28470691	As identity and agency are central to the well-being of people with dementia, this paper explores whether their dialogue conveys a gendered sense of identity and agency. The author discusses whether they demonstrate not just a subjective sense of being but also an understanding of their relational selves. Findings are presented from a qualitative study in the North of England which examined the everyday decisions made by married couples when one partner had dementia. Ethnographic methods were used, including participant observation and interviews. While dialogical analysis usually centres on the subjective self, it was also used to examine intersubjectivity. Comparisons are made between the dialogue of women and men in order to draw conclusions about the gendered nature of identity and agency. The study found that the women and men defined themselves according to their social and gender identities. The literature had suggested that agency might be a gendered concept and the study confirmed that men were somewhat individualistic and rational in their concerns, whereas women were more relational and even spiritual. Yet, women and men demonstrated emotional reflexivity. As national and international health policy prioritises living well with dementia, more systematic attention should be given to the role of gender in influencing well-being in dementia. Health and social care staff should recognise and facilitate the gender identity and related social roles of people with dementia (e.g. parent, carer and worker) in order to enhance their quality of life.
28461225	Control of voice fundamental frequency (F0) relies in part on comparison of the intended F0 level and auditory feedback. This comparison impacts "sense of agency", or SoA, commonly defined as being the agent of one's own actions and plays a key role for self-awareness and social interactions. SoA is aberrant in several psychiatric disorders. Knowledge about brain activity reflecting SoA can be used in clinical practice for these disorders. It was shown that perception of voice feedback as one's own voice, reflecting the recognition of SoA, alters auditory sensory processing. Using a voice perturbation paradigm we contrasted vocal and bioelectrical brain responses to auditory stimuli that differed in magnitude: 100 and 400 cents. Results suggest the different magnitudes were perceived as a pitch error in self-vocalization (100 cents) or as a pitch shift generated externally (400 cents). Vocalizations and neural responses to changes in pitch of self-vocalization were defined as those made to small magnitude pitch-shifts (100 cents) and which did not show differential neural responses to upward versus downward changes in voice pitch auditory feedback. Vocal responses to large magnitude pitch shifts (400 cents) were smaller than those made to small pitch shifts, and neural responses differed according to upwards versus downward changes in pitch. Our results suggest that the presence of SoA for self-produced sounds may modify bioelectrical brain responses reflecting differences in auditory processing of the direction of a pitch shift. We suggest that this modification of bioelectrical response can be used as a biological index of SoA. Possible neuronal mechanisms of this modification of bioelectrical brain response are discussed.
28453829	The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities.After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out.	Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy.	Census of medical and non-medical staff (n. 479).	Web-based self-administered questionnaire.	Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites.	Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant.	Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.	
28445007	Ultra-broadband light-absorbing materials are highly desired for effective solar-energy harvesting. Herein, novel cobalt phosphide double-shelled nanocages (CoP-NCs) are synthesized. Uniquely, these CoP-NCs are able to nonselectively absorb light spanning the full solar spectrum, benefiting from its electronic properties and hollow nanostructure. They promise a wide range of applications involving solar energy utilization. As proof-of-concept demonstrations, CoP-NCs are employed here as effective photothermal agents to ablate cancer cells by utilizing their ability of near-infrared heat conversion, and as photoactive material for self-powered photoelectrochemical sensing by taking advantage of their ability of photon-to-electricity conversion.
28412643	Time perception distorts across different phases of bodily movement. During motor execution, sensory feedback matching an internal sensorimotor prediction is perceived to last longer. The sensorimotor prediction also underlies sense of agency. We investigated association between subjective time and agency during voluntary action. Participants performed hand action while watching a video feedback of their hand with various delays to manipulate agency. The perceived duration and agency over the video feedback were judged. Minimal delay of the video feedback resulted in longer perceived duration than the actual duration and stronger agency, while substantial feedback delay resulted in shorter perceived duration and weaker agency. These fluctuations of perceived duration and agency were nullified by the feedback of other's hand instead of their own, but not by inverted feedback from a third-person perspective. Subjective time during action might be associated with agency stemming from sensorimotor prediction, and self-other distinction based on bodily appearance.
28390032	While ICU clerkships are commonplace in undergraduate medical education, little is known about how students learn there. This study aimed to explore students' perceptions of the ICU as a learning environment, the factors influencing their learning and any perceived differences between learning in the ICU and non-ICU settings.We used interpretivist methodology, a social cognitive theoretical framework and a qualitative descriptive strategy. Ten medical students and four graduate doctors participated in four semi-structured focus group discussions. Data were analyzed by six-step thematic data analysis. Peer debriefing, audit trail and a reflexive diary were used.	Social cognitive influences on learning were apparent in the discussions. Numerous differences emerged between ICU and non-ICU clinical clerkships, in particular an unfamiliarity with the environment and the complex illness, and difficulty preparing for the clerkship. A key emergent theme was the concept of three phases of student learning, termed pre-clerkship, early clerkship and learning throughout the clerkship. A social cognitive perspective identified changes in learner agency, self-regulatory activities and reciprocal determinism through these phases. The findings were used to construct a workplace model of undergraduate intensive care learning, providing a chronological perspective on the clerkship experience.	The ICU, a rich, social learning environment, is different in many respects to other hospital settings. Students navigate through three phases of an ICU clerkship, each with its own attendant emotional, educational and social challenges and with different dynamics between learner and environment. This chronological perspective may facilitate undergraduate educational design in the ICU.	
28371819	Strategies to promote patient involvement in medical error prevention have been implemented, but little is known about the effects of education on changes in perceptions and attitudes about patients' own safety.We administered a survey to military personnel admitted to the Armed Forces Capital Hospital. Responses were classified according to perception and attitude.	Single military hospital in Korea.	A total of 483 completed surveys were included in our study; 252 of the respondents received safety education at admission.	We provided educational program material to one-half of the patients at admission (intervention group). The other one-half of patients received no safety education (non-intervention group). We then performed two rounds of a self-administered survey, based on whether the patient received patient safety education. Cronbach's alpha was calculated to determine scale score reliability. Regression analysis was used to evaluate associations between education and change in scores.	Scores for perception and attitude were greater in the intervention group. The results of the regression analysis revealed that compared with the non-intervention respondents, the respondents who received education had higher perception (estimate: 7.809, P < 0.0001) and attitude scores (estimate: 5.539, P < 0.0001).	Our study results suggested that patient education was associated with higher scores in both perception and attitudes about safety. To improve patient engagement in this area, efficient methods that encourage patient empowerment should be developed. Specialized health care providers who provide patient level education are needed to achieve a satisfactory patient safety climate.	
28362073	HIV testing is key to the delivery of pre-exposure prophylaxis (PrEP): testing HIV-uninfected at-risk persons is the first step for PrEP initiation and ongoing HIV testing is an essential part of PrEP delivery. Thus, novel and cost-effective HIV-testing approaches to streamline delivery of PrEP are urgently needed. Within a demonstration project of PrEP for HIV prevention among high-risk HIV serodiscordant couples in Kenya (the Partners Demonstration Project), we conducted a pilot evaluation of HIV self-testing.Clinic visits were scheduled quarterly and included in-clinic HIV testing using fingerstick rapid HIV tests and refills of PrEP prescriptions. HIV oral fluid self-test kits were provided for participants to use in the two-month interval between scheduled quarterly clinic visits. Acceptability of HIV self-testing was assessed using both quantitative and qualitative methods.	We found that 222 of 226 (98%) HIV-uninfected persons who were offered accepted self-testing. Nearly all (96.8%) reported that using the self-testing kit was easy. More than half (54.5%) reportedly did not share the HIV results from self-testing with anyone and almost all (98.7%) the participants did not share the HIV self-testing kits with anyone. Many participants reported that HIV self-testing was empowering and reduced anxiety associated with waiting between clinic HIV tests.	HIV self-testing was highly acceptable and may therefore be a feasible strategy to efficiently permit routine HIV testing between PrEP refills.	
28357895	Autobiographical memories are particularly adaptive because they function not only to preserve the past, but also to direct our future thoughts and behaviours. Two studies were conducted to examine how communal and agentic themes of positive autobiographical memories differentially predicted the route from autobiographical memories to optimism for the future. Across two studies, results revealed that the degree to which participants focused on communal themes in their autobiographical memories predicted their experience of nostalgia. In turn, the experience of nostalgia increased participants' levels of self-esteem and in turn, optimism for the future. By contrast, the degree to which participants focused on agentic themes in their memories predicted self-esteem and optimism, operating outside the experience of nostalgia. These effects remained even after controlling for self-focused attention. Together, these studies provide greater understanding of the interrelations among autobiographical memory, self-concept, and time, and demonstrate how agency and communion operate to influence perceptions of one's future when thinking about the past.
28353499	Current knowledge about the interplay between emotions and professional identity formation is limited and largely based on research in Western settings. This study aimed to broaden understandings of professional identity formation cross-culturally.In fall 2014, the authors purposively sampled 22 clinical students from Taiwan and the Netherlands and asked them to keep audio diaries, narrating emotional experiences during clerkships using three prompts: What happened? What did you feel/think/do? How does this interplay with your development as a doctor? Dutch audio diaries were supplemented with follow-up interviews. The authors analyzed participants' narratives using a critical discourse analysis informed by Figured Worlds theory and Bakhtin's concept of dialogism, according to which people's spoken words create identities in imagined future worlds.	Participants talked vividly, but differently, about their experiences. Dutch participants' emotions related to individual achievement and competence. Taiwanese participants' rich, emotional language reflected on becoming both a good person and a good doctor. These discourses constructed doctors' and patients' autonomy in culturally specific ways. The Dutch construct centered on "hands-on" participation, which developed the identity of a technically skilled doctor, but did not address patients' self-determination. The Taiwanese construct located physicians' autonomy within moral values more than practical proficiency, and gave patients agency to influence doctor-patient relationships.	Participants' cultural constructs of physician and patient autonomy led them to construct different professional identities within different imagined worlds. The contrasting discourses show how medical students learn about different meanings of becoming doctors in culturally specific contexts.	
28314707	Stress experienced by law enforcement officers is often extreme and is in many ways unique among professions. Although past research on officer stress is informative, it is limited, and most studies measure stress using self-report questionnaires or observational studies that have limited generalizability. We know of no research studies that have attempted to track direct physiological stress responses in high fidelity, especially within an operational police setting. The outcome of this project will have an impact on both practitioners and policing researchers. To do so, we will establish a capacity to obtain complex, multisensor data; process complex datasets; and establish the methods needed to conduct idiopathic clinical trials on behavioral interventions in similar contexts.The objective of this pilot study is to demonstrate the practicality and utility of wrist-worn biometric sensor-based research in a law enforcement agency.	We will use nonprobability convenience-based sampling to recruit 2-3 participants from the police department in Durham, North Carolina, USA.	Data collection was conducted in 2016. We will analyze data in early 2017 and disseminate our results via peer reviewed publications in late 2017.	We developed the Biometrics & Policing Demonstration project to provide a proof of concept on collecting biometric data in a law enforcement setting. This effort will enable us to (1) address the regulatory approvals needed to collect data, including human participant considerations, (2) demonstrate the ability to use biometric tracking technology in a policing setting, (3) link biometric data to law enforcement data, and (4) explore project results for law enforcement policy and training.	
28293209	Some scholars have noted that an impressive number of self-related terms have been gradually introduced in the scientific literature. Several of these terms are either ill-defined or synonymous, creating confusion, and redundancy. In an effort to minimize this problem, I present a novel and systematic way of looking at possible relations between several key self-terms. I also propose a tentative classification scheme of self-terms as follows: (1) basic terms related to the overall process of self-perception (e.g., self-awareness), (2) non self-terms that are importantly associated to some other self-terms (e.g., consciousness and Theory of Mind), (3) processes related to the executive self and involving agency, volition, and self-control (e.g., self-regulation), and (4) self-views, that is, the content and feelings about the self (e.g., self-esteem). Three additional categories not discussed in this paper are self-biases, reactions to the self, and interpersonal style. Arguably unambiguous definitions for some of the most important and frequently used self-terms are suggested. These are presented in tables meant for the reader to search for definitions as well as related terms.
28287928	Vibration applied to muscle tendons induces an illusory perception of movement by activating spindle receptors and Ia afferent fibers. While neural structures supporting such illusions are quite defined, functional and psychophysical correlates of their perception have not been deeply investigated. The authors aimed at exploring subjective perception of illusory movements thanks to a repeated-stimulation multimodal approach. The integrated analysis of electroencephalography, source data (standardized low-resolution brain electromagnetic tomography-sLORETA), and psychophysical evaluation pointed at the activation of a frontoparietal sensorimotor network, with prefrontal-medial regions mainly involved in supporting the awareness for illusory movements. Further, illusions showed consistency in terms of presence, vividness, and duration. Finally, superior parietal structures seemed to play an important role in self-attribution of agency and ownership during such experiences.
28281051	This initial study examined a therapist-led, synchronous, online support group (OSG) with psycho-education (OSG + E) compared to self-help psycho-education (E). The study aims were to examine proof of concept-feasibility, acceptability, and usefulness-and to hone methods for a formal RCT.One hundred five young breast cancer survivors (<50 years) post-treatment were randomized either to OSG + E or E. OSG + E received a therapist-led 10-week synchronous online intervention. E received a self-help workbook. Assessments were at baseline, 10 weeks, and 3 months, with willing OSG + E members completing post-study interviews. Researchers used inductive analysis, generating qualitative themes for feasibility, acceptability, and usefulness. We examined trajectories for one primary and two secondary quantitative outcomes and a combined moderator to discover who preferentially benefitted from the intervention.	Qualitative analyses revealed that synchronous chat was at times challenging, but minimal technical coaching, structure, set topics, and professional facilitation enabled conversations that were focused and meaningful. A combined moderator indicated that generally more women benefitted from OSG + E relative to E and particularly those women in semi-rural and rural areas.	This study suggests that therapist-led synchronous OSGs are feasible, acceptable, and useful for young breast cancer survivors and that a future RCT with a larger sample size, perhaps more focused on non-urban areas, is needed to establish its effectiveness.	
28270779	Previous research has suggested that stability of self-concept differs across cultures: in North American cultural contexts, people's self-concept is stable across social contexts, whereas in Japan, different self-concepts are activated within specific social contexts. We examined the implications of this cultural difference for preference-choice consistency, which is people's tendency to make choices that are consistent with their preferences. We found that Japanese were less likely than Americans to choose items that they liked the most, showing preference-choice inconsistency. We also investigated the conditions in which Japanese might exhibit greater preference-choice consistency. Consistent with research showing that in Japanese culture, the self is primarily conceptualized and activated by social contexts, we found that subtle social cues (e.g., schematic representations of human faces) increased preference-choice consistency among Japanese, but not among Americans. These findings highlight that choices do not reveal preferences to the same extent in all cultures, and that the extent to which choices reveal preferences depends on the social context.
28259606	Group voice therapy has been successfully used in patients with dysphonia, but there is little objectively documented evidence of its effects on voice quality and the self-perception of voice fatigue. The aim of this study was to investigate the effectiveness of group therapy in patients with functional dysphonia and minor anatomic vocal fold pathologies linked by appearance and history to voice use in an objective and multidimensional manner.This is a prospective longitudinal study.	Before and after treatment, 34 adult women underwent perceptual voice assessments using the grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) scale, Evaluation Vocale Assistée (EVA) system aerodynamic and acoustic assessments, and maximum phonation time measurements, and made subjective evaluations using the Voice Handicap Index. The pretreatment baseline values of the participants were obtained by means of two examinations separated by an interval of 1 week. The parameters belonging to each main dimension were clustered by means of Z-transformation, and the corresponding Z-scores were analyzed.	Group therapy was associated with a statistically significant improvement in the perceptual (P = 0.008), acoustic (P = 0.040), aerodynamic (P = 0.009 and <0.001), and self-evaluation parameters (P = 0.011).	Our findings provide evidence that group voice therapy can be associated with improvements in perceptual, acoustic, aerodynamic, and self-evaluated parameters in some patients with dysphonia. Controlled, randomized studies are needed in follow-up. This method of treatment may be a means of reducing the costs and waiting lists associated with rehabilitative treatment, and enhancing patients' motivation and compliance.	
28255094	The primary purpose of this study is to evaluate the relative effectiveness of 2 of the best developed and most promising forms of therapy for problem gambling, namely face-to-face motivational interviewing (MI) combined with a self-instruction booklet (W) and follow-up telephone booster sessions (B; MI+W+B) and face-to-face cognitive-behavioural therapy (CBT).This project is a single-blind pragmatic randomised clinical trial of 2 interventions, with and without the addition of relapse-prevention text messages. Trial assessments take place pretreatment, at 3 and 12 months. A total of 300 participants will be recruited through a community treatment agency that provides services across New Zealand and randomised to up to 10 face-to-face sessions of CBT or 1 face-to-face session of MI+W+up to 5 B. Participants will also be randomised to 9 months of postcare text messaging. Eligibility criteria include a self-perception of having a current gambling problem and a willingness to participate in all components of the study (eg, read workbook). The statistical analysis will use an intent-to-treat approach. Primary outcome measures are days spent gambling and amount of money spent per day gambling in the prior month. Secondary outcome measures include problem gambling severity, gambling urges, gambling cognitions, mood, alcohol, drug use, tobacco, psychological distress, quality of life, health status and direct and indirect costs associated with treatment.	The research methods to be used in this study have been approved by the Ministry of Health, Health and Disability Ethics Committees (HDEC) 15/CEN/99. The investigators will provide annual reports to the HDEC and report any adverse events to this committee. Amendments will also be submitted to this committee. The results of this trial will be submitted for publication in peer-reviewed journals and as a report to the funding body. Additionally, the results will be presented at national and international conferences.	ACTRN12615000637549.	
28251993	In adult life, people normally know what they are doing. This experience of controlling one's own actions and, through them, the course of events in the outside world is called 'sense of agency'. It forms a central feature of human experience; however, the brain mechanisms that produce the sense of agency have only recently begun to be investigated systematically. This recent progress has been driven by the development of better measures of the experience of agency, improved design of cognitive and behavioural experiments, and a growing understanding of the brain circuits that generate this distinctive but elusive experience. The sense of agency is a mental and neural state of cardinal importance in human civilization, because it is frequently altered in psychopathology and because it underpins the concept of responsibility in human societies.
28206792	People overestimate themselves in domains that are central to their self-concept. Critically, the psychological status of this "self-centrality principle" remains unclear. One view regards the principle as an inextricable part of human nature and, thus, as universal and resistant to normative pressure. A contrasting view regards the principle as liable to pressure (and subsequent modification) from self-effacement norms, thus questioning its universality. Advocates of the latter view point to Christianity's robust self-effacement norms, which they consider particularly effective in curbing self-enhancement, and ascribe Christianity an ego-quieting function. Three sets of studies examined the self-centrality principle among Christians. Studies 1A and 1B (N = 2,118) operationalized self-enhancement as better-than-average perceptions on the domains of commandments of faith (self-centrality: Christians ≫ nonbelievers) and commandments of communion (self-centrality: Christians > nonbelievers). Studies 2A-2H (N = 1,779) operationalized self-enhancement as knowledge overclaiming on the domains of Christianity (self-centrality: Christians ≫ nonbelievers), communion (self-centrality: Christians > nonbelievers), and agency (self-centrality: Christians ≈ nonbelievers). Studies 3A-3J (N = 1,956) operationalized self-enhancement as grandiose narcissism on the domains of communion (self-centrality: Christians > nonbelievers) and agency (self-centrality: Christians ≈ nonbelievers). The results converged across studies, yielding consistent evidence for Christian self-enhancement. Relative to nonbelievers, Christians self-enhanced strongly in domains central to the Christian self-concept. The results also generalized across countries with differing levels of religiosity. Christianity does not quiet the ego. The self-centrality principle is resistant to normative pressure, universal, and rooted in human nature. (PsycINFO Database Record
28182482	Both human infants and nonhuman primates can recognize unfamiliar entities as instrumental agents ascribing to them goals and efficiency of goal-pursuit. This competence relies on movement cues indicating distal sensitivity to the environment and choice of efficient goal-approach. Although dogs' evolved sensitivity to social cues allow them to recognize humans as communicative agents, it remains unclear whether they have also evolved a basic concept of instrumental agency. We used a preferential object-choice procedure to test whether adult pet dogs and human toddlers can identify unfamiliar entities as agents based on different types of movement cues that specify different levels of agency. In the navigational agency condition, dogs preferentially chose an object that modified its pathway to avoid collision with obstacles over another object showing no evidence of distal sensitivity (regularly bumping into obstacles). However, in the goal-efficiency condition where neither object collided with obstacles as it navigated toward a distal target, but only 1 of them exhibited efficient goal-approach as well, toddlers, but not dogs, showed a preference toward the efficient goal-directed agent. These findings indicate that dogs possess a limited concept of environmentally sensitive navigational agency that they attribute to self-propelled entities capable of modifying their movement to avoid colliding with obstacles. Toddlers, in contrast, demonstrated clear sensitivity to cues of efficient variability of goal-approach as the basis for differentiating, attributing, and showing preference for goal-directed instrumental agency. (PsycINFO Database Record
28077329	Stroke can lead to motor impairments that can affect the body structure and restraint mobility. We hypothesize that brain lesions and their motor sequelae can distort the body schema, a sensorimotor map of body parts and elements in the peripersonal space through which human beings embody the reachable space and ready the body for forthcoming movements. Two main constructs have been identified in the embodiment mechanism: body-ownership, the sense that the body that one inhabits is his/her own, and agency, the sense that one can move and control his/her body. To test this, the present study simultaneously investigated different embodiment subcomponents (body-ownership, localization, and agency) and different neurophysiological measures (galvanic skin response, skin temperature, and surface electromyographic activity), and the interaction between them, in clinically-controlled hemiparetic individuals with stroke and in healthy subjects after the rubber hand illusion. Individuals with stroke reported significantly stronger body-ownership and agency and reduced increase of galvanic skin response, skin temperature, and muscular activity in the stimulated hand. We suggest that differences in embodiment could have been motivated by increased plasticity of the body schema and pathological predominance of the visual input over proprioception. We also suggest that differences in neurophysiological responses could have been promoted by a suppression of the reflex activity of the sympathetic nervous system and by the involvement of the premotor cortex in the reconfiguration of the body schema. These results could evidence a body schema plasticity promoted by the brain lesion and a main role of the premotor cortex in this mechanism.
