by safety and are less inclined to take risks. We tested if having a prevention (vs. promotion) focus before the COVID-19 pandemic outbreak predicted threat perceptions and health outcomes throughout the pandemic. Participants (N = 161) took part in a longitudinal study. Measures were assessed before the pandemic was declared (on November 2019, T1) and after a global pandemic was declared (on June 2020, T2). Participants who were more focussed on prevention prior to the onset of the pandemic (at T1) perceived greater risk and were more worried about contracting COVID-19, and engaged in more preventive behaviours during the pandemic (at T2). They also reported less anxiety and felt healthier later on (at T2). Exploratory analyses revealed that enacting preventive behaviours helped people cope with pandemic-related anxiety. Being motivated by security and enacting preventive behaviours seems to have helped people reduce anxiety over risk even during the pandemic.

Evaluating the Adequacy of Emoji Use in Positive and Negative Messages from Close and Distant Senders.

Computer-mediated communication allows people to communicate across several contexts (e.g., friends, professional settings) by using video-based or text-based channels. In the latter case, communication lacks nonverbal cues (e.g., tone of voice) that are critical to message interpretation. Including emoji can help express emotion and reinforce or clarify the meaning of a message. However, the benefits of using emoji are likely to depend on the context (e.g., the relationship between interlocutors) and the messages' features (e.g., the valence of the message). To date, studies have not systematically and empirically examined how the use of emoji is perceived across different communication scenarios. In the current study, we asked 175 participants (49.5 percent women; Mage = 36.32, SD = 12.22) to imagine receiving either a negative or a positive message from 22 senders (e.g., friend; bank manager) and to indicate, for each case, how much they would like to receive an emoji and how useful and appropriate they considered the use of emoji. These ratings were combined into a single index of emoji use adequacy. Based on factor analysis, the 22 scenarios were aggregated in distant and close scenarios. Overall, results showed that participants considered emoji use more inadequate in distant (vs. close) scenarios and for negative (vs. positive) messages. These findings suggest that the perceived benefits of emoji use for text-based communication may not be generalized to all text-based communication contexts, such that relationship proximity and message valence should not be overlooked. Implications for the fields of consumer psychology and communication are discussed.

Regulatory Focus and Sexual Health: Motives for Security and Pleasure in Sexuality are Associated with Distinct Protective Behaviors.

We examined if motives for security (i.e., prevention focus) or pleasure (i.e., promotion focus) were uniquely associated with intentions to get tested for STIs and behavioral control over condom use, over and above variables already identified in theoretical models. We conducted an online survey with Portuguese adults (N = 836; Mage = 22.27, SD = 5.14). Overall, 99.4% of the participants knew at least one of eight STIs, but only 25.2% got tested in the last six months. Participants more focused on prevention had condomless sex less frequently, whereas participants more focused on promotion knew more STIs and got tested for more STIs. Furthermore, participants had stronger intentions to get tested for STIs if they got tested for more STIs in the past, were more concerned about STIs, perceived greater susceptibility to STI acquisition, and were more focused on promotion (but not prevention). Participants had greater behavioral control over condom use if they had condomless sex less often and were more focused on prevention (but not promotion). These findings suggest that promotion-focused people are more likely to consider the consequences of having condomless sex. In contrast, prevention-focused people are more likely to take control of their sexual health.

What Drives the Dehumanization of Consensual Non-Monogamous Partners?

We built upon a recent study by Rodrigues, Fasoli, Huic, and Lopes (2018) by investigating potential mechanisms driving the dehumanization of consensual non-monogamous (CNM) partners. Using a between-subjects experimental design, we asked 202 Portuguese individuals (158 women; Mage = 29.17, SD = 9.97) to read the description of two partners in a monogamous, open, or polyamorous relationship, and to make a series of judgments about both partners. Results showed the expected dehumanization effect, such that both groups of CNM partners (open and polyamorous) were attributed more primary (vs. secondary) emotions, whereas the reverse was true for monogamous partners. Moreover, results showed that the dehumanization effect was driven by the perception of CNM partners as less moral and less committed to their relationship. However, these findings were observed only for individuals with unfavorable (vs. favorable) attitudes toward CNM relationship. Overall, this study replicated the original findings and extended our understanding of why people in CNM relationships are stigmatized.

A qualitative study about college students' attitudes, knowledge and perceptions regarding sugar intake.

