The health belief model and the contraceptive behavior of college women: implications for health education

This study applied the "health belief model" in a comparison of the subjective perceptions, attitudes and beliefs between college women who were adequate or inadequate contraceptors. The 171 sexually active subjects were ascertained from clients of the Family Planning Clinic at the University of Illinois. A questionnaire was designed and tested to measure variables of perceived susceptibility to pregnancy, seriousness of unplanned pregnancy, benefits and barriers of contraceptive use. Inadequate contraceptors or risk-takers were defined as women who used no contraception, less effective methods such as rhythm, spermicides only or withdrawal, or effective methods sporadically. 49.5% of the subjects were risk-takers. Among the inadequate contraceptors, 17% were nonusers, 29% relied on ineffective methods, and 52% used effective methods sporadically. There was no difference between the 2 groups in their belief in seriousness of an unplanned pregnancy. The groups differed significantly in their perceived susceptibility to pregnancy (p.001). They also differed significantly in perception of overall costs and benefits of contraception (p.001), a score created by combining 12 questions on topics such as difficulty and embarrassment in obtaining contraceptives and inconvenience and awkwardness in dealing with them. There was a smaller significant difference (p.05) in a score termed "general use cost benefits," but no difference in a score called "method specific perceptions." These results were corroborated by a discriminate analysis which singled out the perceived costs and benefits and the perceived susceptibility variables as accurate predictors of the adequate contraceptor group. The health belief model showed considerable utility in explaining contraceptive behavior.     

Authorship and publication practices: evaluation of the effect of responsible conduct of research instruction to postdoctoral trainees

We have studied postdoctoral trainees funded by NIH F32 fellowship awards in order to test the effectiveness of responsible conduct of research (RCR) education in the areas of authorship and publication practices. We used a 3-wave telephone and on-line survey design, conducted over a period of two years, in order to test for individual change before and after completing RCR education. Overall the responses of the subjects suggested a clear awareness of standards and practices in publication. However, our results failed to suggest that RCR education in this group significantly increased the level of ethically appropriate behavioral responses measured in the study. Similarly we saw no significant effect on increasing awareness of or attention to ethical guidelines about authorship and publication practices. Our interpretation of these null findings was influenced by the significant publication experience of our cohort of subjects. We forward possible explanations for these null findings in this context. Most importantly, we do not suggest that our results argue against continued instruction in RCR education. Instead, we believe our data reinforce the importance of careful articulation of course goals and objectives with attention to the background and experience of the student audience when developing RCR curricula.     

Awareness of publication guidelines and the responsible conduct of research

We have conducted a longitudinal survey of NIH-funded F32 postdoctoral fellows to determine if mandated instruction in the responsible conduct of research (RCR) has measurable effects on awareness of, attentiveness to, and behavioral judgments about research ethics and authorship and publication. Of 418 F32 fellows participating in the study, 50% were aware of and had referred to guidelines on authorship and publication practices while 50% were either unaware of or had not referred to guidelines. Groups were similar with regard to total number of peer-reviewed publications and total number of first author publications, years of research experience, years since completing their doctoral degree, and receipt of RCR training. The equal distribution of guideline awareness and use, and group similarities with regard to career development and achievement provided us with an opportunity to consider whether awareness of and use of guidelines is associated with broader judgments about author roles and responsibilities. The findings suggest that awareness and utilization of guidelines are, at best, only modestly associated with more ethically appropriate judgments and attitudes about author roles and responsibilities among novice F32's.     

The Health Belief Model and the Contraceptive Behavior of College Women: Implications for Health Education

Abstract

“The Incidence of Primary Cardiac Arrest During Vigorous Exercise,” David S. Siscovick, et al. To examine the risk of primary cardiac arrest during vigorous exercise, we interviewed the wives of 133 men without known prior heart disease who had had primary cardiac arrest. Cases were classified according to their activity at the time of cardiac arrest and the amount of their habitual vigorous activity. From interviews with wives of a random sample of healthy men, we estimated the amount of time members of the community spent in vigorous activity.

Among men with low levels of habitual activity, the relative risk of cardiac arrest during exercise compared with that of other times was 56 (95% confidence limits, 23 to 131). The risk during exercise among men at the highest level of habitual activity was also elevated, but only by a factor of 5 (95% confidence limits, 2 to 14). However, among the habitually vigorous men, the overall risk of cardiac arrest—i.e., during and not during vigorous activity—was only 40% that of the sedentary men (95% confidence limits, 0.23 to 0.67).

Although the risk of primary cardiac arrest is transiently increased during vigorous exercise, habitual vigorous exercise is associated with an overall decreased risk of primary cardiac arrest. (New England Journal of Medicine 1984;311:874-7.)

“Osteoporosis in Women with Anorexia Nervosa,” Nancy A. Rigotti, et al. Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 ±0.06 vs. 0.72 ±0.04 g per square centimeter, P < 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes.

The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P < 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls.

We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons. (New England Journal of Medicine 1984;311:1601-6.)     

Awareness of Publication Guidelines and the Responsible Conduct of Research

We have conducted a longitudinal survey of NIH-funded F32 postdoctoral fellows to determine if mandated instruction in the responsible conduct of research (RCR) has measurable effects on awareness of, attentiveness to, and behavioral judgments about research ethics and authorship and publication. Of 418 F32 fellows participating in the study, 50% were aware of and had referred to guidelines on authorship and publication practices while 50% were either unaware of or had not referred to guidelines. Groups were similar with regard to total number of peer-reviewed publications and total number of first author publications, years of research experience, years since completing their doctoral degree, and receipt of RCR training. The equal distribution of guideline awareness and use, and group similarities with regard to career development and achievement provided us with an opportunity to consider whether awareness of and use of guidelines is associated with broader judgments about author roles and responsibilities. The findings suggest that awareness and utilization of guidelines are, at best, only modestly associated with more ethically appropriate judgments and attitudes about author roles and responsibilities among novice F32’s.     

Guiding the Next Generation of NIH Investigators in Responsible Conduct of Research: The Role of the Mentor

National Institutes of Health (NIH) K award recipients and their mentors were surveyed to investigate the role of the mentor. We found that a majority of mentors provided guidance in responsible research conduct (RCR), and that most of these relationships were deemed helpful. Mentors also responded that they played a greater importance in RCR training of their mentees than the mentees reported. Our results suggest both mentors and mentees report that mentors ideally should play a more important role in RCR training than was actually the case. For conflicting interests, subjects' protection, and misconduct, approximately 50% of K recipients found the mentor to be not at all important or only somewhat important for these areas of RCR training. We conclude the mentor's role is important but not optimal based on the results of our study cohort.     

Production planning in practice

The changes and pressures facing the manufacturing and engineering industries today are increasing the importance of effective aggregate manpower and production planning. Several different theoretical optimisation models to tackle this problem have been described in detail in the literature but there have been few applications of them in practice.The reasons for this are many but include: the difficulty in expressing managements' conflicting and mixed objectives in an objective function; the necessity to oversimplify real life systems to enable these methods to be used; the simplistic approach to manpower planning used in these models; the difficulty in gaining managements' acceptance and finally the fact that what management actually wants is a tool to assist them in planning and decision making.What is being used by many managements is a case-study deterministic simulation model. Many companies are adopting this type of model for all types of planning and twelve out of twenty-seven companies visited in a research project described in this paper were using this type of model for aggregate manpower and production planning. It is proving to be an effective management tool and is being readily accepted principally because modern specialised financial modelling languages are enabling these models to be built, understood and used by non-specialist managers.