28075038	Change in cognitive ability is a commonly reported adverse effect by breast cancer survivors. The underlying etiology of cognitive complaints is unclear and to date, there is limited evidence for effective intervention strategies. Exercise has been shown to improve cognitive function in older adults and animal models treated with chemotherapy. This proof-of-concept randomized controlled trial tested the effect of aerobic exercise versus usual lifestyle on cognitive function in postmenopausal breast cancer survivors.Women, aged 40 to 65 years, postmenopausal, stages I to IIIA breast cancer, and who self-reported cognitive dysfunction following chemotherapy treatment, were recruited and randomized to a 24-week aerobic exercise intervention (EX; n = 10) or usual lifestyle control (CON; n = 9). Participants completed self-report measures of the impact of cognitive issues on quality of life (Functional Assessment of Cancer Therapy-Cognitive version 3), objective neuropsychological testing, and functional magnetic resonance imaging at baseline and 24 weeks.	Compared to CON, EX had a reduced time to complete a processing speed test (trail making test-A) (-14.2 seconds, P < .01; effect size 0.35). Compared to CON, there was no improvement in self-reported cognitive function and effect sizes were small. Interestingly, lack of between-group differences in Stroop behavioral performance was accompanied by functional changes in several brain regions of interest in EX compared to CON at 24 weeks.	These findings provide preliminary proof-of-concept results for the potential of aerobic exercise to improve cancer-related cognitive impairment and will serve to inform the development of future trials.	
28068961	Within work sociology, several studies have addressed construction workers' practices of masculinity, class, economy, safety risks and production. However, few studies have investigated room for agency in relation to bodily pain or musculoskeletal disorders and even fewer have made a quantitative approach. Accordingly, by means of a questionnaire, we examined the association between construction workers' room for agency and physical exertion, bodily and mental fatigue, and lower back pain.A total of 481 Danish construction workers who responded to a multifaceted questionnaire were included. Drawing on previous studies and a Foucauldian inspired concept of agency, agency was quantified through specially crafted questions and examined in relation to established measures on physical exertion, physical and mental fatigue and pain in the lower back. Associations were tested using analyses of variance (general linear models) and controlled for age, gender, job group, lifestyle and depression.	When asked about options for agency reducing the burden of work, few workers believed themselves to be prime agents of such practices. When asking about their view on performing alternative agency implying caring for the body, 39-49% expected negative reactions from management, and 20-33% expected negative reactions from colleagues. In contrast, only 13-18% of the participants stated that they would give a negative reception to such alternative practices. Using the expected reception outcomes (positive, neutral, negative) to alternative practices as predictors, the statistical regression analyses showed that negative expectations to management were associated with higher levels of physical exertion 0.62 (95% CI = 0.14-1.09) (scale 0-11), bodily fatigue 0.63 (95% CI = 0.22-1.04), mental fatigue 0.60 (95% CI = 0.07-1.12), and low back pain 0.79 (95% CI = 0.13-1.46) (scales 0-10).	In our study, construction workers answered questions about work and MSD. The answers indicated a contradiction between perceived responsibility and room for agency. Based on the study, a number of target areas could fruitfully be addressed in aiming to reduce MSD among construction workers. To change workers' expectances to the reception of lowering work pace if needed to take care of the body, their expectances to the reception of sickness absence as a result of pain, of discussing physical exertion in work and of demanding appropriate technical assistive devices are such examples. Our results emphasize that management plays an important role in this.	
28068502	This paper, written from a relational perspective, examines the final minutes of an individual psychotherapy session, and is organized around the topics of boundary negotiation, unwitting self-disclosures, visual challenges, and countertransference. Attending to session-ending material is important because the separation involved lends heightened emotional intensity to the oftensignificant material that appears in the final minutes. This material often serves as a bridge to the psychotherapeutic work to be taken up in subsequent sessions. Session-ending dynamics call upon the therapist to prioritize empathy, validation, and support for the patient suffering from early deprivation; identify and heal narcissistic injury in the patient wishing to be special; judiciously alter the frame when doing so will benefit the patient and not constitute a boundary violation; avoid re-traumatization; admit mistakes; confront blatant denial; advance agency; address uncomfortable topics; set appropriate limits; and deal authentically with uncomfortable countertransference. Numerous clinical examples serve to illustrate these clinical phenomena.
27977085	Notre objectif visait à étudier les variables liées au bien-être, mesurées par une autoévaluation de la santé mentale (AESM) très positive et une satisfaction élevée à l’égard de la vie (SV) chez des adultes canadiens (âgés de 18 ans et plus) présentant un trouble de l’humeur ou d'anxiété.Nous avons utilisé des données nationales représentatives tirées de l’Enquête sur les personnes ayant une maladie chronique au Canada – Composante des troubles de l’humeur et d’anxiété (EPMCC-TAH) de 2014 afin de décrire l’association entre bien-être et comportements d’autogestion (activité physique, sommeil et méditation) ainsi que stress, adaptation et soutien social perçus. Nous avons eu recours à une régression logistique multivariée pour modéliser la relation entre ces facteurs et les mesures du bien-être.	Environ une personne sur trois atteinte d’un trouble de l’humeur ou d’anxiété a fait état d'une AESM positive. Les modèles de régression logistique ont révélé que plusieurs caractéristiques, comme un âge plus avancé, une autoévaluation de la santé générale positive, des limitations fonctionnelles moins nombreuses ainsi que la perception d’un moindre stress à l’égard de la vie, de meilleures capacités d’adaptation et d’un plus grand soutien social, étaient associées à des niveaux de bien-être plus élevés. Les comportements d’autogestion (entamer une activité physique, méditer, adopter de saines habitudes de sommeil et atteindre un certain nombre d’heures de sommeil chaque nuit) n’étaient pas significativement associés à des mesures du bien-être dans notre modèle multivarié.	Les adultes canadiens souffrant de troubles de l’humeur ou d'anxiété qui ont déclaré percevoir un niveau de stress plus faible, un plus grand soutien social et une meilleure capacité d’adaptation étaient plus susceptibles de déclarer également des scores de bien-être plus élevés. Cette étude a fourni des données probantes à partir d’un échantillon représentatif de la population montrant qu’il est possible de vivre dans un état de bien-être même en présence d’un trouble de l'humeur ou d'anxiété.	Our objective was to examine variables associated with well-being as measured by high self-rated mental health (SRMH) and life satisfaction (LS), among Canadian adults (aged 18+) living with a mood and/or an anxiety disorder.	We used nationally representative data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorders Component (SLCDC-MA) to describe the association between well-being and self-management behaviours (physical activity, sleep and meditation) as well as perceived stress, coping and social support. We used multivariate logistic regression to model the relationship between these factors and measures of well-being.	Approximately one in three individuals with mood and/or anxiety disorders reported high SRMH. The logistic regression models demonstrated that several characteristics such as being older, and reporting higher self-rated general health, fewer functional limitations, lower levels of perceived life stress, higher levels of perceived coping and higher levels of perceived social support were associated with higher levels of wellbeing. Self-management behaviours (including starting physical activity, meditation, adopting good sleep habits and attaining a certain number of hours of nightly sleep) were not significantly associated with measures of well-being in our multivariate model.	Canadian adults with mood and/or anxiety disorders who reported lower levels of perceived stress and higher levels of social support and coping were more likely to report high levels of well-being. This study contributes evidence from a representative population-based sample indicating well-being is achievable, even in the presence of a mood and/or an anxiety disorder.	
27965556	Feeling embodiment over our body or body part has a major role in the understanding of the self and control of self-actions. Even though it is crucial in our daily life, embodiment is not an homogenous phenotype across population, as quantified by implicit and explicit measures (i.e., neuroimaging or self-reports). Studies have shown differences in neuropathological conditions compared to healthy controls, but also across healthy individuals. We discuss examples of self-perception differences, and the molecular origin of embodiment, focusing on clinical cases, during the first and second section. We then discuss two important questions in this molecular-to-embodiment relationship: (i) which are the molecular levels (and their associated techniques) that can be relevant to embodiment, and (ii) which are the most adequate experiments to correlate molecular profiles and embodiment quantification across individuals. Potential answers for both questions will be outlined during the third and fourth sections, respectively, in order to design a framework to study the molecular profile of body embodiment.
27920737	Agency (A) and communion (C) are fundamental content dimensions. We propose a facet-model that differentiates A into assertiveness (AA) and competence (AC) and C into warmth (CW) and morality (CM). We tested the model in a cross-cultural study by comparing data from Asia, Australia, Europe, and the USA (overall N = 1.808). Exploratory and confirmatory factor analyses supported our model. Both the two-factor model and the four-factor model showed good fit indices across countries. Participants answered additional measures intended to demonstrate the fruitfulness of distinguishing the facets. The findings support the model's construct validity by positioning the fundamental dimensions and their facets within a network of self-construal, values, impression management, and the Big Five personality factors: In all countries, A was related to independent self-construal and to agentic values, C was related to interdependent self-construal and to communal values. Regarding the facets, AA was always related to A values, but the association of AC with A values fell below our effect size criterion in four of the five countries. A (both AA and AC) was related to agentic impression management. However, C (both CW and CM) was neither related to communal nor to agentic impression management. Regarding the Big Five personality factors, A was related to emotional stability, to extraversion, and to conscientiousness. C was related to agreeableness and to extraversion. AA was more strongly related to emotional stability and extraversion than AC. CW was more strongly related to extraversion and agreeableness than CM. We could also show that self-esteem was more related to AA than AC; and that it was related to CM, but not to CW. Our research shows that (a) the fundamental dimensions of A and C are stable across cultures; and (b) that the here proposed distinction of facets of A and C is fruitful in analyzing self-perception. The here proposed measure, the AC-IN, may be a useful tool in this research area. Applications of the facet model in social perception research are discussed.
27885971	Perceptions of menstruation by media discourses portray this bodily function to be messy, inconvenient, and as an unnecessary phenomenon to be controlled or possibly eliminated. Commercials shown on YouTube targeted toward young women suggest that having a monthly period is not healthy and a lifestyle that is menses free is both pharmacologically available and recommended in order to live a fuller life. We explored the meanings attached to online menstrual suppression commercials with 10 women aged between 18 and 25. In-depth open-ended interviews were conducted over a 10-month period in 2014 after each participant viewed three menstrual suppression online advertisements. Feminist critical discourse was used for analysis with both authors coding for inter-rater reliability recognizing how our age difference and relationship as mother and daughter informed our interpretation. An overarching theme of tension emerged from the interviews with participants feeling detached due to the gendered stereotypes the commercials used to frame menstruation as compared to their own lived experience. Meanings associated with the menstrual suppression commercials were contrary to the participants' lived experience of menstruation as a healthy process not a detrimental one to their well-being as suggested by the commercials. Subliminal messages within the advertisements were identified as reinforcing gender bias and prejudices, including those associated with femininity. Despite attempting to emulate popular culture, the menstrual suppression advertisements were largely dismissed by this group of participants as undermining their intelligence and of intentionally creating divisive binaries between groups of women. This study suggests that historical bias and stereotypical prejudices were identified by this group of young women within the marketing of menstrual suppression products and, as such, were dismissed as inauthentic to the menstruation experience reflecting a form of menstrual activism.
27882504	The concept of free will has been heavily debated in philosophy and the social sciences. Its alleged importance lies in its association with phenomena fundamental to our understandings of self, such as autonomy, freedom, self-control, agency, and moral responsibility. Consequently, when neuroscience research is interpreted as challenging or even invalidating this concept, a number of heated social and ethical debates surface. We undertook a content analysis of media coverage of Libet's et al.'s (Brain 106(Pt 3):623-642, 1983) landmark study, which is frequently interpreted as posing a serious challenge to the existence of free will. Media descriptions of Libet et al.'s experiment provided limited details about the original study. Overall, many media articles reported that Libet et al.'s experiments undermined the existence of free will, despite acknowledging that several methodological limitations had been identified in the literature. A propensity to attribute greater credibility than warranted to neurobiological explanations could be at stake.
27852419	The aim of this study was to explore cancer survivors' return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants' external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors' transition through the RTW journey towards optimal coping phases.
27826275	The concept of self-representation is commonly decomposed into three component constructs (sense of embodiment, sense of agency, and sense of presence), and each is typically investigated separately across different experimental contexts. For example, embodiment has been explored in bodily illusions; agency has been investigated in hypnosis research; and presence has been primarily studied in the context of Virtual Reality (VR) technology. Given that each component involves the integration of multiple cues within and across sensory modalities, they may rely on similar underlying mechanisms. However, the degree to which this may be true remains unclear when they are independently studied. As a first step toward addressing this issue, we manipulated a range of cues relevant to these components of self-representation within a single experimental context. Using consumer-grade Oculus Rift VR technology, and a new implementation of the Virtual Hand Illusion, we systematically manipulated visual form plausibility, visual-tactile synchrony, and visual-proprioceptive spatial offset to explore their influence on self-representation. Our results show that these cues differentially influence embodiment, agency, and presence. We provide evidence that each type of cue can independently and non-hierarchically influence self-representation yet none of these cues strictly constrains or gates the influence of the others. We discuss theoretical implications for understanding self-representation as well as practical implications for VR experiment design, including the suitability of consumer-based VR technology in research settings.
27812138	We define gaze agency as the awareness of the causal effect of one's own eye movements in gaze-contingent environments, which might soon become a widespread reality with the diffusion of gaze-operated devices. Here we propose a method for measuring gaze agency based on self-monitoring propensity and sensitivity. In one task, naïf observers watched bouncing balls on a computer monitor with the goal of discovering the cause of concurrently presented beeps, which were generated in real-time by their saccades or by other events (Discovery Task). We manipulated observers' self-awareness by pre-exposing them to a condition in which beeps depended on gaze direction or by focusing their attention to their own eyes. These manipulations increased propensity to agency discovery. In a second task, which served to monitor agency sensitivity at the sensori-motor level, observers were explicitly asked to detect gaze agency (Detection Task). Both tasks turned out to be well suited to measure both increases and decreases of gaze agency. We did not find evident oculomotor correlates of agency discovery or detection. A strength of our approach is that it probes self-monitoring propensity-difficult to evaluate with traditional tasks based on bodily agency. In addition to putting a lens on this novel cognitive function, measuring gaze agency could reveal subtle self-awareness deficits in pathological conditions and during development.
26743453	Constructs such as personal recovery, patient engagement and consumer involvement are central in mental health care delivery. These approaches emphasise the importance of empowerment and choice.Under some circumstances Involuntary Treatment Orders (ITO) allow a person to be treated for a mental illness without their consent. This study explores the tensions between the principles of empowerment and control and involuntary treatment.	Twenty-five involuntary inpatients of a major teaching hospital were interviewed about their experiences of being placed under an ITO. The interviews were analysed thematically.	Being able to have some sense of agency and re-asserting personal control are critical components of an involuntary mental health admission. Participants wanted information about their treatment, the ITO process and their environment. They also spoke about the importance of a space where they felt safe from themselves and others to make sense of the experience.	This study suggests that for coercive treatment to aid, rather than disrupt recovery, treatment services need to focus on: the provision of rights; the creation of a sense of safety; establishing supportive relationships; carrying hope and finding ways to foster a strong sense of agency and empowerment.	
27742666	The first brain-wide voxel-level resting state functional connectivity neuroimaging analysis of depression is reported, with 421 patients with major depressive disorder and 488 control subjects. Resting state functional connectivity between different voxels reflects correlations of activity between those voxels and is a fundamental tool in helping to understand the brain regions with altered connectivity and function in depression. One major circuit with altered functional connectivity involved the medial orbitofrontal cortex Brodmann area 13, which is implicated in reward, and which had reduced functional connectivity in depression with memory systems in the parahippocampal gyrus and medial temporal lobe, especially involving the perirhinal cortex Brodmann area 36 and entorhinal cortex Brodmann area 28. The Hamilton Depression Rating Scale scores were correlated with weakened functional connectivity of the medial orbitofrontal cortex Brodmann area 13. Thus in depression there is decreased reward-related and memory system functional connectivity, and this is related to the depressed symptoms. The lateral orbitofrontal cortex Brodmann area 47/12, involved in non-reward and punishing events, did not have this reduced functional connectivity with memory systems. Second, the lateral orbitofrontal cortex Brodmann area 47/12 had increased functional connectivity with the precuneus, the angular gyrus, and the temporal visual cortex Brodmann area 21. This enhanced functional connectivity of the non-reward/punishment system (Brodmann area 47/12) with the precuneus (involved in the sense of self and agency), and the angular gyrus (involved in language) is thus related to the explicit affectively negative sense of the self, and of self-esteem, in depression. A comparison of the functional connectivity in 185 depressed patients not receiving medication and 182 patients receiving medication showed that the functional connectivity of the lateral orbitofrontal cortex Brodmann area 47/12 with these three brain areas was lower in the medicated than the unmedicated patients. This is consistent with the hypothesis that the increased functional connectivity of the lateral orbitofrontal cortex Brodmann area 47/12 is related to depression. Relating the changes in cortical connectivity to our understanding of the functions of different parts of the orbitofrontal cortex in emotion helps to provide new insight into the brain changes related to depression.
27720024	This study presents British farmers' perception of, and barriers to, implementing Salmonella control on pig farms. Four farms that had implemented interventions and their 33 close contacts (known to the intervention farmers) took part in interviews before (phase 1) and after (phase 2) intervention trials to assess the difference in perception over time. Their results were compared against those from nine randomly selected control farms. The hypothesis was that farms implementing interventions whether or not successful, would influence their close contacts' opinion over time. Based on a 'pathway to disease control' model, three intrinsic factors known to influence motivation - attitudes, social norms and self-efficacy - were evaluated. Farmers mentioned that successful interventions on a farm would attract their attention. The use of an appropriate communication strategy is therefore recommended to stimulate farmers' intent to implement control measures. Both before and after the intervention trials, all farmers had a positive attitude towards Salmonella control and felt that their peers and authorities were supportive of controlling Salmonella on farms. In phase 2, however, farmers were more likely to want to share the burden of control with other stakeholders along the food chain and their belief in self-efficacy had weakened. Whilst social norms were not associated with an intention to take action on control, a positive attitude towards Salmonella control and a belief in self-efficacy were more likely to result in an intent to control. In phase 2, farmers with an intent to implement an intervention appeared to have a greater, but not significant positive belief in self-efficacy (p=0.108). This study confirmed that farmers recognised their responsibility for controlling Salmonella in pork - even though their confidence in their ability to control Salmonella decreased over time - and believed that responsibility should be shared with the rest of the production chain. It showed that farmers trusted their veterinarian as a source of advice to guide them during the process of implementing change, though an increase in farms' Salmonella seroprevalence score (Zoonosis National Control Programme (ZNCP) score) especially for those with a low ZNCP score was also likely to influence their behaviour. Getting concrete feedback from customers or a tangible benefit from their action was a strong incentive especially for farms with a ZNCP score higher than 50%. The study also revealed a need to validate which measures are effective as farmers did not perceive that the current advised interventions were worth the additional effort.