Excessive sugar intake has been associated with multiple health conditions (e.g., higher risk for non-communicable diseases). Hence, health organizations have issued guidelines defining the maximum daily intake of free or added sugars. However, data from several countries suggests that these guidelines are rarely met, particularly by young adults. For example, almost half of Portuguese adolescents and young adults exceed the recommended sugar intake. In this work, we aim to further explore college students' attitudes, knowledge, and perceptions about sugar intake, as well as about sugar intake guidelines. A thematic analysis on data from five focus groups (N = 40) indicated that participants reported difficulty in the comprehension of added/free sugars definition and sugar intake recommendations. Overall, attitudes toward sugar were ambivalent. Sugar was simultaneously perceived as pleasurable and needed, but also as addictive and harmful. Although aware of the potential negative health outcomes associated with excessive sugar intake, most participants did not perceive being at risk due to their youth, exercise habits, or type of diet. The few concerns expressed were mostly associated with the negative impact of high sugar intake on body image (e.g., weight gain). The main barriers to reducing sugar intake identified were environmental (e.g., time restrictions, food available at the university). Still, participants could identify several individual strategies to effectively regulate sugar intake. By identifying knowledge gaps and sources of bias related to sugar consumption, our findings are useful to inform future interventions aiming to address the problem of high sugar intake among university students.

With or Without You: Associations Between Frequency of Internet Pornography Use and Sexual Relationship Outcomes for (Non)Consensual (Non)Monogamous Individuals.

More frequent internet pornography use is often associated with decreased sexual satisfaction. However, individuals who use internet pornography more often can experience better relationship outcomes, depending on how they use it in the context of their relationship. Indeed, internet pornography use with the partner seems to be positively associated with sexual satisfaction. We explored whether the type of agreement partners have about monogamy is related to this association. We conducted a cross-sectional study (N = 866; 66.3% women, Mage = 27.40, SD = 8.58) with individuals in monogamous (n = 552), non-consensual non-monogamous (NCNM; n = 210) and consensually non-monogamous (CNM; n = 104) relationships. Results showed that CNM individuals used internet pornography substantially more than the other two groups, but they were as sexually satisfied with themselves and with their primary partner as monogamous individuals. NCNM individuals were the least sexually satisfied and reported more sexual arousal difficulties than the other groups. Results further showed that CNM individuals included their primary partner in their internet pornography use more frequently than the other groups, and this inclusion was positively associated with sexual satisfaction with the primary partner. The frequency of internet pornography use with the partner was negatively associated with sexual arousal difficulties for monogamous individuals and positively associated with personal and relational sexual satisfaction in both monogamous and NCNM individuals. These results complement past findings by shedding light on the role of internet pornography use for different relationship agreements, and its association with personal and relational experiences.

Knowledge about Sugar Sources and Sugar Intake Guidelines in Portuguese Consumers.

In this work, we examined knowledge about sugars and guidelines for its consumption and explored the relationship between knowledge and measures related to nutritional information processing as well as sugar consumption. Specifically, we asked participants (n = 1010 Portuguese) to categorize a set of ingredients (e.g., glucose, aspartame) regarding their composition (i.e., intrinsic vs. added/free sugars) and origin (e.g., natural vs. artificial) and if they were aware of the WHO guidelines for sugar intake. Overall, despite using information about sugar frequently and considering attending to such information as very important to stay healthy, most participants were unaware of the WHO guidelines and revealed difficulties in the categorization task. Women, participants with a higher level of education, and those with children in the household reported higher use of sugar content information present in nutritional labels, higher perceived knowledge of nutritional guidelines, and higher hit rates in categorizing sugar sources. Almost one-fourth of the population exceeds the daily limit recommended by the WHO. Therefore, characterizing the knowledge of a Portuguese sample regarding sugar sources and sugar intake guidelines is particularly relevant, and our results emphasize the need to implement effective strategies to reduce sugar intake.

Knowledge and acceptance of interventions aimed at reducing sugar intake in Portugal.

OBJECTIVE: Governments worldwide have been implementing interventions aimed at improving citizens' dietary habits. Examining how individuals perceive these interventions is relevant for promoting future policies in this area, as well as informing the way they are designed and implemented. In the current study, we focused on interventions aimed at reducing sugar intake in Portugal, given the current high sugar consumption patterns in the population. DESIGN: Online survey to assess which interventions are the most salient and receive greater public support. SETTING: Portugal. PARTICIPANTS: 1010 (76·7 % female, MAge 36·33, sd 13·22). RESULTS: Data from a free-recall task showed that only about one-third of participants reported knowing about these interventions, namely those related to taxation, weight restrictions in individual sugar packets and limited availability of products with high sugar content. We also found evidence of high support for the eight interventions presented (except for replacing sugar by artificial sweeteners), positive attitudes towards the need of reducing sugar intake in the Portuguese population and high agreement with the importance of reducing sugar intake across all age groups, particularly among children. Participants also indicated paying attention to the amount of sugar in their diets and a low self-reported frequency of consumption of high sugary foods and beverages. A hierarchical regression analysis suggested that these variables were significantly associated with the overall acceptance of interventions, independently of social-demographic variables (i.e., age, education and sex). CONCLUSION: By examining how people perceive and accept different interventions targeting the reduction of sugar intake, the current work aims to support policymaking in this domain.