27670921	Cette étude visait à évaluer le biais dans la mesure de l’indice de masse corporelle (IMC) dans l’Enquête canadienne sur l’expérience de la maternité (ECEM) ainsi que les répercussions possibles de ce biais sur l’association entre l’IMC et certaines issues de grossesse.Nous avons évalué la répartition des valeurs de l’IMC en comparant des données autodéclarées et des données mesurées. Nous avons utilisé un échantillon aléatoire de 6 175 participantes à l’ECEM dont l’IMC avait été calculé d’après la taille et le poids autodéclarés et un échantillon aléatoire de 259 participantes à l’Enquête canadienne sur les mesures de santé (ECMS) ayant déjà accouché et dont l’IMC avait été calculé d’après la taille et le poids autodéclarés et mesurés. Nous avons appliqué deux équations de correction à l’IMC fondé sur des valeurs autodéclarées, et nous avons examiné l’impact de ces corrections sur les associations entre l’IMC et un accouchement par césarienne, un faible poids pour l’âge gestationnel (FPAG) et un poids élevé pour l’âge gestationnel (PEAG).	Dans l’ensemble, 86,9 % des femmes du sous-échantillon de l’ECMS appartenaient à la même catégorie d’IMC lorsque ses valeurs étaient autodéclarées et lorsqu’elles étaient mesurées. Cependant, les différences de répartition ont eu un effet considérable sur la proportion de femmes des catégories de poids insuffisant et d’obésité. Par exemple, le pourcentage de femmes classées comme obèses était de 14,5 % avec les données autodéclarées contre 20,8 % avec les données mesurées. Les corrections ont permis d’améliorer les estimations de la prévalence de l’obésité, mais ont surestimé ou sous-estimé les autres catégories d’IMC. Les corrections ont eu un effet non significatif sur les associations entre l’IMC et l’accouchement par césarienne, le FPAG et le PEAG.	Bien que la concordance pour la répartition des valeurs de l’IMC entre la taille et le poids autodéclarés et la taille et le poids mesurés soit élevée, il existe un biais dans les mesures fondées sur les valeurs autodéclarées susceptible d’entraîner de légères surestimations ou sous-estimations des risques associés à une catégorie d’IMC donnée. La tendance générale des associations reste néanmoins inchangée.	The objective of this study was to assess bias in the body mass index (BMI) measure in the Canadian Maternity Experiences Survey (MES) and possible implications of bias on the relationship between BMI and selected pregnancy outcomes.	We assessed BMI classification based on self-reported versus measured values. We used a random sample of 6175 women from the MES, which derived BMI from self-reported height and weight, and a random sample of 259 women who had previously given birth from the Canadian Health Measures Survey (CHMS), which derived BMI from self-reported and measured height and weight. Two correction equations were applied to self-reported based BMI, and the impact of these corrections on associations between BMI and caesarean section, small-for-gestational age (SGA) and large-for-gestational age (LGA) births was studied.	Overall, 86.9% of the CHMS subsample was classified into the same BMI category based on self-reported versus measured data. However, misclassification had a substantial effect on the proportion of women in underweight and obese BMI categories. For example, 14.5% versus 20.8% of women were classified as obese based on self-reported data versus measured data. Corrections improved estimates of obesity prevalence, but over- and underestimated other BMI categories. Corrections had nonsignificant effects on the associations between BMI and SGA, LGA, and caesarean section.	While there was high concordance in BMI classification based on selfreported versus measured height and weight, bias in self-reported based measures may slightly over- or underestimate the risks associated with a particular BMI class. However, the general trend in associations is unaffected.	
27642658	Affective valence is a core component of all emotional experiences. Building on recent evidence and theory, we reason that valence informs individuals about their agency-the mental capability of doing and intending. Expressed affect may also lead to perceptions of agency by others. Supporting the hypothesis that valence influences self- and other-perception of agency, across 5 studies, we showed that participants perceived more agency in themselves in positive versus neutral and negative personal (Study 1) and interpersonal (Study 2) events. Participants also perceived more agency in fictional characters showing positive versus negative affect, regardless of how acceptable the characters' behavior was (Studies 3 and 4). Finally, we had participants personify 24 specific emotions across the valence dimension, and found that the more positive and less negative an emotion was, the more agency participants ascribed to the "person" (Study 5). We discuss the results in terms of how valence may help with human self- and social regulation. (PsycINFO Database Record
27626038	Encouraging bystander intervention in intimate partner violence (IPV) against women is potentially an important method of reducing the prevalence of such violence in urban communities. Most existing research has been conducted on campuses and in relation to sexual violence among teens or young adults. Our understanding of which bystander behaviors are feasible is nascent, and our knowledge of which situational factors influence neighbors' self-reported willingness to intervene is underdeveloped. We conducted a concept mapping study to identify potential bystander intervention behaviors in IPV among neighbors in urban settings; we also assessed whether perceived feasibility and effectiveness of those behaviors varied by situational characteristics. Using data collected from 41 residents of a low-income New York City neighborhood in late 2011, concept mapping was used to create a conceptual map of the 74 behaviors identified by participants. We examined participant differences in mean feasibility (i.e., that the participants "could" or "would" enact a behavior), feasibility given two situational characteristics (if the couple was perceived to have a history of IPV, and if children were believed to be involved or present), and perceived effectiveness of bystander behaviors. Differences across select sociodemographic factors of participants were also analyzed. A 13-cluster solution emerged, with clusters of bystander behaviors grouped into four larger cluster areas: victim focused, parenting/education focused, perpetrator focused, and community involvement focused. Bivariate analyses revealed that participants rated the four cluster areas as more feasible when a child was believed to be involved. Male participants rated intervention as less feasible when the couple was believed to have a history of IPV. Participants who reported a history of IPV victimization rated all four cluster areas as less effective on average, as compared with participants without a history of IPV. This study explored bystander intervention into IPV outside of a college context and among urban adults living in high-poverty areas. Results suggest that the presence of children and perceived history of IPV may affect bystander intervention. Specific recommendations to build the research base on bystander intervention in adult IPV as well as what situational, sociodemographic, and other factors mitigate against intervention among potential responders are offered.

27570959	Objectives Located at the heart of a mental health university institute in Montreal, Canada, the University of Recovery (UR) is a peer-run agency of service users who came together as a private non-profit organization to promote their experiential knowledge in science and public health, and to transform the academic milieu as an inclusive work environment conducive to recovery and full citizenship. UR students can thus have access to scientific conferences and classes on various topics and invite scientists or other professionals to further discuss new discoveries and techniques, and possible ways of improving healthcare from a patients' and service users' perspective. Our conversation with a scientist specialized in obsessive-compulsive disorders triggered this collective reflection on neuroimaging in terms of psychiatric diagnoses, prognoses, recovery opportunities and meta-cognition.Method At the core of the UR as a therapeutic education program is the Projet Citoyen, an adaptation and a transposition in Montreal of the Yale Citizens Project, which has been developed in New Haven, USA, over the past fifteen years. The Projet Citoyen is comprised of four main components: bi-weekly group discussions, individualized peer support, involvement and practicum in the community, and participation in public events and debates. UR students therefore evolve in the academic and scientific milieu, here regarded as a translational community and human laboratory towards social inclusion and full citizenship. UR students can be involved as auxiliaries of medical training to always promote and illustrate recovery opportunities when psychiatric 'dysfunctions' or 'disorders' are the topics of a medical class. In April 2016, UR students invited Dr Marc Lavoie to discuss is work on obsessive-compulsive disorders (OCD). The content of this group discussion is herein reported.Results UR students learned, among other things, that neuroimaging can be used to identify patterns of brain reactions to various stimuli and situations, reactions that can be different from one psychiatric condition to another and to the rest of the 'normal' population. For example, bright red, green, or blue shades of color can show an over-activation of the thalamus for persons with OCD. This difference can be indicative of a so-called cognitive impairment, with some people reacting more 'emotionally' to an image than other persons for whom the reaction would imply parts of the brain which are normally rather associated to 'rational' thinking (e.g.: the cerebral cortex). Such a difference, when it appears through a neuroimaging technique like EEG or MRI, does not lead to the enunciation of a particular diagnosis for an individual, but can give some complementary indications to be used in conjunction with other observations and can inform the choice for a therapeutic approach. Cognitive Behavioural Therapy, for instance, has been statistically shown to be associated with anatomic changes in the human brain. Through some quite spectacular images of parts and subparts of the brain in action, UR students were able to admire all this beautiful neurodiversity. Then we discussed the concept of neuroplasticity: we now know that many aspects of the brain remain changeable or "plastic" even into adulthood, which contrasts with the previous common consensus that the human brain develops during childhood, then remains at once unchangeable afterward and "static."Conclusion Diverse neurological conditions appear as a result of normal variations in the human genome and in affect, the concepts of neurodiversity and of neuroplasticity go much beyond the prevailing prior conceptual conditioning of neurological differences as being inherently pathological and an irreversible "error of Mother Nature." There may be behaviors that cannot be controlled through rational thought, but rather emerge based on prior conditioning from the environment and other external and/or internal stimuli, and a psychotherapy could then consist of recognizing this conditioning and learning how to think and react differently to a triggering stimulus. The University of Recovery is thus first and foremost a principle of mutuality among its members - the students in recovery - who are allied through self-help as a basis for metacognitive therapeutic education. 
27570956	The sense of agency (SoA) refers to the ability for one to detect that she is the cause of an action (Gallagher, 2000). The SoA is linked to motor control but also to self-awareness and could play an important role in social interactions. Autism spectrum disorder (ASD) is characterized by an alteration of social interactions and communication (DSM-5; APA, 2013) and is often seen as a primary deficit of functions specific to social cognition. However, motor control is also altered in ASD. We hypothesize that motor symptoms and social impairments could both arise from the same alteration of SoA. We first introduce theoretical models of implicit and explicit SoA (Synofzik et al., 2008) and present their neurofunctional basis. Then, we assess the clinical expressions of a disrupted SoA in different neuropsychiatric disorders such as schizophrenia. In ASD, the atypical formation of internal models of action during motor acquisition (Haswell et al., 2009) could be at the source of an altered implicit SoA. A lack of fidelity of sensorimotor agency cues (Zalla et al., 2015) could also entail an alteration of explicit SoA. We discuss the main clinical expressions of ASD that may ensue from a disrupted SoA (difficulties in theory of mind and imitation, deficits in motor coordination and praxis, etc.). 
27551301	The further development of public health ethics will be assisted by a more direct engagement with political theory. In this way, the moral vocabulary of the liberal tradition should be supplemented-but not supplanted-by different conceptual and normative resources available from other traditions of political and social thought. This article discusses four lines of further development that the normative conceptual discourse of public health ethics might take. (i) The relational turn. The implications for public health ethics of the new 'ecological' or 'relational' interpretation that is emerging for concepts such as agency, self-identity, autonomy, liberty and justice. (ii) Governing the health commons. The framework of collective action problems is giving way to notions of democratic governance and management of common resources. (iii) The concept of membership. Membership is specified by the notions of equal respect and parity of voice and agency. (iv) The concept of mutuality. Mutuality is specified by the notions of interdependent concern and care.
27524887	Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use.To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia.	A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted.	The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of "staff training and skills" were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup.	The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety.	
27461972	When faced with a threat to gender identity, people may try to restore their gender status by acting in a more gender-typical manner. The present research investigated effects of gender identity threat on self-presentations of agentic and communal traits in a Swedish and an Argentine sample (N = 242). Under threat (vs. affirmation), Swedish women deemphasized agentic traits (d [95% CI] = -0.41 [-0.93, 0.11]), Argentine women increased their emphasis on communal traits (d = 0.44 [-0.08, 0.97]), and Argentine men increased their emphasis on agentic traits (d = 0.49 [-0.03, 1.01]). However, Swedish men did not appear to be affected by the threat regarding agentic (d = 0.04 [-0.47, 0.55]) or communal traits (d = 0.23 [-0.29, 0.74]). The findings are to be considered tentative. Implications for identity threat research are discussed. 
27460934	Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based health indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH) may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures.Data were combined from the 2003-2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20-50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors.	Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma) were also associated with poorer SRH.	Based on the many significant associations between SRH and serological assays of health risk, sociodemographic measures, health care access and utilization, and lifestyle factors, SRH appears to be a useful health indicator with potential relevance for screening level community-based health and environmental studies.	
27458394	Gender stereotype theory suggests that men are generally perceived as more masculine than women, whereas women are generally perceived as more feminine than men. Several scales have been developed to measure fundamental aspects of gender stereotypes (e.g., agency and communion, competence and warmth, or instrumentality and expressivity). Although omitted in later version, Bem's original Sex Role Inventory included the items "masculine" and "feminine" in addition to more specific gender-stereotypical attributes. We argue that it is useful to be able to measure these two core concepts in a reliable, valid, and parsimonious way. We introduce a new and brief scale, the Traditional Masculinity-Femininity (TMF) scale, designed to assess central facets of self-ascribed masculinity-femininity. Studies 1-2 used known-groups approaches (participants differing in gender and sexual orientation) to validate the scale and provide evidence of its convergent validity. As expected the TMF reliably measured a one-dimensional masculinity-femininity construct. Moreover, the TMF correlated moderately with other gender-related measures. Demonstrating incremental validity, the TMF predicted gender and sexual orientation in a superior way than established adjective-based measures. Furthermore, the TMF was connected to criterion characteristics, such as judgments as straight by laypersons for the whole sample, voice pitch characteristics for the female subsample, and contact to gay men for the male subsample, and outperformed other gender-related scales. Taken together, as long as gender differences continue to exist, we suggest that the TMF provides a valuable methodological addition for research into gender stereotypes. 
27428032	Temporary messaging programs continue to rise in popularity, due in large part to the perceived privacy that they afford. However, recent controversies have revealed that messages shared on ephemeral messaging services are persistent and potentially retrieval, thus undermining the privacy they are assumed to provide. Given this paradox, why are temporary messaging services so popular? Does the allure of privacy still motivate the use of temporary messaging programs? Or, if privacy is no longer afforded by ephemeral messaging, what other psychological gratifications do these applications fulfill that might account for their continued use? Informed by the Modality-Agency-Interactivity-Navigability (MAIN) model and the uses and gratifications tradition, the current study conducted qualitative interviews to identify the gratifications that individuals derive from the popular ephemeral messaging application, Snapchat. Study results show that the visual affordances of ephemeral messaging have legitimized photographic communication, providing self-expression and relational gratifications that are unfulfilled by text-based applications. By comparison, users report low levels of trust in the privacy affordances of ephemeral messaging, and instead projecting negative effects of temporary messaging on other users rather than self. Theoretical and practical implications of these results are discussed. 
27378893	Disorders of consciousness and the self are at the forefront of schizophrenia symptomatology. Patients are impaired in feeling themselves as the authors of their thoughts and actions. In addition, their flow of consciousness is disrupted, and thought fragmentation has been suggested to be involved in the patients' difficulties in feeling as being one unique, unchanging self across time. Both impairments are related to self disorders, and both have been investigated at the experimental level. Here we review evidence that both mechanisms of motor control and the temporal structure of signal processing are impaired in schizophrenia patients. Based on this review, we propose that the sequencing of action and perception plays a key role in the patients' impairments. Furthermore, the millisecond time scale of the disorders, as well as the impaired sequencing, highlights the cooperation between brain networks including the cerebellum, as proposed by Andreasen (1999). We examine this possibility in the light of recent knowledge on the anatomical and physiological properties of the cerebellum, its role in timing, and its involvement in known physiological impairments in patients with schizophrenia, e.g., resting states and brain dynamics. A disruption in communication between networks involving the cerebellum, related to known impairments in dopamine, glutamate and GABA transmission, may help to better explain why patients experience reduced attunement with the external world and possibly with themselves. 
27378228	Emergency room (ER) use is increasing in several countries. Variability in the proportion of non-urgent ER visits was found to range from 5 to 90 % (median 32 %). Non-urgent emergency visits are considered an inappropriate and inefficient use of the health-care system because they may lead to higher expenses, crowding, treatment delays, and loss of continuity of health care provided by a general practitioner. Urgency levels of doctor-walk-in patient encounters were assessed based on their region of origin in a diverse Norwegian population.An anonymous, multilingual questionnaire was distributed to all walk-in patients at a general emergency outpatient clinic in Oslo during two weeks in September 2009. We analysed demographic data, patient-doctor assessments of the level of urgency, and the results of the consultation. We used descriptive statistics to obtain frequencies with 95 % confidence interval (CI) for assessed levels of urgency and outcomes. Concordance between the patients' and doctors' assessments was analysed using a Kendall tau-b test. We used binary logistic regression modelling to quantify associations of explanatory variables and outcomes according to urgency level assessments.	The analysis included 1821 walk-in patients. Twenty-four per cent of the patients considered their emergency consultation to be non-urgent, while the doctors considered 64 % of encounters to be non-urgent. The concordance between the assessments by the patient and by their doctor was positive but low, with a Kendall tau-b coefficient of 0.202 (p < 0.001). Adjusted logistic regression analysis showed that patients from Eastern Europe (odds ratio (OR) = 3.04; 95 % CI 1.60-5.78), Asia and Turkey (OR = 4.08; 95 % CI 2.43-6.84), and Africa (OR = 8.47; 95 % CI 3.87-18.5) reported significantly higher urgency levels compared with Norwegians. The doctors reported no significant difference in assessment of urgency based on the patient's region of origin, except for Africans (OR = 0.64; 95 % CI 0.43-0.96).	This study reveals discrepancies between assessments by walk-in patients and doctors of the urgency level of their encounters at a general emergency clinic. The patients' self-assessed perception of the urgency level was related to their region of origin.	
27253333	Contemporary discourses in the health sciences vary in their treatment of aging bodies and the mind-body relationship, yet our understanding of aging experiences and health care practices can be limited by an overreliance on biomedical or social constructionist approaches alone. This paper offers a conceptual exploration of embodiment as an innovative approach to enhance our understandings of aging bodies and health in physiotherapy practice. Embodiment attends to body and mind, nature and culture, structure and agency, while appreciating differences in aging bodies and health in aging. Conclusions consider embodiment in the practice and disciplinary discourse of contemporary physiotherapy, specifically, considering the ways embodied perspectives can support therapists in their health care practice and relationships with people with aging bodies. 
27242642	Over the course of a century, the meaning of interoception has changed from the restrictive to the inclusive. In its inclusive sense, it bears relevance to every individual via its link to emotion, decision making, time-perception, health, pain, and various other areas of life. While the label for the perception of the body state changes over time, the need for an overarching concept remains. Many aspects can make any particular interoceptive sensation unique and distinct from any other interoceptive sensation. This can range from the sense of agency, to the physical cause of a sensation, the ontogenetic origin, the efferent innervation, and afferent pathways of the tissue involved amongst others. In its overarching meaning, interoception primarily is a product of the central nervous system, a construct based on an integration of various sources, not per se including afferent information. This paper proposes a definition of interoception as based on subjective experience, and pleas for the use of specific vocabulary in addressing the many aspects that contribute to it. 
27236476	There are multiple indicators of disruption in the way girls and women inhabit their bodies. The qualitative research program examined lived experiences of embodiment among girls and women by conducting 171 interviews with 69 girls and women in three different studies: (a) A life history study of 30 interviews with 11 women, ages 20-27; (b) A 5-year prospective interview study of 87 interviews with 27 girls, ages 9-14 in the first phase of the study; and (c) A life history study of 54 interviews with 31 women, ages 50-68. Data analyses used a constructivist grounded theory approach. In all three studies the emergent core construct of Experience of Embodiment had five central dimensions, each with a positive and negative pole. These dimensions included: body-self connection, agency, desire, self-attunement, and resisting objectification. The Experience of Embodiment provides a new, integrated perspective on ways girls and women inhabit their bodies. 
27196642	We examined the benefits of a collaboration between the Indian Health Service and an academic medical center to address the high rates of unintentional drug overdose in American Indians/Alaska Natives. In January 2015, the Indian Health Service became the first federal agency to mandate training in pain and opioid substance use disorder for all prescribing clinicians. More than 1300 Indian Health Service clinicians were trained in 7 possible 5-hour courses specific to pain and addiction. We noted positive changes in pre- and postcourse knowledge, self-efficacy, and attitudes as well as thematic responses showing the trainings to be comprehensive, interactive, and convenient. 
27192609	Previous research saw older gay men as subject to structural marginalization of ageism but yet possessing agency to interpret aging in diverse ways. I move beyond this duality, drawing on the theory of defensive othering to understand how older gay men live with the aging discourse in the gay community. Informed by grounded theory, I analyzed interviews with 25 self-identified single gay men aged 50 or above in England inductively. It emerged that many older gay men found it difficult to escape the discourse that marginalizes the aging body. Even when they argued they were the exception and "looked good," they were discursively producing a two-tier system: they themselves as the "good older gay men," as opposed to the other "bad older gay men," who "had given up." Such a defensive othering tactic seemingly allowed them to resist age norms from applying to them personally, but unintentionally reinforced an ageist discourse.
27170589	This paper makes a contribution to an emerging debate on dementia and citizenship through a focus on the everyday experiences of women living with dementia and in receipt of care. In particular, a link is drawn between hairdressing and citizenship in the context of dementia care. Informed by a wider debate over the importance of an emplaced, embodied and performative approach to citizenship, the authors highlight the way that intersecting forms of resistance unfold in the salon. The Hair and Care project, as the name implies, focused upon hair care and styling in the context of a wider consideration of appearance and how it is managed and what it means for people living with dementia. With a focus upon the routine, mundane and thereby often unproblematised aspects of everyday life in/with care, the discussion draws together two key ideas concerned with the interplay of power and resistance: Essed's (1991) theory of 'everyday discrimination' and Scott's (1985) notion of 'everyday resistance'. The findings illuminate the creative and collective forms of agency exercised by older women living with dementia, in the context of their relationships with one another and with the hairdressers whose services and support inspire their loyalty and patronage. Findings from the study point to the link between (inter-)personal practices of appearance management and a wider set of social conditions that are manifest in the on-going struggle over time, space and bodies in dementia care. 
27150462	Numerous responsible gambling (RG) strategies are promoted to assist consumers to "gamble responsibly". However, consumer adoption of RG strategies, how this varies by gambler risk group, and whether usage is associated with non-problematic gambling are largely unknown. This study aimed to (1) determine how use of RG-related strategies differs amongst regular gamblers by gambler risk group; and (2) identify RG-related strategies whose usage predicts non-problem/low risk gambling. Regular Australian gamblers on high-risk products (N = 860), recruited through gambling venues and an online wagering operator, were surveyed about their use of RG strategies promoted on the website of their jurisdiction's main RG agency. Knowledge of RG strategies was reasonably high amongst all gambler risk groups, but lower-risk groups were more likely to use RG strategies. A logistic regression correctly predicted 82.1 % of lower-risk gamblers and 77.2 % of higher-risk gamblers. Predictors of lower-risk gambling included: greater confidence in their understanding of RG; endorsement of lower gambling expenditure and frequency limits; fewer erroneous gambling beliefs; being less likely to gamble to win money, challenge their skills/beat the odds, or forget about worries and stresses; and being more likely to gamble for pleasure/entertainment. Lower-risk gamblers were more likely to set a money limit in advance of gambling and to balance their gambling with other activities. These findings contribute to understanding which strategies are favoured by different risk groups, and which are associated with safer levels of gambling. They can guide consumer information aimed at enhancing RG consumption and future research on RG consumption.