Romantic Jealousy: A Test of Social Cognitive and Evolutionary Models in A Population-Representative Sample of Adults.

Whereas sexually dimorphic evolutionary models argue for clear sex differences in responses to jealousy-evoking scenarios, social cognitive models emphasize the importance of other factors. This paper explores variables associated with responses to a commonly-used jealousy-evoking scenario in a population-representative sample. Data from 8,386 Australian men and women aged 16-69 were weighted to match the population. The results provided some support for evolutionary models among heterosexual respondents, but findings contrary to evolutionary models were found among non-heterosexual respondents. Support for social cognitive models was provided by the identification of six variables that had significant independent multivariate associations with jealousy: sex, age, education, lifetime number of partners, relationship status, and attitudes toward infidelity. The results suggest that although men and women may tend to respond differently to sexual or emotional infidelity scenarios, the anticipated experience of jealousy in each context is strongly influenced by biographical and cultural factors.

Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults.

INTRODUCTION: Several theoretical models and intervention programs overlook the importance of individual motivations for the decision to have condomless sex. For instance, people focused on promotion (ie, eager to pursue pleasure) report less intentions to use condoms, because they perceive a lower risk of acquiring sexually transmitted infections. AIM: We aimed at understanding to what extent individual motivations are predictive of condomless sex behavior among single individuals. METHODS: A sample of 415 Portuguese individuals (254 women) with ages ranging from 18-46 years (M = 23.30; SD = 5.28) were recruited to a cross-sectional study. All participants were neither dating nor in a romantic relationship at the time of the study. The link to an anonymous web survey was shared in social networking platforms. MAIN OUTCOME MEASURE: The survey included self-reported demographic variables (eg, age and sex), recent condomless sex behavior, and previously validated measures assessing regulatory focus in sexuality, ability in sexual restraint, perceived control over condom use, perceived safety with sex partners, and salience of the condom use norm. RESULTS: More than two-thirds of the sample had recently engaged in condomless sex. A logistic regression showed that condomless sex was more likely for participants predominantly focused on promotion in sexuality. It was also more likely among less educated participants, those with a lower ability to restrain their sexual behavior, those who perceive to have less control over condom use, those for whom the condom use norm was less salient, and those who perceived to be safer with their sex partners. No other results were significant. CLINICAL IMPLICATIONS: Our results can be informative to sexual health care professionals when planning strategies to increase condom use awareness, by considering the role of specific individual motivations. STRENGTHS & LIMITATIONS: This is the first study showing that individual motivations uniquely contribute to the decision to have condomless sex. This study has 2 main limitations that constraint the generalizability of the findings: (a) cross-sectional data prevents us from establishing causality, and (b) individual data does not account for dyadic processes in sexuality (eg, condom use negotiation). CONCLUSION: Our findings showed that condomless sex results from an individual focus on seeking pleasure, a lack of control in sexual behavior, and a perception of sex partners as more trustworthy. Overall, these findings are likely to help researchers and health care professionals improving theoretical models predicting condom use and preventing the spread of sexually transmitted infections. Rodrigues DL, Lopes D, Pereira M, et al. Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults. J Sex Med 2020;17:26-36.

Perceived sexual self-control and condom use with primary and casual sex partners: age and relationship agreement differences in a Portuguese sample.

OBJECTIVE: Consistent condom use is still not ideal. Research showed that perceived sexual self-control is associated with greater likelihood of using condoms. However, this association seems to vary according to age and relationship agreement (i.e. non-consensual non-monogamy, NCNM vs. consensual non-monogamy, CNM). DESIGN: Cross-sectional study with 307 heterosexual users of a dating web site for romantically involved individuals (81.8% men; Mage = 42.24, SD = 9.65, range: 23-76 years). All individuals were in a romantic relationship (Mlength = 13.47 years, SD = 9.39). MEASURES: Demographic information, perceived sexual self-control, condom use frequency (casual sex partners; primary partner in the last 3 months) and relationship agreement. RESULTS: Independently of relationship agreement, perceived sexual self-control was positively associated with condom use frequency with casual sex partners among younger and middle age participants, but not older ones (>49 years). Regarding the primary partner, a similar pattern emerged for CNM participants. In contrast, no significant association between perceived sexual self-control and condom use frequency with the primary partner emerged for NCNM individuals, regardless of age. CONCLUSION: Our findings can inform evidence-based strategies to promote consistent condom use as an effective behaviour to prevent sexually transmitted infections, especially among older and NCNM individuals.