27142686	With advances in medical science, the concept of agency has received increasing attention in biomedical ethics. However, most of the ethical discussion around definitions of agency has focused either on patients suffering from mental disorders or on patients receiving cutting-edge medical treatments in developed countries. Very little of the discussion around concepts of agency has focused on the situation of patients suffering from common diseases that affect populations worldwide. Therefore, the most widely-used definitions of agency may be not appropriate to analyse common diseases among large populations. The branch of social sciences known as development studies draw on their own definitions of the term agency that may provide a more applicable and accurate way of referring to common and general cases than the definitions currently used in bioethics. Moreover, the psychological Self-Determination Theory may improve the usefulness of these definitions in common situations. This article explains the characteristics and the shortcomings of current bioethical definitions of agency when they are applied to common medical conditions worldwide. A new, value-based concept of agency, informed by development studies, is proposed as more accurate and useful for biomedical ethics. 
27137101	Stimuli caused by our own movements are given special treatment in the brain. Self-generated sounds evoke a smaller brain response than externally generated ones. This attenuated response may reflect a predictive mechanism to differentiate the sensory consequences of one's own actions from other sensory input. It may also relate to the feeling of being the agent of the movement and its effects, but little is known about how sensory suppression of brain responses to self-generated sounds is related to judgments of agency. To address this question, we recorded event-related potentials in response to sounds initiated by button presses. In one condition, participants perceived agency over the production of the sounds, whereas in another condition, participants experience an illusory lack of agency caused by changes in the delay between actions and effects. We compared trials in which the timing of button press and sound was physically identical, but participants' agency judgment differed. Results show reduced amplitudes of the auditory N1 component in response to self-generated sounds irrespective of agency experience, whilst P2 effects correlate with the perception of agency. Our findings suggest that suppression of the auditory N1 component to self-generated sounds does not depend on adaptation to specific action-effect time delays, and does not determine agency judgments, however, the suppression of the P2 component might relate more directly to the experience of agency. 
27073211	Chronic heat stress and dehydration from strenuous work in hot environments is considered an essential component of the epidemic of chronic kidney disease in Central America.(1) To assess feasibility of providing an intervention modelled on OSHA's Water.Rest.Shade programme (WRS) during sugarcane cutting and (2) to prevent heat stress and dehydration without decreasing productivity.	Midway through the 6-month harvest, the intervention introduced WRS practices. A 60-person cutting group was provided water supplied in individual backpacks, mobile shaded rest areas and scheduled rest periods. Ergonomically improved machetes and efficiency strategies were also implemented. Health data (anthropometric, blood, urine, questionnaires) were collected preharvest, preintervention, mid-intervention and at the end of harvest. A subsample participated in focus group discussions. Daily wet bulb globe temperatures (WBGT) were recorded. The employer provided individual production records.	Over the harvest WBGT was >26°C from 9:00 onwards reaching average maximum of 29.3±1.7°C, around 13:00. Postintervention self-reported water consumption increased 25%. Symptoms associated with heat stress and with dehydration decreased. Individual daily production increased from 5.1 to a high of 7.3 tons/person/day postintervention. This increase was greater than in other cutting groups at the company. Focus groups reported a positive perception of components of the WRS, and the new machete and cutting programmes.	A WRS intervention is feasible in sugarcane fields, and appears to markedly reduce the impact of the heat stress conditions for the workforce. With proper attention to work practices, production can be maintained with less impact on worker health.	
27056203	Technological progress provides us with an increasing variety of devices that now mediate what previously has been achieved by social face-to-face interaction. Here, we investigate whether this leads to the incorporation of such devices into representations of our body. Using explicit (body ownership questionnaire) and implicit (proprioceptive drift rate) measures together with a synchronous/asynchronous stroking technique, we show that people have an increased tendency to integrate non-corporeal objects into their body after synchronous stroking. Explicit measures of body ownership show that people had greater average scores in the synchronous condition as compared to the asynchronous condition for all objects that we tested (computer mouse, rubber hand, smart phone, and a wooden block). However, our implicit measure of body ownership showed a numerically larger proprioceptive drift for a rubber hand than for a computer mouse, numerically comparable ownership measures for a smart phone and a rubber hand, and a significantly stronger proprioceptive drift for a smart phone than for a wooden block. These findings suggest that direct, subjective measures and indirect, objective measures of body ownership are based on different kinds of information; the latter might be more sensitive to objects for which we recall past agency based on our history of personal experiences with these objects. Taken altogether, our observations support the idea that the perceived bodily self is rather flexible and is likely to emerge through multisensory integration and top-down expectations of agency.
27042814	Free will is a perception that people have that they choose to make their movements. This perception includes a sense of willing the movement and self-agency that they are responsible for the movement. If there is a "free will force" that plays a role in movement selection, it should precede movement. There is no evidence for a driving force, and the perception of willing is not fully processed until after the movement. The perceptions of free will likely arise from an interaction between frontal and parietal areas. Free will might be considered to exist if a person's brain is functioning normally without coercion. Ann Neurol 2016;80:5-12. 
27023692	Comprehensive medication reviews (CMRs) consist of in-depth reviews of patients' medications to identify effectiveness or safety problems and often generate cost savings for individuals. Despite their advantages, CMRs are not widely obtained. Previous studies found that older age, female sex, and experience of side effects were associated with obtaining a medication review.To quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a CMR among Medicare Part D beneficiaries.	A sample of Medicare Part D beneficiaries from 1 health care plan (n = 660) completed a 14-item survey over the telephone assessing factors that were hypothesized to affect their intention and behavior to obtain a CMR. The survey collected medication use history and health care information with the medication user self-evaluation tool, health status, adherence, intention to obtain a CMR, and demographic characteristics. Subjects subsequently were informed that they could obtain a CMR from their pharmacies. Claims data were obtained that indicated which subjects received a CMR. Two dependent variables were predicted: intention to schedule a CMR using a multivariate linear regression model and receipt of a CMR using a logistic regression and including intention as a predictor variable.	The mean age of participants was 76.6 (SD = 7.61) years; 71% were female; and participants took an average of 5.2 (SD = 3.18) medications. The intention to have a CMR was 2.85 (SD = 1.41) on a 5-point scale, and 5.6% of the participants actually had a CMR. Worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR. Patients who perceived their health status to be poorer compared with others their age were more likely to have a CMR. Intention to obtain a CMR was not associated with receipt of a CMR.	Stakeholders should target patients who perceive their health to be poor for a CMR, hence expanding the scope of CMRs and increasing the number of older adults benefiting from this service.	This study was funded by a grant from the Agency for Healthcare Research and Quality (1R18HS018353). Frank is an employee of Outcomes MTM. Pendergast has received grants from the NIH, NIA, and PICORI. Farris has received grants from NIH and speaker fees from Chulalongkorn University, Bangkok, Thailand, and the American College of Clinical Pharmacy. All other authors declare that they have no conflicts of interest. Study concept was developed by Farris, Pendergast, Chrischilles, and Doucette. Pendergast, Frank, Farris, and Aneese collected the data, with assistance from Chrischilles and Doucette. Data interpretation was performed by Farris, Marshall, Salgado, and Aneese, with assistance from the other authors. The manuscript was written by Farris, Salgado, and Aneese, with assistance from the other authors, and revised by Salgado and Marshall, assisted by the other authors.	
26951932	Traditionally conceived of and studied as a disorder of cognitive and emotional functioning, schizophrenia (SZ) is also characterized by alterations in bodily sensations. These have included subjective reports based on self-evaluations and/or clinical observations describing motor, as well as sensory-based corporeal anomalies. There has been, however, a paucity of objective methods to capture and characterize bodily issues in SZ. Here we present a new research method and statistical platform that enables precise evaluation of peripheral activity and its putative contributions to the cognitive control of visuomotor actions. Specifically, we introduce new methods that facilitate the individualized characterization of the function of sensory-motor systems so as to detect if subjects perform outside of normal limits. In this paper, we report data from a cohort of patients with a clinical diagnosis of SZ. First, we characterize neurotypical subjects performing a visually guided pointing task that requires visuomotor transformations, multi-joint coordination, and the proper balance between different degrees of intent, among other factors. Then we measure SZ patients against the normative statistical ranges empirically determined. To this end, we examine the stochastic signatures of minute fluctuations in motor performance (micro-movements) of various velocity- and geometric-transformation-dependent trajectory parameters from the hand motions. These include the motions en-route to the target as well as spontaneous (without instructions) hand-retractions to rest. The comparisons reveal fundamental differences between SZ patients and controls. Specifically, velocity-dependent signatures show that SZ patients move significantly slower than controls with more noise and randomness in their moment-by-moment hand micro-motions. Furthermore, the normative geometric-dependent signatures of deliberateness are absent from the goal-directed reaches in SZ, but present within normative ranges in their spontaneous hand retractions to rest. Given that the continuous flow of micro-motions contributes to internally sensed feedback from self-produced movements, it is highly probable that sensory-motor integration with externally perceived inputs is impaired. Such impairments in this SZ cohort seem to specifically alter the balance between deliberate and spontaneous control of actions. We interpret these results as potential indexes of avolition and lack of agency and action ownership. We frame our results in the broad context of Precision Psychiatry initiatives and discuss possible implications on the putative contributions of the peripheral nervous system to the internal models for the cognitive control of self-produced actions in the individual with a clinical diagnosis of SZ. 
26945544	Compelling evidence for the long-term impact of conditions in gestation and early childhood on both physical and psychosocial functioning and productivity has stimulated a focus in global health policy and social services on the "first 1000 days". Consequently, related initiatives may assume that rationale for this orientation and the agency of parents during this period is self-evident and widely shared among parents and communities. In 2012, we tested this assumption among a sample of 38 township-dwelling caregivers in Cape Town, by asking a question identified during a study of cultural models of parenting, namely: At what age or stage can a parent or caregiver have the most influence on a child's development? Formal cultural consensus analysis of responses met criteria for strong agreement that the period for greatest impact of parenting on a child's development occurs at adolescence, at a median age of 12 years. In follow-up focus groups and structured interviews, caregivers articulated clear ecological and developmental reasons for this view, related to protection both of developmental potential and against powerful, context-specific ecological risks (early pregnancy, substance ab/use, violence and gangs) that emerge during adolescence. Such risks threaten educational attainment, reproductive health, and social derailment with enduring consequences for lifetime well-being that caregivers are highly motivated to prevent. Developmental needs in pregnancy and early childhood, by contrast, were considered more manageable. These findings resonate with emerging evidence for multiple sensitive periods with corresponding developmental needs, and urge the value of complementing efforts to optimize early development with those to sustain and enhance it during later windows of developmental opportunity such as adolescence. Our results also indicate the need to consult local views of developmental risk and parenting practice in communicating with caregivers and planning interventions, and the value of using available methodological tools to do so. 
26909537	Integrated in a multiphase development project, the Care Expert is a prototype of a novel e-supportive system aiming to mediate person-centered care in the context of outpatient oncology. At this early stage of development, the current study was conducted aiming at exploring the person-centeredness concept underlying the Care Expert version 1.0 and its usability for patients receiving outpatient chemotherapy for breast cancer. Within a user-centered design, we followed a mixed-methods approach entailing subjective assessment and diagnostic evaluation of the prototype. Four women undergoing outpatient chemotherapy participated in individual sessions and rated highly the system's usability. Their accounts led to identifying three supportive functions: continuous communication, reinforcement of self-driven agency, and cooperative agency with a sense of being looked after. We discuss the results in relation to theoretical fields that might guide further the development of the supportive system and usability recommendations. Care Expert has the potential to mediate person-centered care in outpatient oncology. Nevertheless, additional cycles of iterative development with the software team and of participatory design focusing on oncology nurses' perspectives are required before departing to the feasibility phase in intervention research. 
26891191	We assessed self-tickling sensations in a group of participants high in schizotypal traits (n=27) and group of participants low in schizotypal traits (n=27). The groups were formed by screening a pool of 397 students for extreme scores in the French version of the Schizotypal Personality Questionnaire. As observed in a previous study involving psychiatric people with auditory hallucinations and/or passivity experiences our results showed that self-applied tactile stimulations are felt to be more ticklish by healthy individuals high in schizotypal traits. In contrast, there were no significant intergroup differences in the mean tickle rating in the externally-produced tickling condition. Furthermore, more successful self-tickling was associated with more frequent self-reports of unusual perceptual experiences (such as supernatural experiences) and passivity experiences in particular (such as a feeling of being under the control of an outside force or power). 
26881386	We sought to distinguish mastery goals (i.e., desire to learn) from performance goals (i.e., desire to achieve more positive evaluations than others) in the light of social judgment research. In a pilot study, we made a conceptual distinction between three types of traits (agency, competence, and effort) that are often undifferentiated. We then tested the relevance of this distinction for understanding how people pursuing either mastery or performance goals are judged. On self-perception, results revealed that effort was predicted by the adoption of mastery goals and agency by performance goals (Study 1). On judgments, results showed that (a) the target pursuing mastery goals was perceived as oriented toward effort, and (b) the target pursuing performance goals was oriented toward agency (Study 2). Finally, these links were shown again by participants who inferred a target's goals from his traits (Study 3). Results are discussed in terms of the social value of achievement goals at school.
26878392	Complex interactions between pain, depression, and anxiety impact quality of life in patients with ALS. Psychological approaches to pain control may be useful. This study explored the role of self-efficacy in mitigating pain. Individuals registered with the Agency for Toxic Substances and Disease Registry National ALS Registry and who experienced pain were invited to participate in an online survey. Subjects completed the Brief Pain Inventory-Short Form, Hospital Anxiety and Depression Scale, and Chronic Pain Self-Efficacy Scale. Correlations between variables were determined. Multiple linear regression models assessed relationships between depression, anxiety and self-efficacy predictions, and pain severity, interference, and relief. Results recorded that there were 197 participants (58% males, mean age 59 ± 10 years). Cases or borderline cases of depression or anxiety were common. Mean levels of pain were moderate. Higher pain self-efficacy scores predicted lower pain severity, lower pain interference, and higher pain relief with treatment. As depression scores increased, pain interference with daily life was higher. In conclusion, anxiety and depression are common in patients with ALS and pain. Self-efficacy appears to mitigate pain. A multifactorial approach to pain management should be considered in these patients, addressing mental health and self-efficacy to augment pharmacologic pain treatments. 
26877116	In this paper, I explain why I adopted a Research Domain Criteria (RDoC) approach to study the neurobiology of auditory verbal hallucinations (AVH), or voices. I explain that the RDoC construct of "agency" fits well with AVH phenomenology. To the extent that voices sound nonself, voice hearers lack a sense of agency over the voices. Using a vocalization paradigm like those used with nonhuman primates to study mechanisms subserving the sense of agency, we find that the auditory N1 ERP is suppressed during vocalization, that EEG synchrony preceding speech onset is related to N1 suppression, and that both are reduced in patients with schizophrenia. Reduced cortical suppression is also seen across multiple psychotic disorders and in clinically high-risk youth, but it is not related to AVH. The motor activity preceding talking and connectivity between frontal and temporal lobes during talking have both proved sensitive to AVH, suggesting neural activity and connectivity associated with intentions to act may be a better way to study agency and predictions based on agency. 
26859273	A quick guide to tickling, a form of laughter-evoking play that can be considered as an index of agency, with a discussion of its taxonomic distribution and its possible relationship to traditional measures of self-recognition. 
26835855	Positive psychological capital is reported to have positive effects on people's well-being and attitudes to their working lives.The objective of this study was to investigate if it is possible to increase the level of positive psychological capital by two group intervention programs.	The research design was a controlled study with 2 × 2 experimental groups and two control groups. Two of the experimental groups received intervention I (IG I), the other two experimental groups received intervention II (IG II). Assessments were made before and after the intervention programs, with a follow-up at six months post-intervention. Instruments measuring the fundamentals of psychological capital: self-efficacy, hope, optimism, as well as health and job satisfaction were used.	The results show that it is possible to increase the level of positive emotions, self-efficacy and job satisfaction of members of a working team by using group intervention methods. The positive changes observed at the end of the program remained six months after the intervention, with the exception of job satisfaction in IG II. It seems that the intervention had a greater influence on those persons who at the start of the study reported a low level of self-enhancement. The results were more pronounced in intervention group I where reinforcement of the resources and positive aspects of the work place environment were provided.	A 10-week group intervention program that focused on learned optimism proved to be successful in increasing levels of self-efficacy and job satisfaction. While improvement was maintained six months post-intervention the small sample size and the attrition rate are limitations. Results are promising and further research is warranted.	
26832991	Humans display an intriguing propensity to help the victim of social norm violations or punish the violators which require theory-of-mind (ToM)/mentalizing abilities. The hypothalamic peptide oxytocin (OXT) has been implicated in modulating various pro-social behaviors/perception including trust, cooperation, and empathy. However, it is still elusive whether OXT also influences neural responses during third-party altruistic decisions, especially in ToM-related brain regions such as the temporo-parietal junction (TPJ). To address this question, we conducted a pharmacological functional magnetic resonance imaging experiment with healthy male participants in a randomized, double-blind, cross-over design. After the intranasal administration synthetic OXT (OXT(IN)) or placebo (PLC), participants could transfer money from their own endowment to either punish a norm violator or help the victim. In some trials, participants observed the decisions made by a computer. Behaviorally, participants under OXT(IN) showed a trend to accelerate altruistic decisions. At the neural level, we observed a strong three-way interaction between drug treatment (OXT/PLC), agency (self/computer), and decision (help/punish), such that OXT(IN) selectively enhanced activity in the left TPJ during observations of others being helped by the computer. Collectively, our findings indicate that OXT enhances prosocial-relevant perception by increasing ToM-related neural activations. 
26821556	The role the brain plays in the creation and maintenance of tobacco dependence has become increasingly prominent in explanations of smoking that are presented to the public. The potential for brain-based explanations of smoking to influence smokers' understandings of their addiction, their sense of self-efficacy, and perhaps even their treatment preferences, has been raised by some working in the addiction field. However, little empirical evidence exists in this area.This paper reports on semi-structured interviews with 29 daily smokers. Participants were shown a brief presentation about the neuroscience of nicotine dependence. They were then queried about their awareness of the role of the brain in smoking, and the consequences of this knowledge for their understandings of smoking and their treatment preferences.	Our results indicated that many participants displayed some awareness of the link between the brain and addiction. While there was a diversity of ideas about the potential impacts of neuroscience knowledge about smoking, there was an overall tendency to maintain pre-existing treatment preferences, and to assert individual responsibility for smoking. Emergent themes that arose were the brain as a special organ, the discourse of the "other" smoker, and the distinction between physical and psychological facets of addiction.	While brain-based explanations of smoking are unlikely to revolutionise lay understandings of smoking, neuroscience information should be presented in a way that does not negate people's sense of agency and self-efficacy in relation to quitting smoking.	
26821193	Illness perception was found to be a better predictor of psychological outcome among cancer patients than the objective characteristics of illness. The current study explored the association between the perceived threat of illness (a major aspect of illness perception) and depression among cancer patients. We examined the hypothesis that this association will be higher for persons with low External (others) or internal (self) Health Locus of Control (HLC) than for those with high HLC. The study took an exploratory approach regarding the role that different sources of control (external and internal) may assume. Fifty-seven cancer patients completed self-report measures of Perceived Life Threat (PLT), HLC and Depression. The possible moderating role of HLC on the relationship between PLT and Depression was examined. A significant relationship between perceived threat and depression was found only among participants reporting low levels of internal locus of control. The results support the hypothesis that perception of cancer as life threatening is important factor in determining the level of depression among cancer patients. The results also support the differentiation between internal and external HLC and suggest that internal HLC may be more relevant than external HLC in managing perceived threat. Internal locus of control can be interpreted as having a sense of agency and mastery which is important in managing the cognitive perception of the threat of illness. Further research is needed in order to determine the role of external HLC in managing perceived or actual threats. 
26818937	Limited recent evidence implicates the anterior/posterior cingulate (ACC/PCC) and lateral prefrontal networks as the neural substrates of risky decision-making biases such as illusions of control (IoC) and gambler's fallacy (GF). However, investigation is lacking on the dynamic interactive effect of those biases during decision making. Employing a card-guessing game that independently manipulates trial-by-trial perceived control and gamble outcome among 29 healthy female participants, we observed both IoC- and GF-type behaviors, as well as an interactive effect of previous control and previous outcome, with GF-type behaviors only following computer-selected, but not self-selected, outcomes. Imaging results implicated the ACC and left dorsolateral prefrontal cortex (DLPFC) in agency processing, and the cerebellum and right DLPFC in previous outcome processing, in accordance with past literature. Critically, the right inferior parietal lobule (IPL) exhibited significant betting-related activities to the interaction of previous control and previous outcome, showing more positive signals to previous computer-selected winning versus losing outcomes but the reverse pattern following self-selected outcomes, as well as responding to the interactive effect of control and outcome during feedback. Associations were also found between participants' behavioral sensitivity to the interactive effect of previous control and previous outcome, and right IPL signals, as well as its functional connectivity with neural networks implicated in agency and previous outcome processing. We propose that the right IPL provides the neural substrate for the interaction of perceived control and GF, through coordinating activities in the anterior and posterior cingulate cortices and working conjunctively with lateral PFC and other parietal networks.
26779000	Temporal contiguity between an action and corresponding auditory feedback is crucial to the perception of self-generated sound. However, the neural mechanisms underlying motor-auditory temporal integration are unclear. Here, we conducted four experiments with an oddball paradigm to examine the specific event-related potentials (ERPs) elicited by delayed auditory feedback for a self-generated action. The first experiment confirmed that a pitch-deviant auditory stimulus elicits mismatch negativity (MMN) and P300, both when it is generated passively and by the participant's action. In our second and third experiments, we investigated the ERP components elicited by delayed auditory feedback for a self-generated action. We found that delayed auditory feedback elicited an enhancement of P2 (enhanced-P2) and a N300 component, which were apparently different from the MMN and P300 components observed in the first experiment. We further investigated the sensitivity of the enhanced-P2 and N300 to delay length in our fourth experiment. Strikingly, the amplitude of the N300 increased as a function of the delay length. Additionally, the N300 amplitude was significantly correlated with the conscious detection of the delay (the 50% detection point was around 200 ms), and hence reduction in the feeling of authorship of the sound (the sense of agency). In contrast, the enhanced-P2 was most prominent in short-delay (≤200 ms) conditions and diminished in long-delay conditions. Our results suggest that different neural mechanisms are employed for the processing of temporally deviant and pitch-deviant auditory feedback. Additionally, the temporal window for subjective motor-auditory integration is likely about 200 ms, as indicated by these auditory ERP components. 
26766546	Preconception health programs have resulted in improved health behaviors among participants and have shown promise in reducing adverse birth outcomes. However, the role of health beliefs in preconception health program outcomes has been overlooked but warrants attention due to reported positive associations between women's views of control over fetal health and health behavior in pregnancy. Towards an ultimate aim of improving preconception health program reach and effectiveness, we examined properties of a fetal health locus of control (FHLC; Labs & Wurtele, 1986) measure in nulliparous, childbearing aged university women and men. Students (n=1467) completed an online survey that included the FHLC subscales maternal, powerful others', and chance control over fetal health. Factor analyses and correlations with related scales supported the soundness of FHLC constructs in both women and men. All participants rated maternal control in fetal health nearly twice as highly as powerful others' and chance. We therefore recommend that FHLC be integrated into preconception health program evaluation as personal agency in fetal health likely has an important role in women's and men's preconception health behavior and health behavior change. 
26745684	Deficits in metacognition, or the ability to form complex ideas about self and others, may be a root cause of dysfunction in schizophrenia. Accordingly, forms of psychotherapy have been proposed to address metacognitive deficits. This study explored whether metacognitively focused individual psychotherapy can affect self-experience by conducting narrative interviews of patients with a schizophrenia spectrum disorder enrolled in either metacognitively oriented psychotherapy (n = 12) or supportive psychotherapy (n = 13) in a naturalistic setting.Participants in both groups completed a narrative interview consisting of questions that focused on perceptions and process of psychotherapy and its impact on outcomes. Interviews were audiotaped, transcribed, and coded using an inductive process informed by grounded theory.	Qualitative analyses revealed all participants reported psychotherapy led to improvements in self-esteem and the ability to think more clearly and set meaningful goals. The group receiving metacognitively oriented therapy, in contrast to those receiving supportive therapy, reported being able to integrate their current experiences into the larger narratives of their lives and an increased experience of sense of agency and the ability to understand and manage pain.	Results provide evidence that metacognitively oriented psychotherapy may promote subjective forms of recovery.	
26741858	Here we investigated the temporal perception of self- and other-generated actions during sequential joint actions. Participants judged the perceived time of two events, the first triggered by the participant and the second by another agent, during a cooperative or competitive interaction, or by an unspecified mechanical cause. Results showed that participants perceived self-generated events as shifted earlier in time (anticipation temporal judgment bias) and non-self-generated events as shifted later in time (repulsion temporal judgment bias). This latter effect was observed independently from the kind of cause (i.e., agentive or mechanical) or interaction (i.e., cooperative or competitive). We suggest that this might represent a mental process which allows discriminating events that cannot plausibly be linked to one's own action. When an event immediately follows a self-generated one, temporal judgment biases operate as self-serving biases in order to separate self-generated events from events of another physical causality. 
26708251	"Freedom from animal disease" is an ambiguous concept that may have a different meaning in trade and science. For trade alone, there are different levels of freedom from OIE listed diseases. A country can: be recognized by OIE to be "officially free"; self-declare freedom, with no official recognition by the OIE; or report animal disease as absent (no occurrence) in six-monthly reports. In science, we apply scenario tree models to calculate the probability of a population being free from disease at a given prevalence to provide evidence of freedom from animal disease. Here, we link science with application by describing how a scenario tree model may contribute to a country's claim of freedom from animal disease. We combine the idea of a standardized presentation of scenario tree models for disease freedom and having a similar model for two different animal diseases to suggest that a simple generic model may help veterinary authorities to build and evaluate scenario tree models for disease freedom. Here, we aim to develop a generic scenario tree model for disease freedom that is: animal species specific, population specific, and has a simple structure. The specific objectives were: to explore the levels of freedom described in the OIE Terrestrial Animal Health Code; to describe how scenario tree models may contribute to a country's claim of freedom from animal disease; and to present a generic swine scenario tree model for disease freedom in Canada's domestic (commercial) swine applied to Aujeszky's disease (AD). In particular, to explore how historical survey data, and data mining may affect the probability of freedom and to explore different sampling strategies. Finally, to frame the generic scenario tree model in the context of Canada's claim of freedom from AD. We found that scenario tree models are useful to support a country's claim of freedom either as "recognized officially free" or as part of a self-declaration but the models should not stand alone in a claim. The generic AD scenario tree model demonstrated the benefit of combining three sources of surveillance data and helped to design the surveillance for the next year. The generic AD scenario model is one piece in Canada's self-declaration of freedom from AD. The model is strongly supported by the fact that AD has never been detected in Canada. 
26690814	Blind source separation is the computation underlying the cocktail party effect--a partygoer can distinguish a particular talker's voice from the ambient noise. Early studies indicated that the brain might use blind source separation as a signal processing strategy for sensory perception and numerous mathematical models have been proposed; however, it remains unclear how the neural networks extract particular sources from a complex mixture of inputs. We discovered that neurons in cultures of dissociated rat cortical cells could learn to represent particular sources while filtering out other signals. Specifically, the distinct classes of neurons in the culture learned to respond to the distinct sources after repeating training stimulation. Moreover, the neural network structures changed to reduce free energy, as predicted by the free-energy principle, a candidate unified theory of learning and memory, and by Jaynes' principle of maximum entropy. This implicit learning can only be explained by some form of Hebbian plasticity. These results are the first in vitro (as opposed to in silico) demonstration of neural networks performing blind source separation, and the first formal demonstration of neuronal self-organization under the free energy principle. 
26671292	In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed. 
26669474	Breathlessness is a prevalent and distressing symptom in intensive care unit patients. There is little evidence of the ability of healthcare workers to assess the patient's experiences of breathing. Patient perception of breathing is essential in symptom management, and patient perception during a spontaneous breathing trial (SBT) might be related to extubation success.To assess mechanically ventilated patients' experiences of breathlessness during SBT.	This was a prospective observational multicenter study of 100 mechanically ventilated patients. We assessed the agreement between nurses, physicians, and patients' 11-point Numerical Rating Scales scores of breathlessness, perception of feeling secure, and improvement of respiratory function at the end of an SBT (most performed with some level of support). We also determined the association between breathlessness and demographic factors or respiratory observations.	Sixty-two patients (62%) reported moderate or severe breathlessness (Numerical Rating Scales ≥ 4). The median intensity of breathlessness reported by patients was five compared with two by nurses and physicians (P < 0.001). Patients felt less secure and reported less improvement of respiratory function compared with nurses' and physicians' ratings. About half of the nurses and physicians underestimated breathlessness (difference score, ≤-2) compared with the patients' self-reports. Underestimation of breathlessness was not associated with professional competencies. There were no major differences in objective assessments of respiratory function in patients with moderate or severe breathlessness, and no apparent relationship between breathlessness during the SBT and extubation outcome.	
26655388	It has been argued that though correlated with mental health, mental well-being is a distinct entity. Despite the wealth of literature on mental health, less is known about mental well-being. Mental health is something experienced by individuals, whereas mental well-being can be assessed at the population level. Accordingly it is important to differentiate the individual and population level factors (environmental and social) that could be associated with mental health and well-being, and as people living in deprived areas have a higher prevalence of poor mental health, these relationships should be compared across different levels of neighbourhood deprivation.A cross-sectional representative random sample of 1,209 adults from 62 Super Output Areas (SOAs) in Belfast, Northern Ireland (Feb 2010 - Jan 2011) were recruited in the PARC Study. Interview-administered questionnaires recorded data on socio-demographic characteristics, health-related behaviours, individual social capital, self-rated health, mental health (SF-8) and mental well-being (WEMWBS). Multi-variable linear regression analyses, with inclusion of clustering by SOAs, were used to explore the associations between individual and perceived community characteristics and mental health and mental well-being, and to investigate how these associations differed by the level of neighbourhood deprivation.	Thirty-eight and 30 % of variability in the measures of mental well-being and mental health, respectively, could be explained by individual factors and the perceived community characteristics. In the total sample and stratified by neighbourhood deprivation, age, marital status and self-rated health were associated with both mental health and well-being, with the 'social connections' and local area satisfaction elements of social capital also emerging as explanatory variables. An increase of +1 in EQ-5D-3 L was associated with +1SD of the population mean in both mental health and well-being. Similarly, a change from 'very dissatisfied' to 'very satisfied' for local area satisfaction would result in +8.75 for mental well-being, but only in the more affluent of areas.	Self-rated health was associated with both mental health and mental well-being. Of the individual social capital explanatory variables, 'social connections' was more important for mental well-being. Although similarities in the explanatory variables of mental health and mental well-being exist, socio-ecological interventions designed to improve them may not have equivalent impacts in rich and poor neighbourhoods.	
26642823	For this contribution to the special issue on "Mapping Queer Bioethics," the author undertakes the curatorial spaces of the library, the museum, the textbook, and the public exhibition. With showcases such as natural history museums and the recent Bodyworlds traveling exhibit as touchstones, the author argues that distinctions between medical and popular visual culture in pedagogical contexts are porous, such that the study of sensational body types (queer, anatomically atypical, and otherwise) are couched in culturally problematic appreciations of the agency of certain bodies to speak for and/or about themselves. By extension, how and where certain bodies are viewed represent vital, bioethical dilemmas on the nature of corporeal viability. 
26637308	Ambivalence is a widely used concept in gerontology, mostly used in the common sense meaning. We propose that an elaborated notion based on the historical and systematic analysis, reveals important theoretical, methodological and practical potentials of the idea of ambivalence for the study of aging. We exemplify this view by proposing a heuristic perspective for the analysis of processes to constitute and reconstitute identities in old age using a model based on a multidimensional understanding of ambivalence. Ambivalence is defined as referring to the experiences of vacillating between polar contradictions of feeling, thinking, wanting and social structures in the search for the sense and meaning of social relationships, facts and texts, which are important for unfolding and altering facets of the self and agency. 
26613527	The Identity Capital Model proposes that forms of personal agency are associated with identity development as part of the transition to adulthood. This model was examined in two cultural contexts, taking into account age and gender, among college and university students aged 18 to 24 (N = 995). Confirmatory Factor Analyses verified cultural, age, and gender invariance of the two key operationalizations of the model. A Structural Equation Model path analysis confirmed that the model applies in both cultures with minor variations-types of personal agency are associated with the formation of adult- and societal-identities as part of the resolution of the identity stage. It was concluded that forms of personal agency providing the most effective ways of dealing with "individualization" (e.g., internal locus of control) are more important in the transition to adulthood among American students, whereas types of personal agency most effective in dealing with "individualistic collectivism" (e.g., ego strength) are more important among Japanese students. 
26608039	Different models of the formation of age identity explain the empirically determined difference between the chronological age and the age which is subjectively perceived by elderly people themselves. From a biographical point of view and on the basis of two maximally contrasting empirical cases, this article investigates the ways ambivalence appears in the narrations of elderly people about personal aging and the narrative strategies of coping with this experience of ambivalence. The results of the analysis indicate that the conceptualization of age identity in the different models should be seen more as descriptions of potential but not necessary forms of coping with age-specific ambivalences. 
26592778	In addition to mental disorders such as attention, emotion, delusions, hallucinations, and difficulties in social skills, the patients with schizophrenia exhibits significant abnormality in sensorimotor perception and control. To seek a neurobiological cause of the heterogeneous symptoms in schizophrenia, we focused on the impaired inference mechanism of the self-agency of the schizophrenia's brain where the sensory outcome generated by the self-initiated action was misattributed to the other agent's action. By developing a novel computational model of agency experience using a Bayesian decision making framework, we united the computational mechanisms of agency and motor control via internal model: a model for one to predict the sensory consequence of action. Our theory based on optimal feedback control with Kalman filtering successfully predicted a variety of schizophrenia's motor abnormalities assuming a deformed internal model. To discuss the plausibility of these model predictions, we reviewed literature that might support these predictions. We further proposed some experiments that potentially examine the proposed model of schizophrenia. Our approach in investigating a problem of mind by projecting it on the coordinates system of the embodiment effectively shed light on a central neuropathology of this disease that had been latent behind the observed behaviors. 
26584870	The body underlies our sense of self, emotion, and agency. Signals arising from the skin convey warmth, social touch, and the physical characteristics of external stimuli. Surprising or unexpected tactile sensations can herald events of motivational salience, including imminent threats (e.g., an insect bite) and hedonic rewards (e.g., a caressing touch). Awareness of such events is thought to depend upon the hierarchical integration of body-related mismatch responses by the anterior insula. To investigate this possibility, we measured brain activity using functional magnetic resonance imaging, while healthy participants performed a roving tactile oddball task. Mass-univariate analysis demonstrated robust activations in limbic, somatosensory, and prefrontal cortical areas previously implicated in tactile deviancy, body awareness, and cognitive control. Dynamic Causal Modelling revealed that unexpected stimuli increased the strength of forward connections along a caudal to rostral hierarchy-projecting from thalamic and somatosensory regions towards insula, cingulate and prefrontal cortices. Within this ascending flow of sensory information, the AIC was the only region to show increased backwards connectivity to the somatosensory cortex, augmenting a reciprocal exchange of neuronal signals. Further, participants who rated stimulus changes as easier to detect showed stronger modulation of descending PFC to AIC connections by deviance. These results suggest that the AIC coordinates hierarchical processing of tactile prediction error. They are interpreted in support of an embodied predictive coding model where AIC mediated body awareness is involved in anchoring a global neuronal workspace. 
26582181	Negative perceptions of self and others have lately become one of the criteria for Posttraumatic Stress Disorder (PTSD) among adults and adolescents. Drawing from theories of mental representations in psychopathology, this study examined self-reported negative cognitions, self and parental representations, and relationship themes among adolescents with and without PTSD. Thirty one adolescents with PTSD (11 boys, mean age = 14.06, SD = 2.24) were matched with 29 adolescents who had no psychiatric diagnosis (11 boys, mean age = 14.96, SD = 1.78). Adolescents completed self-report measures, wrote a description of self, mother and father, and were interviewed about positive and negative relationship episodes with mother, father, and peers. Adolescents with PTSD reported more self-criticism and performance evaluation than did controls. Their self-representation exhibited a lower sense of agency, which was related to structural variables (i.e., less integrative description). Although parental representations of adolescents with PTSD were not generally less benevolent or more punitive than those of controls, their relationship themes revealed a higher proportion of the wish to be distant from others. Adolescents with PTSD exhibited more passive responses and perceived more dominant or controlling responses from their parents. Findings point out to a serious impairment in representations of self and relationship patterns in adolescent PTSD.
26579043	The reciprocal coupling of perception and action in cognitive agents has been firmly established: perceptions guide action but so too do actions influence what is perceived. While much has been said on the implications of this for the agent's external behavior, less attention has been paid to what it means for the internal bodily mechanisms which underpin cognitive behavior. In this article, we wish to redress this by reasserting that the relationship between cognition, perception, and action involves a constitutive element as well as a behavioral element, emphasizing that the reciprocal link between perception and action in cognition merits a renewed focus on the system dynamics inherent in constitutive biological autonomy. Our argument centers on the idea that cognition, perception, and action are all dependent on processes focussed primarily on the maintenance of the agent's autonomy. These processes have an inherently circular nature-self-organizing, self-producing, and self-maintaining-and our goal is to explore these processes and suggest how they can explain the reciprocity of perception and action. Specifically, we argue that the reciprocal coupling is founded primarily on their endogenous roles in the constitutive autonomy of the agent and an associated circular causality of global and local processes of self-regulation, rather than being a mutual sensory-motor contingency that derives from exogenous behavior. Furthermore, the coupling occurs first and foremost via the internal milieu realized by the agent's organismic embodiment. Finally, we consider how homeostasis and the related concept of allostasis contribute to this circular self-regulation. 
26571072	In the general concept of self-disturbances in schizophrenia and schizophrenia spectrum disorders, somatopsychic depersonalization (SPD) occupies a special place as it constitutes a syndrome that comprises feelings of detachment from one's own body and mental processes. However, apart from clinical descriptions, to date the pathophysiology of SPD is not fully understood due to the rareness of the syndrome and a lack of experimental studies. In a case study of one patient with schizotypal disorder, we applied a multimodal approach to understanding the SPD phenomena. The patient's clinical profile was identified as disruption of implicit bodily function, accompanied by depressive symptoms. On a neuropsychological level, the patient exhibited impairment in executive functioning, intact tactile perception and kinesthetic praxis. Behavioral tests revealed an altered sense of time but unimpaired self-agency. Furthermore, the patient exhibited a lack of empathy and he had autistic traits, although with a sufficient ability to verbalize his feelings. On the neurobiological level using an active and passive touch paradigm during functional magnetic resonance imaging (fMRI), we found a hyperconnectivity of the default-mode network and salience network and a hypoconnectivity of the central executive brain networks in the performance of the touch task as well as intact perceptual touch processing emerging from the direct comparisons of the touch conditions. Our data provide evidence for the important role of altered large-brain network functioning in SPD that corresponds to the specific behavioral and neurocognitive phenomena. 
26568209	The cultural and social contexts of aging have changed a great deal during the last two decades and aging experiences have become more differentiated. However, pervasive age stereotypes still exist that limit the agency and self-perception of older people, and part of the experience of new aging is to actively combat such negative stereotypes. The purpose of this study is to explore how lifelong learning and a degree attainment in midlife become embedded into new aging practices. The study will focus on a specific group of aging workers who attained a Master's degree from Finnish universities in their fifties. In order to better understand the aging experiences of these older graduates, this study seeks to address how they construct the meaning of aging in relation to their own educational and professional status. The data consist of 14 life-history interviews, which were analyzed as narrative identity performances. Differentiating oneself from the stereotype of physical and mental decline and positioning oneself in a favorable way in inter-generational relations were common ways of approaching aging. Age-negotiation and ambivalence about aging were expressed by structuring narratives around clear oppositions and contradictions. University studies at age 50+ became a talking point in countering cultural age-stereotypes, because it showed that aging workers could still accomplish significant goals and "renew" oneself intellectually. University studies also enabled collaboration with the younger generation and the breaking of narrow age boundaries.
26562891	Certain situations may not only cause people to misjudge external information but also distort people's perception of themselves. The present study is the first to report the mirrored hand illusion which could be generated when the experimenter imitated the fist-clenching movements of the subject synchronously. The subjects formed the illusion that the experimenter's hand was "something I can control" when being imitated synchronously. In addition, a sense of ownership over the alien hand was established by integrating multisensory signals and comparing these signals with preexisting body presentations. This method might represent a new avenue for research on the formation of self-consciousness. 
26562332	The network between the parietal cortex and premotor cortex has a pivotal role in sensory-motor control. Grasping-related neurons in the anterior intraparietal area (AIP) and the ventral premotor cortex (F5) showed complementary properties each other. The object information for grasping is sent from the parietal cortex to the premotor cortex for sensory-motor transformation, and the backward signal from the premotor cortex to parietal cortex can be considered an efference copy/corollary discharge that is used to predict sensory outcome during motor behavior. Mirror neurons that represent both own action and other's action are involved in this system. This system also very well fits with body schema that reflects online state of the body during motor execution. We speculate that the parieto-premotor network, which includes the mirror neuron system, is key for mapping one's own body and the bodies of others. This means that the neuronal substrates that control one's own action and the mirror neuron system are shared with the "who" system, which is related to the recognition of action contribution, i.e., sense of agency. Representation of own and other's body in the parieto-premotor network is key to link between sensory-motor control and higher-order cognitive functions. 
26550800	Mirror-touch synaesthesia (MTS) is a condition that leads people to experience tactile sensations on their own body when watching at someone else being touched. Recent accounts postulate that MTS is linked with atypical self-other representations. It has been suggested that this may be associated with disturbances in two main components of self-awareness: sense of agency and sense of ownership. This study investigates changes in sense of agency and sense of ownership in MTS. Using a paradigm that deliberately blurs the boundaries between the self and the other, we not only found that MTS affects sense of agency and sense of ownership, but that these aspects of self-awareness are affected differently. We suggest that alterations in sense of agency can be linked to more profound disturbances in sense of ownership in MTS, and that MTS may be characterised by underlying difficulties in self-other processing. 