Sociosexual Attitudes and Quality of Life in (Non)Monogamous Relationships: The Role of Attraction and Constraining Forces Among Users of the Second Love Web Site.

Research has typically shown that unrestricted sociosexuality is negatively associated with relationship quality and that relationship quality is positively associated with quality of life (QoL). However, these findings may be restricted to individuals in monogamous relationships, especially those with prior extradyadic interactions (i.e., non-consensual non-monogamous; NCNM). Indeed, individuals in consensual non-monogamous (CNM) relationships have more unrestricted sociosexuality and are also more satisfied with and committed to their relationships. Still, little research has examined whether both relationship agreements are associated differently with attraction forces (wanting to be) and constraining forces (having to be) in the relationship and how they are related to QoL. We conducted a cross-sectional study with 373 heterosexuals (73.2% men, Mage = 41.15, SD = 10.18) registered on Second Love, a dating Web site for romantically involved individuals. Results showed differences in the hypothesized model, according to relationship agreement. For individuals in CNM relationships, unrestricted sociosexuality was associated with stronger attraction forces, which were then associated with greater QoL. The opposite pattern was found for those in NCNM relationships. Furthermore, and regardless of relationship agreement, unrestricted sociosexuality was associated with weaker constraining forces, which were associated with greater QoL. These results make a novel contribution to the literature on relationship agreements and how they relate to QoL.

Psychological Correlates of Attitudes toward Pet Relinquishment and of Actual Pet Relinquishment: The Role of Pragmatism and Obligation.

Understanding pet relinquishment is essential to inform interventions and assess their impact. In a cross-sectional study, we explored how attitudes of lack of obligation and pragmatism toward pet relinquishment correlated with, and differed according to, sociodemographic characteristics (age, gender, education, political orientation, religion, income, and household), previous animal experience, and owner perceptions of animals (perceiving pet as a burden, motives for pet relinquishment, regret having a pet, and general trust in pets). We adapted and developed three scales to measure attitudes toward pet relinquishment (ATPR), motives for pet relinquishment (MPR), and general trust in pets (GTP), revealing good psychometric qualities. Hierarchical linear regressions showed that attitudes of lack of obligation toward pet relinquishment were stronger in older people, those perceiving their pet as a burden, and those with lower general trust in pets. Attitudes of pragmatism toward pet relinquishment were stronger in men, those who were main pet caretakers, those perceiving their pet as a burden, those with higher motives for pet relinquishment, and those with lower general trust in pets. Furthermore, results showed that past pet relinquishment behavior was predicted by attitudes of pragmatism, but not attitudes of lack of obligation.

Motivations for Sexual Behavior and Intentions to Use Condoms: Development of the Regulatory Focus in Sexuality Scale.

Despite recurrent efforts to prevent sexually transmitted diseases through the use of condoms, HIV infections are still prevalent across Europe. Recent research framed by the regulatory focus theory has shown that prevention (vs. promotion)-focused individuals are more likely to adopt strategies to protect their health. Therefore, these individuals should also be more motivated to use condoms, because they are more likely to perceive greater health threats. In two cross-sectional preregistered studies (combined N = 520 Portuguese participants; databases available at https://doi.org/10.17605/osf.io/zzkc2 ), we developed the new Regulatory Focus in Sexuality scale (Study 1), and tested if the association between prevention focus and intentions to use condoms was mediated by the perception of health threat (Study 2). Results from Study 1 suggested that the scale is reliable and valid. Results from Study 2 showed, as expected, that a predominant focus on prevention was associated with more condom use intentions with casual and regular sexual partners, because individuals perceived greater threat to their health. Additional exploratory analyses further showed that this mediation occurred only for individuals without a romantic relationship and was independent of how salient the condom use norm was. In contrast, for romantically involved individuals, there was no evidence for the mediation by perceived health threat. Instead, a predominant focus on prevention was positively associated with condom use intentions with the regular partner, but only when the condom use norm was more salient. Taken together, these results emphasize the importance of examining individual motivations for safe sex practices.