26549927	Theories in both contemporary psychotherapy and ancient philosophy associate deprivation with wrongdoing and suffering, but operate with different under-standings of deprivation. The article will focus on two concepts of deprivation, one psychological and the other one ontological, as advanced by Bowlby in attachment theory, and Augustine of Hippo (354-430 CE). In attachment theory deprivation is something one suffers as a result of the others' actions (receipt of insensitive caregiving in early childhood); it has neuropsychological effects, it relates to violent behaviour later in life, and it is therapeutically treated mainly by emotional sensory work directed at attaining self-regulation. Understanding deprivation as Augustine does (i.e., diminishment of a being's inner unity and order caused by one's exercise of will) introduces a distinctive philosophical view on formation and can inform a type of reflective-behavioural work centred on forming impaired volitional and emotional capacities, and on reclaiming agency and responsibility both for what can be called self-deprivation and for ways to counter deprivation in offenders and victims.
26546250	The purpose of this conceptual paper is to explore and map the "espoused theories" (Argyris and Schön 1978) of agency used in educational contexts. More precisely, we limit the focus on the normative view of student agency assumed within dominant school practices, desired by educational practitioners, leaving out non-normative emerging agencies such as student agency of resistance. Agency is a "tricky" concept, and often scholars who use the concept of agency do not define or operationalize it (e.g., Archer 2000). One reason is that there is no consensus among scholars about the notion of agency, especially when applied to educational contexts (Hitlin and Elder Sociological Theory, 25 (2), 170-191, 2007). Moreover, the recent neoliberal framing of individuals' agency as fully autonomous, flexible, and self-entrepreneur is adding the dilemma of agency manipulation in the sphere of education (Gershon 2011; Sidorkin 2004). To tackle this dilemma in educational contexts, we suggest to further interrogating the normative notion of agency in all its modes and develop a more nuanced conceptualization. We hope that such conceptualization would produce an understanding of the diverse manifestations and definitions of agency within a human ideal, educational content, behaviors, and social settings. We observed diverse uses of the normative term "agency" in educational discourse. We examined the term as used by researchers and practitioners. We also looked at the different ways it has been used in philosophical discussions of education, political framing of the civic role of schooling, disciplinary policy statements, school mission statements, and in everyday common use. It is worthy to note that our categorization of the use and meaning of the normative term "agency" depends on the scholars' epistemological paradigmatic assumptions, socio-political and historical situatedness, and ontological projects being translated into diverse scholarships of education. As a result of our research, we suggest four major normative conceptual frameworks related to agency mainly being adopted in educational contexts that we labeled as: 1) instrumental, 2) effortful, 3) dynamically emergent, and 4) authorial. In this paper, we discuss these normative approaches to agency as we compare and contrast the assumptions and their consequences for the current field of education, mostly from a point of view of authorial definition of agency (our bias). 
26542339	The current article reviews the narcissism-self-enhancement literature using a multilevel meta-analytic technique. Specifically, we focus on self-insight self-enhancement (i.e., whether narcissists perceive themselves more positively than they are perceived by others); thus, we only include studies that compare narcissists' self-reports to observer reports or objective measures. Results from 171 correlations reported in 36 empirical studies (N = 6,423) revealed that the narcissism-self-enhancement relationship corrected for unreliability in narcissism was .21 (95% confidence interval [CI] = [.17, .25]), and that narcissists tend to self-enhance their agentic characteristics more than their communal characteristics. The average corrected relationship between narcissism and self-enhancement for agentic characteristics was .29 (95% CI = [.25, .33]), whereas for communal characteristics it was .05 (95% CI = [-.01, .10]). In addition, we individually summarized narcissists' self-enhancement for 10 different constructs (i.e., the Big Five, task performance, intelligence, leadership, attractiveness, and likeability). 
26525051	Using theoretical analysis of self-consciousness concept and experimental evidence on the brain default mode network (DMN) that constitutes the neural signature of self-referential processes, we hypothesized that the anterior and posterior subnets comprising the DMN should show differences in their integrity as a function of meditation training. Functional connectivity within DMN and its subnets (measured by operational synchrony) has been measured in ten novice meditators using an electroencephalogram (EEG) recording in a pre-/post-meditation intervention design. We have found that while the whole DMN was clearly suppressed, different subnets of DMN responded differently after 4 months of meditation training: The strength of EEG operational synchrony in the right and left posterior modules of the DMN decreased in resting post-meditation condition compared to a pre-meditation condition, whereas the frontal DMN module on the contrary exhibited an increase in the strength of EEG operational synchrony. These findings combined with published data on functional-anatomic heterogeneity within the DMN and on trait subjective experiences commonly found following meditation allow us to propose that the first-person perspective and the sense of agency (the witnessing observer) are presented by the frontal DMN module, while the posterior modules of the DMN are generally responsible for the experience of the continuity of 'I' as embodied and localized within bodily space. Significance of these findings is discussed.
26524100	Two studies involving high school physical education students were conducted to investigate associations between 2 x 2 self-presentation motives and theorized antecedents. In Study 1 (n = 445), using path analysis, we found that positive predictive pathways emerged from fear of negative evaluation, trait agency and communion, self-presentational efficacy, and social self-efficacy to 2 x 2 motives. In Study 2 (n = 301), using cluster analysis, we found that approximately half the cohort was classified into a high motive endorsement cluster and half into a low motive endorsement cluster. The high cluster had significantly higher 2 x 2 motive, fear of negative evaluation, trait agency and communion, and self-efficacy scores. This work represents the first concerted effort to empirically examine proposed antecedents of 2 x 2 motives and serves to inform theorists and practitioners about dispositional and context-specific factors that may align with these motives. 
26518886	The Child Oral Health Impact Profile (COHIP) is an Oral Health Related Quality of Life (OHRQOL) tool that assesses the impact of oral diseases on quality of life in children. This study aimed to assess the validity of the COHIP French questionnaire (45 items) and to evaluate the OHRQOL of 12-years children in New Caledonia.After cultural adaptation of the COHIP questionnaire, data were collected from clinical oral examinations and self-administered questionnaires in a representative sample of children aged 12 years in New Caledonia. Questions related to socio-demographic status or children's perception of their oral and general health were added to the COHIP questionnaire. Studying the association between COHIP scores and health subjective perceptions or dental status indicators assessed concurrent and discriminant validity. The items of the COHIP were subjected to principal components analysis. Finally, reproducibility and reliability were evaluated using Intraclass Correlation Coefficients (ICC) and Cronbach's alpha coefficient.	Two hundred and thirty-six children participated in the main study; mean age was 12.6 ± 0.31 years, 55.1 % were girls and diverse ethnic groups were represented. A preliminary reliability analysis has led to calculate COHIP scores with 34 items as in the English version, scores ranged from 35 to 131 (mean ± SD, 101.9 ± 16.84). Lower COHIP scores were significantly associated with the self-perception of poor general or oral health. COHIP was able to discriminate between participants according to gender, ethnic group, oral hygiene, dental attendance, dental fear and the presence of oral diseases. Test-retest reliability and scale reliability were excellent (ICC = 0.904; Cronbach's alpha coefficient = 0.880). Four components were identified from the factor analysis.	The French 34-items COHIP showed excellent psychometric properties. Further testing will examine the structure and utility of the instrument in both clinical and epidemiological samples.	
26515989	The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In-depth interviews using an interpretative-phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it. 
26500582	Parkinson's disease (PD) impairs the control of movement and cognition, including the planning of action and its consequences. This provides the opportunity to study the dopaminergic influences on the perception and awareness of action. Here we examined the perception of the outcome of a goal-directed action made by medicated patients with PD. A visuomotor task probed the integration of sensorimotor signals with the positive expectations of outcomes (Self priors), which in healthy adults bias perception toward success in proportion to trait optimism. We tested the hypotheses that (i) the priors on the perception of the consequences of one's own actions differ between patients and age- and sex-matched controls, and (ii) that these priors are modulated by the levodopa dose equivalent (LDEs) in patients. There was no overall difference between patients and controls in the perceptual priors used. However, the precision of patient priors was inversely related to their LDE. Patients with high LDE showed more accurate priors, representing predictions that were closer to the true distribution of performance. Such accuracy has previously been demonstrated when observing the actions of others, suggesting abnormal awareness of action in these patients. These results confirm a link between dopamine and the positive expectation of the outcome of one's own actions, and may have implications for the management of PD. 
26463879	Brain imaging research in schizophrenia has provided a better understanding of the neural basis of auditory hallucinations (AH). Recently, renewed interest in the phenomenology of AH raised questions related to their neural substrates. Hence, the neural basis of AH self/other attribution have yet to be investigated as beliefs regarding the origin of the voices is a cardinal feature of AH phenomenology. As the right temporoparietal junction (TPJ) and the inferior parietal lobule (IPL) play a key role in disentangling the origin of sensory events and in self/other distinction, we tested the hypothesis that the morphology of the IPL/TPJ area may be involved in AH self/other attribution. Magnetic resonance images of 39 right-handed patients with persistent auditory hallucinations and 19 healthy subjects were analyzed with sulcus-based morphometry. AH self-other attribution were found to be associated with the sulcal pattern of the posterior part of the Sylvian fissure, encompassing the IPL/TPJ area. The preference for the attribution of AH to self or to others could be associated with early neurodevelopmental events as the sulcal pattern is determined during fetal life and is stable after birth. Our study also raises basic cognitive questions regarding self-consciousness and suggest that impairments at a pre-reflexive level, leading to hearing his/her thoughts as voices ('I' level or feeling of agency), and a reflexive level leading to attribution belief ('Me' level or judgment of agency) are likely involved in AH.
26436716	The present review organizes the vocational psychology literature published between 2007 and 2014 into three overarching themes: Promoting (a) agency in career development, (b) equity in the work force, and (c) well-being in work and educational settings. Research on career adaptability, self-efficacy beliefs, and work volition is reviewed in the agency section, with the goal of delineating variables that promote or constrain the exercise of personal agency in academic and occupational pursuits. The equity theme covers research on social class and race/ethnicity in career development; entry and retention of women and people of color in science, technology, engineering, and math (STEM) fields; and the career service needs of survivors of domestic violence and of criminal offenders. The goal was to explore how greater equity in the work force could be promoted for these groups. In the well-being section, we review research on hedonic (work, educational, and life satisfaction) and eudaimonic (career calling, meaning, engagement, and commitment) variables, with the goal of understanding how well-being might be promoted at school and at work. Future research needs related to each theme are also discussed. 
26434736	This article provides a critique of the concept of reflexivity in social theory today and argues against the tendency to define agency exclusively in terms of reflexivity. Margaret Archer, in particular, is highlighted as a key proponent of this thesis. Archer argues that late modernity is characterized by reflexivity but, in our view, this position neglects the impact of more enduring aspects of agency, such as the routinization of social life and the role of the taken-for-granted. These concepts were pivotal to Bourdieu and Giddens' theorization of everyday life and action and to Foucault's understanding of technologies of the self. We offer Bourdieu's habitus as a more nuanced approach to theorizing agency, and provide an alternative account of reflexivity. Whilst accepting that reflexivity is a core aspect of agency, we argue that it operates to a backdrop of the routinization of social life and operates from within and not outside of habitus. We highlight the role of the breach in reflexivity, suggesting that it opens up a critical window for agents to initiate change. The article suggests caution in over-ascribing reflexivity to agency, instead arguing that achieving reflexivity and change is a difficult and fraught process, which has emotional and moral consequences. The effect of this is that people often prefer the status quo, rather than to risk change and uncertainty. 
26429794	Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness".This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation.	Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness.	ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.	
26422484	Policy development is recognized as a core function of public health and a core competency in formal public health education. However, relatively little is known nationally about worker perceptions and competencies related to policy development in the governmental public health workforce.To characterize perceived importance and presence or absence of competency gaps related to policy development.	As part of the Public Health Workforce Interests and Needs Survey (PH WINS), a nationally representative stratified sample of permanently employed state health agency (SHA) central office staff was created. Descriptive and inferential analyses examined correlates of perceived importance and competency gaps related to policy development.	Permanently employed central office employees of SHAs.	Analyses focus on 2 self-reported measures of perceived importance and ability related to policy development skills, as well as awareness and perceptions regarding Health in All Policies (HiAP).	Seventy-two percent of SHA central office staff (95% confidence interval, 71-73) indicated "influencing policy development" was somewhat or very important to their day-to-day work. Among that group, 35% (95% confidence interval, 34-36) reported that they were unable to perform this or they considered themselves to be a beginner at this skill. Approximately three-fourths of staff indicated "understanding the relationship between a new policy and many types of public health problems" was somewhat or very important, and 30% of those who did said they were unable to perform this skill or were a beginner at it. Nationally, one-half of staff have not heard of HiAP. Among those who have, 86% indicated it was somewhat or very important to public health, and 41% reported they would like to see more emphasis on HiAP.	Workforce development, both formal education and on-the-job training, may benefit from placing a greater emphasis on the development of policy skills. HiAP is an important approach to policy development.	
26421646	This article aims to make a theoretical contribution to the field of mistreatment of older adults by introducing Honneth's Struggle for Recognition theory in order to document financial mistreatment of older women. Through a case analysis of an older woman financially exploited by her son, considering self-agency and structure, it shows how financial mistreatment disrespects the three components of Honneth's theory, primary relationships, legal relations, and community of value. Personal integrity, social integrity, and honor and dignity are threatened by mistreatment. This case analysis opens for further theoretical exploration of the Struggle for Recognition theory in the understanding of mistreatment of older adults. 
26409246	Few ideas are as inexorable as the arrow of causation: causes must precede their effects. Explicit or implicit knowledge about this causal order permits humans and other animals to predict and control events in order to produce desired outcomes. The sense of agency is deeply linked with representation of causation, since it involves the experience of a self-capable of acting on the world. Since causes must precede effects, the perceived temporal order of our actions and subsequent events should be relevant to the sense of agency. The present study investigated whether the ability to predict the outcome of an action would impose the classical cause-precedes-outcome pattern on temporal order judgements. Participants indicated whether a visual stimulus (dots moving upward or downward) was presented either before or after voluntary actions of the left or right hand. Crucially, the dot motion could be either congruent or incongruent with an operant association between hand and motion direction learned in a previous learning phase. When the visual outcome of voluntary action was congruent with previous learning, the motion onset was more often perceived as occurring after the action, compared to when the outcome was incongruent. This suggests that the prediction of specific sensory outcomes restructures our perception of timing of action and sensory events, inducing the experience that congruent effects occur after participants' actions. Interestingly, this bias to perceive events according to the temporal order of cause and outcome disappeared when participants knew that motion directions were automatically generated by the computer. This suggests that the reorganisation of time perception imposed by associative learning depends on participants' causal beliefs. 
26407834	This study examined (a) the contribution of math self-efficacy to students' perception of their emotional and social engagement in fifth grade math classes, and (b) the extent to which high quality teacher-student interactions compensated for students' low math self-efficacy in contributing to engagement. Teachers (n = 73) were observed three times during the year during math to measure the quality of teacher-student interactions (emotional, organizational, and instructional support). Fifth graders (n = 387) reported on their math self-efficacy at the beginning of the school year and then were surveyed about their feelings of engagement in math class three times during the year immediately after the lessons during which teachers were observed. Results of multi-level models indicated that students initially lower in math self-efficacy reported lower emotional and social engagement during math class than students with higher self-efficacy. However, in classrooms with high levels of teacher emotional support, students reported similar levels of both emotional and social engagement, regardless of their self-efficacy. No comparable findings emerged for organizational and instructional support. The discussion considers the significance of students' own feelings about math in relation to their engagement, as well as the ways in which teacher and classroom supports can compensate for students lack of agency. The work has implications for school psychologists and teachers eager to boost students' engagement in math class.
26392423	To investigate the development of healthy life expectancy from 65 years (HLE65) in Sweden in the period 1980 and 2010 by using two different health indicators: self-rated health and the global activity limitation indicator (GALI).Sources of data for the HLE computations were Swedish national mortality statistics and the nationwide Swedish Survey of Living Conditions (SSLC), which have been conducted biennially by Statistics Sweden since 1974. We used the Sullivan method for calculations of HLE. A decomposition into mortality and disability effect has been made in accordance with the method devised by Nusselder.	Life expectancy at age 65 (LE65) increased by 3.1 years for women and 4.0 years for men from 1980/85 to 2006/11. Regardless of which health measure investigated - self-rated health or GALI - HLE65 increased between the periods 1980/85 to 2006/2011 more rapidly than LE65 and as a consequence the years with bad self-rated health and years with activity limitations decreased. These increases as well as the decreases were significant (p<0.05).	The Swedish LE65 and HLE65 development, as judged by the SSLC study, are compatible with the postponement hypothesis and there is even a clear tendency for compression. Thus, the years with bad self-rated health and years with activity limitations are postponed to a higher age and the number of those years have decreased. From this respect, the Swedish development looks positive. The need of old age care in 2010 would have been much higher if it had been expansion - not postponement - of bad self-rated health and years with activity limitations during the time period.	
26387079	In recent years, the concept of responsiveness has been put forward as one desirable measure of the performance of health systems. Responsiveness can be defined as a system's ability to respond to the legitimate expectations of potential users regarding non-health enhancing aspects of care. However, since responsiveness is evaluated by patients on a categorical scale, their self-evaluation can be affected by the phenomenon of reporting heterogeneity. A few studies have investigated how standard socio-demographic characteristics influence the reporting style of patients with regard to responsiveness. However, we are not aware of studies that focus explicitly on the influence that both the patients' state of health and their experiencing of pain have on their reporting style on responsiveness. This paper tries to bridge this gap by using data regarding a sample of about 2500 patients hospitalized in four Local Health Authorities (LHA) in Italy's Emilia-Romagna region between 2010 and 2012. These patients have evaluated 27 different aspects of the quality of care, concerning five domains of responsiveness (communication, privacy, dignity, waiting times and quality of facilities). Data have been stratified into five sub-samples, according to these domains. We estimate a generalized ordered probit model, an extension of the standard ordered probit model which permits the reporting behaviour of respondents to be modelled as a function of certain respondents' characteristics, which in our analysis are represented by the variables "state of health" and "pain". Our results suggest that unhealthier patients and patients experiencing pain are more likely to report a lower level of responsiveness, all other things being equal. 
26386015	We propose that the propensity to think creatively tends to be associated with independence and self-direction-qualities generally ascribed to men-so that men are often perceived to be more creative than women. In two experiments, we found that "outside the box" creativity is more strongly associated with stereotypically masculine characteristics (e.g., daring and self-reliance) than with stereotypically feminine characteristics (e.g., cooperativeness and supportiveness; Study 1) and that a man is ascribed more creativity than a woman when they produce identical output (Study 2). Analyzing archival data, we found that men's ideas are evaluated as more ingenious than women's ideas (Study 3) and that female executives are stereotyped as less innovative than their male counterparts when evaluated by their supervisors (Study 4). Finally, we observed that stereotypically masculine behavior enhances a man's perceived creativity, whereas identical behavior does not enhance a woman's perceived creativity (Study 5). This boost in men's perceived creativity is mediated by attributions of agency, not competence, and predicts perceptions of reward deservingness. 
26379087	This paper discusses the phenomenological nature of the sense of boundaries (SB), based on the case of S, who has practiced mindfulness in the Satipathana and Theravada Vipassana traditions for about 40years and accumulated around 20,000h of meditative practice. S's unique abilities enable him to describe his inner lived experience with great precision and clarity. S was asked to shift between three different stages: (a) the default state, (b) the dissolving of the SB, and (c) the disappearance of the SB. Based on his descriptions, we identified seven categories (with some overlap) that alter during the shifts between these stages, including the senses of: (1) internal versus external, (2) time, (3) location, (4) self, (5) agency (control), (6) ownership, and (7) center (first-person-egocentric-bodily perspective). Two other categories, the touching/touched structure and one's bodily feelings, do not fade away completely even when the sense-of-boundaries disappears. 
26377120	Little is understood about factors that influence speech-language pathologists' (SLPs') acceptance of telepractice. The aim of this study was to investigate SLPs' perceptions and experiences of transitioning to a school-based telepractice service to identify factors that contributed to positive clinician attitudes. In-depth interviews were conducted with 15 SLPs who recently commenced providing school-based telepractice services. Interviews were recorded and transcribed verbatim and thematic analysis was used to interpret interviews, with themes compared and contrasted across the group. Results indicated that although SLPs reported initially having mixed feelings towards telepractice, they later evaluated telepractice positively and viewed it as a legitimate service delivery mode. The overarching theme was that positive beliefs about telepractice were associated with perceptions of its consistency with the underlying principles of face-to-face therapy. In evaluating telepractice, SLPs considered: (a) therapeutic relationships with children; (b) collaboration with parents and teachers; (c) adequacy of technology and resources; and (d) access to support for learning telepractice. Therapy assistants and specific clinician attributes emerged as key strategies used to manage threats to acceptability. Preparation of SLPs transitioning to telepractice should address factors that support positive experiences with, and attitudes towards, telepractice to ensure that training achieves the greatest, most sustained change. 
26365106	Difficulties in self-other processing lie at the core of schizophrenia and pose a problem for patients' daily social functioning. In the present selective review, we provide a framework for understanding self-other integration and distinction, and impairments herein in schizophrenia. For this purpose, we discuss classic motor prediction models in relation to mirror neuron functioning, theory of mind, mimicry, self-awareness, and self-agency phenomena. Importantly, we also discuss the role of more recent cognitive expectation models in these phenomena, and argue that these cognitive models form an essential contribution to our understanding of self-other integration and distinction. In doing so, we bring together different lines of research and connect findings from social psychology, affective neuropsychology, and psychiatry to further our understanding of when and how people integrate versus distinguish self and other, and how this goes wrong in schizophrenia patients. 
26356729	In response to concern about strengthening the nation's ability to protect its population and way of life (i.e., security) and ability to adapt and recover from emergencies (i.e., resilience), the President of the United States issued Presidential Policy Directive 8: National Preparedness (PPD-8) (1). Signed on March 30, 2011, PPD-8 is a directive for the U.S. Department of Homeland Security to coordinate a comprehensive campaign across government, private and nonprofit sectors, and individuals to build and sustain national preparedness. Despite efforts by the Federal Emergency Management Agency (FEMA) and other organizations to educate U.S. residents on becoming prepared, growth in specific preparedness behaviors, including actions taken in advance of a disaster to be better prepared to respond to and recover, has been limited (2). In 2012, only 52% of U.S. residents surveyed by FEMA reported having supplies for a disaster (2), a decline from 57% who reported having such supplies in 2009 (3). It is believed that knowledge influences behavior, and that attitudes and beliefs, which are correlated with knowledge, might also influence behavior (4). To determine the association between knowledge and beliefs and household preparedness, CDC analyzed baseline data from Ready CDC, a personal disaster preparedness intervention piloted among Atlanta- and Morgantown-based CDC staff members during 2013–2015. Compared with persons with basic preparedness knowledge, persons with advanced knowledge were more likely to have assembled an emergency kit (44% versus 17%), developed a written household disaster plan (9% versus 4%), and received county emergency alert notifications (63% versus 41%). Similarly, differences in household preparedness behaviors were correlated with beliefs about preparedness. Persons identified as having strong beliefs in the effectiveness of disaster preparedness engaged in preparedness behaviors at levels 7%–30% higher than those with weaker preparedness beliefs. Understanding the influences of knowledge and beliefs on household disaster preparedness might provide an opportunity to inform messages promoting household preparedness.
26323591	Due to the expiry of patents for biological pharmaceuticals, in forthcoming years there will be an increase in the approval of biosimilars by the international health authorities. This will bring potential savings in the range of 11.8-33.4 billion euros in the European Union (EU) in the year 2020.The aims are an understanding of the natural variability of biological substances and the clinical relevance of the diverse product attributes, proof of comparability (similarity) as a self-contained concept in the development and approval of biosimilars and importance of extrapolation to other indications when comparability is demonstrated by comprehensive analytical and functional studies.	This study involved an assessment of the regulations of the European licensing authority, the European Medicines Agency (EMA), with respect to the approval of biosimilars, analytical, physicochemical and biological procedures for determination of comparability and the permissible deviation from the reference product	Approved biological pharmaceuticals have a natural intrinsic variability, e.g. with respect to glycosylation. Furthermore, different batches in the manufacturing process can be different or the manufacturing process itself can be subject to change. Biosimilars are subject to specific and strict approval criteria with the aim of restricting the product attributes to lie within the variability range of the original biologics, can only show deviations from the original preparations within very narrow limits and must show proven safety, quality and effectiveness comparable to them.	The development and approval concept of biosimilars has been proven for nearly 10 years. Strict requirements by the EMA guarantee the highest quality standards, which have led to significant savings in the healthcare system and an expansion of access to biological pharmaceuticals in many countries and for many patients.	
26323167	Self-disturbance, a core feature of schizophrenia, recently has been explained from the standpoint of an abnormal sense of agency (SoA). Previous studies showed that aberrant SoA in schizophrenia arise from imprecise predictions about the sensory consequences of actions. However, the nature of the malfunctioning predictions remains unclear. We examined the temporally "delayed" nature of inadequate predictions. We studied 30 patients with schizophrenia and 30 healthy controls. Our original SoA task evaluates explicit experience of the temporal causal relationship between an intentional action and an effect on a computer screen under the presence of temporal biases. We introduced an adaptation with a "trial-by-trial" method that prolonged or shortened the temporal biases. We hypothesized that delayed prediction signals in schizophrenia could lead to a match in timing between predictions and actual outcomes, resulting in self-agency. The adjustment courses to changing temporal biases were evaluated. Patients with schizophrenia continued to feel self-agency even when the adjusted temporal bias was longer than 1000ms. This result indicated that patient's prediction would be delayed in each trial. Our study empirically showed behavioral evidence for "delayed" prediction signals in a SoA paradigm for the first time. 
26307482	The "Great Recession" shocked the primary institutions that help individuals and families meet their needs and plan for the future. This study examines middle-aged adults' experiences of financial loss and considers how socioeconomic and interpersonal resources facilitate or hinder maintaining a sense of control in the face of economic uncertainty.Using the 2006 and 2010 waves of the Health and Retirement Study, change in income and wealth, giving help to and receiving help from others, household complexity, and sense of control were measured among middle-aged adults (n = 3,850; age = 51-60 years).	Socioeconomic resources predicted both the level of and change in the engagement of interpersonal resources prior to and during the Great Recession. Experiences of financial loss were associated with increased engagement of interpersonal resources and decreased sense of control. The effect of financial loss was dampened by education. Sense of control increased with giving help and decreased with household complexity.	Findings suggest that, across socioeconomic strata, proportional loss in financial resources resulted in a loss in sense of control. However, responses to financial loss differed by socioeconomic status, which differentiated the ability to maintain a sense of control following financial loss.	
26298422	The illusion of control can be defined as the erroneous belief that one's actions cause a specific outcome, whereas sense of agency refers to the subjective feeling of authorship over one's actions. In the present study we investigated the development of illusory control and sense of agency. A novel card-guessing game was developed in which 7- to-12-year old children (Study 1) and adults (Study 2) were required to select a card, and we manipulated the congruence of the outcome with their initial choice (i.e., congruent or incongruent) and the valence of the outcome that was presented (i.e., positive or negative). We found that illusory control and the self-attribution bias (i.e., the bias to attribute positive outcomes to oneself) in the card guessing game decreased, as children get older. In contrast, for both children and adults sense of agency in the task was similarly affected by outcome congruency, suggesting that the ability to relate predicted to observed action outcomes reflects a basic mechanism that helps people to sustain a sense of agency. Thus, while the illusion of control decreases as we get older, the experience of agency as a function of outcome congruency seems to be more stable across development.
26290540	As HIV has transitioned into a chronic disease, reappraisal of clinical management has occurred with chronic disease self-management (CDSM) as one possibility. However, despite extensive work on CDSM across a range of diseases, little attention has focused on psychosocial contexts of the lives of people for whom programs are intended. This article reports semi-structured interviews used to explore health practices and motivations of 33 people with HIV (PWHIV) in Australia. Within participants' accounts, different forms of subjectivity and agency emerged with implications for how they understood and valued health-related behaviors. Four themes arose: health support and disclosure, social support and stigma, employment/structure, and health decisions beyond HIV. The experience of stigma and its intersection with CDSM remains relatively un-chartered. This study found stigma shapes agency and engagement with health. Decisions concerning health behaviors are often driven by perceived social and emotional benefit embedded in concerns of disclosure and stigma.
26286343	Community collectivization is an integral part of condom use and HIV risk reduction interventions among key population. This study assesses community collectivization among female sex workers (FSWs), and explores its relationship with sex workers' consistent condom use (CCU) with different partners considering the interaction effect of time and collectivization. Data were drawn from two rounds of cross-sectional surveys collected during 2010 (N1 = 1986) and 2012 (N2 = 1973) among FSWs in Andhra Pradesh, India. Results of the multiple logistic regression analysis show that, CCU with regular and occasional clients increased over the inter-survey period among FSWs with a high collective efficacy (AOR 2.9 and 6.1) and collective agency (AOR 14.4 and 19.0) respectively. The association of high levels of collectivization with CCU and self-efficacy for condom use are central to improve the usefulness and sustainability of HIV prevention programs worldwide.
26282856	How do we recognize ourselves as the agents of our actions? Do we use the same error detection mechanisms to monitor self-generated vs. externally imposed actions? Using event-related brain potentials (ERPs), we identified two different error-monitoring loops involved in providing a coherent sense of the agency of our actions. In the first ERP experiment, the participants were embodied in a virtual body (avatar) while performing an error-prone fast reaction time task. Crucially, in certain trials, participants were deceived regarding their own actions, i.e., the avatar movement did not match the participant's movement. Self-generated real errors and false (avatar) errors showed very different ERP signatures and with different processing latencies: while real errors showed a classical frontal-central error-related negativity (Ne/ERN), peaking 100ms after error commission, false errors elicited a larger and delayed parietal negative component (at about 350-400ms). The violation of the sense of agency elicited by false avatar errors showed a strong similarity to ERP signatures related to semantic or conceptual violations (N400 component). In a follow-up ERP control experiment, a subset of the same participants merely acted as observers of the avatar correct and error movements. This experimental situation did not elicit the N400 component associated with agency violation. Thus, the results show a clear neural dissociation between internal and external error-monitoring loops responsible for distinguishing our self-generated errors from those imposed externally, opening new avenues for the study of the mental processes underlying the integration of internal and sensory feedback information while being actors of our own actions.
26270552	Self-agency (SA) is a person's feeling that his action was generated by himself. The neural substrates of SA have been investigated in many neuroimaging studies, but the functional connectivity of identified regions has rarely been investigated. The goal of this study is to investigate the neural network related to SA.SA of hand movements was modulated with virtual reality. We examined the cortical network relating to SA modulation with electroencephalography (EEG) power spectrum and phase coherence of alpha, beta, and gamma frequency bands in 16 right-handed, healthy volunteers.	In the alpha band, significant relative power changes and phase coherence of alpha band were associated with SA modulation. The relative power decrease over the central, bilateral parietal, and right temporal regions (C4, Pz, P3, P4, T6) became larger as participants more effectively controlled the virtual hand movements. The phase coherence of the alpha band within frontal areas (F7-FP2, F7-Fz) was directly related to changes in SA. The functional connectivity was lower as the participants felt that they could control their virtual hand. In the other frequency bands, significant phase coherences were observed in the frontal (or central) to parietal, temporal, and occipital regions during SA modulation (Fz-O1, F3-O1, Cz-O1, C3-T4L in beta band; FP1-T6, FP1-O2, F7-T4L, F8-Cz in gamma band).	Our study suggests that alpha band activity may be the main neural oscillation of SA, which suggests that the neural network within the anterior frontal area may be important in the generation of SA.	
26264763	There is a lively debate in the literature on reflective processes and on the necessity to view them as consisting with differing levels of complexity. Within a semiotic and psychodynamic perspective, we present a conceptualization on reflective processes which distinguishes between reflection and reflectivity and articulates their relationship with narrative devices.The study analyzes 224 narratives of critical events written by 77 underachieving university students that took part in group training courses during the INSTALL European project.The corpus was subjected to a qualitative analysis of narrative function, with the aim of detecting narrative functions of reflection, reflectivity and agency, the latter being considered as an interconnected construct to the reflective process.The functions were discussed both on the basis of how the narrators reacted to the discontinuity in their self-image caused by the critical event, and based upon different types of narrative coherence (chronological, causal, thematic, autobiographical).The results highlighted that narratives with a reflection function, attribute the discontinuity generated by the event to the self, and show a causal coherence; those whose function is reflectivity interpret the discontinuity attributing it to the self in relation to others and present a thematic coherence; those of agency ascribe the discontinuity to a potential selves in action, and are characterized by an autobiographical coherence.The implications of the study will be discussed with reference to the value of narrative writing in promoting reflective-agentive processes. 
26221048	Schizophrenia is a disturbance of the self, of which the attribution of agency is a major component. In this article, we review current theories of the Sense of Agency, their relevance to schizophrenia, and propose a novel framework for future research. We explore some of the models of agency, in which both bottom-up and top-down processes are implicated in the genesis of agency. We further this line of inquiry by suggesting that ongoing neurological activity (the brain's resting state) in self-referential regions of the brain can provide a deeper level of influence beyond what the current models capture. Based on neuroimaging studies, we suggest that aberrant activity in regions such as the default mode network of individuals with schizophrenia can lead to a misattribution of internally/externally generated stimuli. This can result in symptoms such as thought insertion and delusions of control. Consequently, neuroimaging can contribute to a more comprehensive conceptualization and measurement of agency and potential treatment implications. 
26207986	Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President's Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality.Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the "good" range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring "good" rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events.	Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach.	
26196450	The rubber hand illusion shows that people can perceive artificial effectors as part of their own body under suitable conditions, and the virtual hand illusion shows the same for virtual effectors. In this study, we compared a virtual version of the rubber-hand setup with a virtual-hand setup, and manipulated the synchrony between stimulation or movement of a virtual "effector" and stimulation or movement of people's own hand, the similarity between virtual effector and people's own hand, and the degree of agency (the degree to which the virtual effector could be controlled by people's own movements). Synchrony-induced ownership illusion was strongly affected by agency but not similarity, which is inconsistent with top-down modulation approaches but consistent with bottom-up approaches to ownership. However, both agency and similarity induce a general bias towards perceiving an object as part of one's body, suggesting that ownership judgments integrate various sources of information. 
26195186	Suicide is common among offenders, who are at increased risk of homelessness, unemployment and mental illness and are prone to impulsivity. Release from prison is a particularly vulnerable time. This qualitative study investigated the views of 35 offenders in South-West England prior to and after release from prison, enquiring into their previous suicide attempts and how they saw their future. Semi-structured interviews were analysed thematically, comparing individuals who had made one, more than one, and no suicide attempts. Multiple attempters were often in despair and enmeshed in substance misuse, with little control over their lives. Most of those with one-off or no previous attempts portrayed themselves as having more mastery. One-off attempters described using particularly violent means. The role of different types of agency in pathways to and from suicide is discussed. Iterational agency, the selective reactivation of past patterns of behaviour, appeared to dominate in individuals who were choosing between further suicide attempts and substance use. Projective agency, having a more future orientation, appeared more prominent in some single attempters and in those individuals with plans to escape crime and social exclusion. 
26123497	People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such 'talk-based' approaches have to be modified for an optimal use.To evaluate an adapted interdisciplinary biographic-narrative intervention using quantitative measures of health-related quality of life (HRQL) and mood. Additionally, semi-structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia.	Twenty-seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face-to-face in-depth interviews and seven group sessions conducted over 10 weeks in a mixed-method design with pre- and post-tests and a follow-up assessment 3 months post-intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi-structured interviews were conducted post-treatment, including questions concerning the participants' experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory.	For all 27 participants, we found significant and stable growth in HRQL. Self-reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: 'evaluation of the face-to-face interviews' and 'evaluation of the group sessions'. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things.	Our quantitative and qualitative results demonstrated the benefits associated with the biographic-narrative intervention. The participants' sense of self changed through the approach. The findings provide foundations for future work using biographic narrative interventions to influence QoL and identity renegotiation in people with aphasia.	
26122122	Oxytocin promotes prosocial behavior, especially in those individuals who are low in affiliation (e.g., avoidantly attached individuals), but can exacerbate interpersonal insecurities in those preoccupied with closeness (e.g., anxiously attached individuals). One explanation for these opposing observations is that oxytocin induces a communal, other-orientation. Becoming more other oriented should help those people who focus on the self to the exclusion of others, but could be detrimental to those who are other focused but have little sense of an agentic self. Using a within-subjects design, we administered intranasal oxytocin and placebo to 40 males and measured their agency (self-orientation) and communion (other-orientation). Oxytocin produced a slight increase in communion for the average participant; however, as predicted, avoidantly attached individuals were especially likely to perceive themselves as more communal ("kind," "warm," "gentle," etc.) after receiving oxytocin than after receiving the placebo. There was no main effect of oxytocin on agency for the average participant; however, anxiously attached individuals showed a selective decrease in agency ("independent," "self-confident," etc.) following administration of oxytocin. These data help explain the complex social effects of oxytocin. 
26117676	To understand the barriers to cessation among young late-onset smokers (young adults who started smoking daily after turning 18). Such information is crucial to the development of interventions aimed at reducing the high smoking prevalence among young adults.The New Zealand Smoking Monitor is a fortnightly telephone survey of current smokers and recent quitters. This study focused on responses from a group of late-onset smokers aged 18 to 28 years (N = 111), who were temporarily (for 11 fortnights) added to the monitor.	Most respondents had low nicotine dependence and were actively trying to quit (81% had made at least one attempt that lasted 24 hours or longer in the last year). One-half had high self-efficacy to quit and three-quarters did not intend to use cessation aids. Smoking was tightly linked to drinking alcohol and conferred social benefits (eg, 51% agreed "smoking helped me to socialise").	The tendency not to use cessation aids, strong links between smoking and drinking, and the social benefits of smoking may act as barriers to successful cessation among young late-onset smokers. Policies and interventions aimed at breaking associations between smoking, drinking and socialising (eg, smokefree bars) could be effective for this group.	
26112398	Biological attributions for depression, which are currently ascendant, can lead to prognostic pessimism-the perception that symptoms are relatively immutable and unlikely to abate (Kvaale, Haslam, & Gottdiener, 2013; Lebowitz, Ahn, & Nolen-Hoeksema, 2013). Among symptomatic individuals, this may have important clinical ramifications, as reduced confidence in one's own ability to overcome depression carries the risk of becoming a self-fulfilling prophecy. Previous research (Lebowitz, Ahn, et al., 2013) has demonstrated that educational interventions teaching symptomatic individuals about how the effects of genetic and neurobiological factors involved in depression are malleable and can be modified by experiences and environmental factors can reduce prognostic pessimism. While previous research demonstrated such effects only in the immediate term, the present research extends these findings by testing whether such benefits persist six weeks after the intervention. Indeed, among individuals who initially considered biological factors to play a major role in influencing their levels of depression, exposure to malleability-focused psychoeducation reduced levels of depression-related prognostic pessimism and stronger belief in their ability to regulate their moods. Critically, this benefit persisted six weeks after the intervention. Clinical implications of the findings are discussed. 
26108951	Corollary discharge (CD) refers to "copies" of motor signals sent to sensory areas, allowing prediction of future sensory states. They enable the putative mechanisms supporting the distinction between self-generated and externally generated sensations. Accordingly, many authors have suggested that disturbed CD engenders psychotic symptoms of schizophrenia, which are characterized by agency distortions. CD also supports perceived visual stability across saccadic eye movements and is used to predict the postsaccadic retinal coordinates of visual stimuli, a process called remapping. We tested whether schizophrenia patients (SZP) show remapping disturbances as evidenced by systematic transsaccadic mislocalizations of visual targets. SZP and healthy controls (HC) performed a task in which a saccadic target disappeared upon saccade initiation and, after a brief delay, reappeared at a horizontally displaced position. HC judged the direction of this displacement accurately, despite spatial errors in saccade landing site, indicating that their comparison of the actual to predicted postsaccadic target location relied on accurate CD. SZP performed worse and relied more on saccade landing site as a proxy for the presaccadic target, consistent with disturbed CD. This remapping failure was strongest in patients with more severe psychotic symptoms, consistent with the theoretical link between disturbed CD and phenomenological experiences in schizophrenia. 
26107160	Reduced sensitivity to positive feedback is common in patients with major depressive disorder (MDD). However, findings regarding negative feedback are ambiguous, with both exaggerated and blunted responses being reported. The ventral striatum (VS) plays a major role in processing valenced feedback, and previous imaging studies have shown that the locus of controls (self agency v. external agency) over the outcome influences VS response to feedback. We investigated whether attributing the outcome to one's own action or to an external agent influences feedback processing in patients with MDD. We hypothesized that depressed participants would be less sensitive to the feedback attribution reflected by an altered VS response to self-attributed gains and losses.Using functional MRI and a motion prediction task, we investigated the neural responses to self-attributed (SA) and externally attributed (EA) monetary gains and losses in unmedicated patients with MDD and healthy controls.	We included 21 patients and 25 controls in our study. Consistent with our prediction, healthy controls showed a VS response influenced by feedback valence and attribution, whereas in depressed patients striatal activity was modulated by valence but was insensitive to attribution. This attribution insensitivity led to an altered ventral putamen response for SA - EA losses in patients with MDD compared with healthy controls.	Depressed patients with comorbid anxiety disorder were included.	These results suggest an altered assignment of motivational salience to SA losses in patients with MDD. Altered striatal response to SA negative events may reinforce the belief of not being in control of negative outcomes contributing to a cycle of learned helplessness.	
26094223	Rubber-hand and virtual-hand illusions show that people can perceive body ownership for objects under suitable conditions. Bottom-up approaches assume that perceived ownership emerges from multisensory matching (e.g., between seen object and felt hand movements), whereas top-down approaches claim that novel body parts are integrated only if they resemble some part of a permanent internal body representation. We demonstrate that healthy adults perceive body ownership for a virtual balloon changing in size, and a virtual square changing in size or color, in synchrony with movements of their real hand. This finding is inconsistent with top-down approaches and amounts to an existence proof that non-corporeal events can be perceived as body parts if their changes are systematically related to one's actions. It also implies that previous studies with passive-stimulation techniques might have underestimated the plasticity of body representations and put too much emphasis on the resemblance between viewed object and real hand. 
26092283	An assessment of self-efficacy and social capital may have the potential to detect an effect of dynamic, complex and comprehensive collective actions in community-based health promotion. In 2003, a healthy village project was launched in Santa Cruz, Bolivia with technical assistance from the Japan International Cooperation Agency (JICA). The originally developed FORSA (Fortalecimiento de Redes de Salud) model accounted for participatory processes in which people could improve their health and well-being through individual behavioral changes and family/community-driven activities. This study aimed to examine the extent of self-efficacy and social capital obtained via project activities by a cross-sectional analysis.We randomly selected 340 subjects from the healthy village project site and 113 subjects from a control area. Both groups were interviewed using the same structured questionnaire. Self-efficacy was assessed with a General Self-Efficacy Scale (GSES), while social capital was measured as the frequency of formal group participation in community meetings during the past three months, perceived social solidarity, and general trust.	The study results showed that the participants in the project site had higher self-efficacy and social capital compared to those in the control site. The number of times a subject participated in the health committee activities was positively associated with the self-efficacy scale. Regarding social capital, females and lower-educated people were more likely to have had more frequent participation in formal groups; males and higher-educated participants showed less formal group participation, but more generosity to contribute money for the community. The main perceived benefit of participation in formal group activities varied among individuals.	The findings suggest that people in the healthy village project site have higher self-efficacy, especially those with active participation in the health committee activities. To recruit more participants in future healthy village projects, we should consider the gender and level of education, and match the perceived benefits of participants accordingly.	
26090797	Psychotic patients have problems with bodily self-recognition such as the experience of self-produced actions (sense of agency) and the perception of the body as their own (sense of ownership). While it has been shown that such impairments in psychotic patients can be explained by hypersalient processing of external sensory input it has also been suggested that they lack normal efference copy in voluntary action. However, it is not known how problems with motor predictions like efference copy contribute to impaired sense of agency and ownership in psychosis or psychosis-related states. We used a rubber hand illusion based on finger movements and measured sense of agency and ownership to compute a bodily self-recognition score in delusion-proneness (indexed by Peters' Delusion Inventory - PDI). A group of healthy subjects (n=71) experienced active movements (involving motor predictions) or passive movements (lacking motor predictions). We observed a highly significant correlation between delusion-proneness and self-recognition in the passive conditions, while no such effect was observed in the active conditions. This was seen for both ownership and agency scores. The result suggests that delusion-proneness is associated with hypersalient external input in passive conditions, resulting in an abnormal experience of the illusion. We hypothesize that this effect is not present in the active condition because deficient motor predictions counteract hypersalience in psychosis proneness. 
26087078	The authors explored the effects of linguistic agency and point of view on narrative force. Participants (N = 499) were randomly assigned to read one version of an article about colon cancer, defined by a 2 (disease agency: cancer, human) × 2 (temporal agency: death, human) × 2 (point of view: first person, third person) between-subjects design. Disease agency language assigned agency to cancer (e.g., "Cancer developed in me") or to humans (e.g., "I developed cancer"). Temporal agency language described death as approaching humans (e.g., "as death closes in on patients) or as being approached by humans (e.g., "as patients close in on death"). The narrative was presented from the first-person singular or third-person plural viewpoint. Participants then completed a questionnaire measuring threat perceptions, efficacy, transportation, and other study variables. Language assigning agency to humans rather than to cancer elevated susceptibility beliefs. Death-approach language led to greater fear than human-approach language without impacting efficacy perceptions. Human-approach language was rated more persuasive than death-approach language, but only in first-person point-of-view narratives. Transportation and identification were positively associated with ratings of threat severity and susceptibility, fear, efficacy, behavioral intentions, and message persuasiveness. Implications for message design are discussed. 
26086194	The aim of this study was to understand online public perceptions of the debate surrounding the choice of annual influenza vaccinations or wearing masks as a condition of employment for healthcare workers, such as the one enacted in British Columbia in August 2012.Four national and 82 local (British Columbia) Canadian online news sites were searched for articles posted between August 2012 and May 2013 containing the words "healthcare workers" and "mandatory influenza vaccinations/immunizations" or "mandatory flu shots and healthcare workers." We included articles from sources that predominantly concerned our topic of interest and that generated reader comments. Two researchers coded the unedited comments using thematic analysis, categorizing codes to allow themes to emerge. In addition to themes, the comments were categorized by: 1) sentiment towards influenza vaccines; 2) support for mandatory vaccination policies; 3) citing of reference materials or statistics; 4) self-identified health-care worker status; and 5) sharing of a personal story.	1163 comments made by 648 commenters responding to 36 articles were analyzed. Popular themes included concerns about freedom of choice, vaccine effectiveness, patient safety, and distrust in government, public health, and the pharmaceutical industry. Almost half (48%) of commenters expressed a negative sentiment toward the influenza vaccine, 28% were positive, 20% were neutral, and 4% expressed mixed sentiment. Of those who commented on the policy, 75% did not support the condition to work policy, while 25% were in favour. Of the commenters, 11% self-identified as healthcare workers, 13% shared personal stories, and 18% cited a reference or statistic.	The perception of the influenza vaccine in the comment sections of online news sites is fairly poor. Public health agencies should consider including online forums, comment sections, and social media sites as part of their communication channels to correct misinformation regarding the benefits of HCW influenza immunization and the effectiveness of the vaccine.	
26066518	Fewer men than women with severe obesity undergo bariatric surgery for weight loss, and knowledge about men's situation after surgery, beyond medical status, is lacking. Our aim was to explore men's experiences with life after bariatric surgery from a long-term perspective. We conducted in-depth interviews with 13 men, aged 28-60 years, between 5 and 7 years after surgery. The analysis was inspired by Giorgi's phenomenological method. We found that agency was pivotal for how the men understood themselves and their lives after surgery. Weight loss meant regaining opportunities for living and acting in unrestricted and independent daily lives, yet surgery remained a radical treatment with complex consequences. Turning to surgery had involved conceptualizing their own body size as illness, which the men had resisted doing for years. After surgery, the rapid and major weight loss and the feelings of being exhausted, weak, and helpless were intertwined. The profound intensity of the weight loss process took the men by surprise. Embodying weight loss and change involved an inevitable renegotiating of experiences connected to the large body. Having bariatric surgery was a long-term process that seemed unfinished 5 years after surgery. Restrictions and insecurity connected to health and illness persist, despite successful weight loss and embodied change. Bariatric surgery initiated a complex and long-lasting life-changing process, involving both increased capacity for agency and illness-like experiences. 
26052714	Studies of innovative behavior (the generation, dissemination, and implementation of new ideas) have generally overlooked the agency perspective on this important type of performance behavior. Guided by social-cognitive theory, we propose a moderated mediation relationship to explain why and how employees become motivated to make things happen through their innovative endeavors. First, we propose that within-individual increases in organizational trust and perceived respect by colleagues promote within-individual increases in creative, persuasion, and change self-efficacy over time. Second, we propose that within-individual increases in self-efficacy beliefs promote within-individual increases in idea generation, dissemination, and implementation over time. Finally, we propose that psychological collectivism (a between-individual variable) is a moderator, and that a higher level of psychological collectivism weakens the positive relationship between within-individual increases in self-efficacy beliefs and within-individual increases in innovative behavior. Repeated measures collected from 267 employees in Italy at 3 time points over an 8-month period generally support our proposed dynamic moderated mediation relationship.
26048722	Despite our best medical and behavioural strategies, the physical and mental health of the overweight and obese remains compromised. In an effort to improve treatment outcomes, research has begun to focus on (1) specific BMI categories, and (2) subjective well-being (SWB), a broad construct exploring how we evaluate and experience our lives. Positive psychology is concerned with SWB, through the application of variables associated with health, happiness and optimal functioning. To date, research exploring the relationship between BMI categories and SWB is lacking for community based Australians. This study employed a cross-sectional design using an online survey method (n=260). SWB and related variables were assessed over five BMI categories including normal, overweight, and obese classes one, two and three. Main findings suggest the class two and three obese demonstrated significantly lower scores on flourishing in comparison with the normal and overweight. The class three obese also demonstrated higher depression, and lower scores on agency and positive affect in comparison with the normal and overweight. Furthermore class two and three obese reported lower scores on pathways thinking than the overweight. Results provide preliminary support for the hypothesis that a lack of SWB may contribute to or maintain atypical BMI. Implications for treatment interventions are discussed. 
26014653	Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries.We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran.	We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models.	Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood.	HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.	
26010957	Identity fusion theory suggests that merging groups into one's personal identity should result in heightened levels of group agency. Research on the self-expansion model complementarily indicates that including others into the self is linked to a greater feeling of self-efficacy. Across three correlational studies, we examined whether personal and group identity fusion is associated with stronger feelings of personal agency, and we propose that relatively stable feelings of clarity of self-concept would mediate this association. Individuals strongly fused with a country (Studies 1-3) and family (Study 2) exhibited greater feelings of agency and goal-adherence, and self-concept clarity emerged as a significant mediator of this association when controlling for group identification measures. 
25999826	Bodily self-consciousness consists of one's sense of agency (I am causing an action) and body ownership (my body belongs to me). Both stem from the temporal congruence between different modalities, although some visuomotor temporal incongruence is acceptable for agency. To examine the association or dissociation between agency and body ownership in the context of different temporal sensitivities, we applied a temporal recalibration paradigm, in which subjective synchrony between asynchronous hand action and its visual feedback can be perceived after exposure to the asynchronous visuomotor stimulation. In the experiment, participants continuously clasped and unclasped their hand while watching an online video of their hand that was presented with delays of 50, 110, 170, 230, 290, and 350 ms. Then, they rated a video of their hand with a delay of 50 ms (test stimulus) with respect to the synchrony between hand action and hand video and the perceived agency over the video. Moreover, proprioceptive drift of participants' hand location toward the hand video during the exposure was measured as an index of illusory body ownership. Results indicated that perception of agency emerged over the delayed hand video as subjective visuomotor synchrony was recalibrated, but that body ownership did not emerge for the delayed video, even after the recalibration. We suggest that there is a dissociation between agency and body ownership following visuomotor temporal recalibration. 
25990539	Goal-oriented thinking, including hope and self-efficacy, might play a constructive and integral role in the substance abuse recovery process, although such an effect may differ by race. The current study investigated hope and self-efficacy, specifically abstinence self-efficacy, as predictors of negative affect (i.e. depression and anxiety) in a longitudinal sample of men and women in substance abuse recovery who lived in sober living homes. We found hope agency and self-efficacy were related but not identical constructs; hope agency and self-efficacy predicted depressive and anxiety symptoms for individuals in recovery, yet these relationships were moderated by race. Theoretical and clinical implications for promoting positive affect among individuals in substance abuse recovery are discussed. 

25984787	While action plans and intentions have been considered to be important factors contributing to the personal sense of causation known as agency, the present research is the first to empirically investigate how action plans influence agency. Participants in multiple studies were required to plan or not to plan ahead their actions. Results consistently show that on trials in which participants were required to plan their actions, participants experienced reduced agency compared to trials in which participants were not required to plan their actions. These results were found for both explicit agency paradigms in which participants were asked for their experiences of causation (Studies 1 and 2), as well as in an implicit agency paradigm in which participants were asked to estimate the time between their actions and the consequences of their actions (Study 3). In addition, it was shown that the reduction in agency was smaller when plans and actions were temporally closer together (Study 4). In a final line of experiments we discovered that prior planning similarly reduced both the emotional experience of acting and feelings of responsibility in agents (Studies 5-7). However, the direction of this effect was reversed in observers, for whom cues related to planning by others increased attributions of responsibility toward those others (Study 8).
25965942	Here we question the mechanisms underlying the emergence of the feeling of control that can be modulated even when the feeling of being the author of one's own action is intact. With a haptic robot, participants made series of vertical pointing actions on a virtual surface, which was sometimes postponed by a small temporal delay (15 or 65 ms). Subjects then evaluated their subjective feeling of control. Results showed that after temporal distortions, the hand-trajectories were adapted effectively but that the feeling of control decreased significantly. This was observed even in the case of subliminal distortions for which subjects did not consciously detect the presence of a distortion. Our findings suggest that both supraliminal and subliminal temporal distortions that occur within a healthy perceptual-motor system impact the conscious experience of the feeling of control of self-initiated motor actions.
25959328	By focus group methodology, we examined the opinions and requirements of persons with ALS, their caregivers, and health care assistants with regard to developing a brain-computer interface (BCI) system that fulfills the user's needs. Four overarching topics emerged from this analysis: 1) lack of information on BCI and its everyday applications; 2) importance of a customizable system that supports individuals throughout the various stages of the disease; 3) relationship between affectivity and technology use; and 4) importance of individuals retaining a sense of agency. These findings should be considered when developing new assistive technology. Moreover, the BCI community should acknowledge the need to bridge experimental results and its everyday application. 
25956971	Individuals differ in their ability to attribute actions to self or other. This variance is thought to explain, in part, the experience of voice-hearing. Misattribution can also be context-driven. For example, causal ambiguity can arise when the actions of two or more individuals are coordinated and produce similar effects (e.g., music-making). Experience in such challenging contexts may refine skills of action attribution. Forty participants completed a novel finger-tapping task which parametrically manipulated the proportion of control that 'self' versus 'other' possessed over resulting auditory tones. Results showed that action misattribution peaked in the middle of the self-to-other continuum and was biased towards other. This pattern was related to both high hallucination-proneness and to low musical-experience. Findings suggest not only that causal ambiguity plays a key role in agency but also that action attribution abilities may improve with practice, potentially providing an avenue for remediation of the positive symptoms of schizophrenia. 
25940532	Intentional binding (IB) refers to the temporal compression between a voluntary action and its sensory effect, and it is considered an implicit measure of sense of agency (SoA), that is, the capacity to control one's own actions. IB has been thoroughly studied from a behavioural point of view but only few studies have investigated its neural underpinnings, always using the same two paradigms. Although providing evidence that the supplementary motor complex is involved, findings are still too scarce to draw definitive conclusions. The aim of the present study was to establish a causal relationship between the pre-supplementary motor area (pre-SMA), known for its key role in action planning and initiation, and IB by means of transcranial direct current stimulation (tDCS). Participants underwent anodal, cathodal and sham control stimulations during three separate sessions (Experiment I). Subsequently, they underwent the same stimulation protocol (Experiment II) using as control a region potentially involved in the processing of the sensory effects of voluntary action (i.e., the right primary auditory cortex for the auditory effects of action). A significant reduction in IB was found only after stimulation of the pre-SMA, which supports the causal contribution of this prefrontal area in the perceived linkage between action and its effects. As SoA could be disrupted in many psychiatric and neurological diseases, these results have direct clinical relevance as tDCS could be successfully used in this domain in virtue of the promising advantages it offers for rehabilitation. 
25939137	Imagining oneself performing a simple action can trigger false memories of self-performance, a phenomenon called imagination inflation. However, people can, and often do, imagine others' behavior and actions. According to a visual-similarity account, imagining another person's actions should induce the same kind of memory error, a false memory of self-performance. We tested this account in three experiments, in which performance was followed by imagination. In the imagination phase, participants were asked to either imagine themselves or to imagine another person performing actions, some of which were not previously performed. Two weeks later, a surprise source-memory test was administered in which participants had to decide whether a depicted action had been performed or not performed. Results revealed that imagining another person can trigger false memories of self-performance. However, visual similarity between performance and imagination predicted the amount of false memories only for other-imagination but not for self-imagination. These findings are consistent with research suggesting that other- and self-imagination rely on different mechanisms: While other-imagination primarily involves visual imagery, self-imagination primarily involves motor imagery. Accordingly, false action memories from other-imagination may result from visual similarity, whereas false action memories from self-imagination may result from motor simulation. 
25931387	This research presents the findings from an evaluation and organizational development initiative that was requested by a Canadian youth agency working in a large urban setting. A team of four researchers affiliated with the Center for Research on Educational and Community Services (CRECS) at the University of Ottawa conducted the evaluation. The purpose of the evaluation was to identify the supervision needs and challenges of coordinators and front line staff, assess the efficiency of the current supervision practices, and evaluate the supervisors' and supervisees' satisfaction with these current practices. A literature review was performed to help provide a clear definition of 'supervision' and the different professional roles it encompasses. Additionally, research evidence pertaining both to what contributes to supervision efficacy and supervisor competency was reviewed to distill the most robust findings in the existing literature. The lines of evidence consisted of a document and file review, an online employee survey, group discussions (i.e. focus groups), and interviews with key informants. The results of the evaluation helped the research team formulate recommendations to the agency for the development of enhanced supervision practices across its various service areas. 
25893992	The sense of agency refers to the feeling that one is controlling events through one's own behavior. This study examined how task performance and the delay of events influence one's sense of agency during continuous action accompanied by a goal. The participants were instructed to direct a moving dot into a square as quickly as possible by pressing the left and right keys on a keyboard to control the direction in which the dot traveled. The interval between the key press and response of the dot (i.e., direction change) was manipulated to vary task difficulty. Moreover, in the assisted condition, the computer ignored participants' erroneous commands, resulting in improved task performance but a weaker association between the participants' commands and actual movements of the dot relative to the condition in which all of the participants' commands were executed (i.e., self-control condition). The results showed that participants' sense of agency increased with better performance in the assisted condition relative to the self-control condition, even though a large proportion of their commands were not executed. We concluded that, when the action-feedback association was uncertain, cognitive inference was more dominant relative to the process of comparing predicted and perceived information in the judgment of agency. 
25888453	Mood symptoms are highly prevalent among frail old people residing in nursing homes. Systematic diagnostics of depression is scarce, and treatment is not always in accordance with best evidence. The distinction between non-pathological sadness and depression may be challenging, and we know little of the older peoples' perspectives. The aim of this qualitative interview study was to explore residents' perceptions of their own sadness.We performed individual, semi-structured interviews with twelve older people residing in nursing homes with no dementia. The interview guide comprised questions on what made the informants sad and what prevented sadness. We recorded, transcribed verbatim and analysed the interviews using systematic text condensation.	The interviews revealed three main themes. I. Decay and loss of agency. The informants perceived their sadness to be caused by loss of health and functional ability, reliance on long-term care, dysfunctional technical aids and poor care. II. Loneliness in the middle of the crowd. Loss of family and friends, and lack of conversations with staff members and fellow patients were also sources of sadness. III. Relating and identity. The informants kept sadness at bay through: acceptance and re-orientation to their current life situation, maintaining narratives about their identity and belonging, and religiosity.	Nursing home nurses and doctors should identify and respond to sadness that is a rational response to manageable causes. Further, identifying and supporting residents' resources and coping strategies is a salutogenetic approach that may alleviate sadness.	
25887217	Among the working population, unemployed, temporary agency and expired fixed-term contract workers having psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. Studies investigating the effectiveness of return-to-work (RTW) interventions on these workers, who are without an employment contract, are scarce. Therefore, a RTW intervention called 'Brainwork' was developed. The objective of this paper is to describe the 'Brainwork Intervention' and the trial design evaluating its effectiveness in reducing the duration of sick leave compared to usual care.The 'Brainwork Intervention' is designed to assist unemployed, temporary agency and expired fixed-term contract workers who are sick-listed due to psychological problems, with their return to work. The 'Brainwork Intervention' uses an activating approach: in the early stage of sick leave, workers are encouraged to exercise and undertake activities aimed at regaining control and functional recovery while job coaches actively support their search for (temporary) jobs. The content of the intervention is tailored to the severity of the psychological problems and functional impairments, as well as the specific psychosocial problems encountered by the sick-listed worker. The intervention study is designed as a quasi-randomized controlled clinical trial with a one-year follow-up and is being conducted in the Netherlands. The control group receives care as usual with minimal involvement of occupational health professionals. Outcomes are measured at baseline, and 4, 8 and 12 months after initiation of the program. The primary outcome measure is the duration of sick leave. Secondary outcome measures are: the proportion of subjects who returned to work at 8 and 12 months; the number of days of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. The cost-benefit analysis will be evaluated from an insurer's perspective.	The methodological considerations of the study design are discussed. In this trial we evaluate the effectiveness of an intervention in real occupational health practice, rather than under highly controlled circumstances. The results will be published in 2015.		NTR4190. Date of registration: September 27(th) 2013.	
25868868	The impact of self esteem and Locus of Control (LoC) on clinical presentation across different ethnic groups of patients at their first psychotic episode (FEP) remains unknown. We explored these constructs in 257 FEP patients (Black n=95; White British n=119) and 341 controls (Black n=70; White British n=226), and examined their relationship with symptom dimensions and pathways to care. FEP patients presented lower self-esteem and a more external LoC than controls. Lower self esteem was associated with a specific symptoms profile (more manic and less negative symptoms), and with factors predictive of poorer outcome (longer duration of untreated psychosis (DUP) and compulsory mode of admission). A more external LoC was associated with more negative symptoms and an insidious onset. When we explored these constructs across different ethnic groups, we found that Black patients had significantly higher self esteem than White British. This was again associated with specific symptom profiles. While British patients with lower self esteem were more likely to report delusions, hallucinations and negative symptoms, Black patients with a lower self esteem showed less disorganization symptoms. These findings suggest that self esteem and LoC may represent one way in which social experiences and contexts differentially influence vulnerable individuals along the pathway to psychosis. 
25843918	People usually experience agency over their actions and subsequent outcomes. These agency inferences over action-outcomes are essential to social interaction, and occur when an actual outcome corresponds with either a specific goal (goal-based), and matches with action-outcome information that is subtly pre-activated in the situation at hand (prime-based). Recent research showed that schizophrenia patients exhibit goal-based inferences, but not prime-based inferences. Intrigued by these findings, and underscoring their potential role in explaining poor social functioning, we replicate patients' deficit in prime-based agency inferences. Additionally, we exclude the account that patients are unable to visually process and attend to primed information. 
25837478	Il fenomeno immigratorio è in continuo aumento e anche in sanità è ormai forte la presenza di utenza immigrata che richiede un riorientamento dei servizi e la necessità di un approccio terapeutico-assistenziale multiculturale.Obiettivo del presente studio è indagare il bisogno formativo degli operatori dell’Azienda Città della Salute e della Scienza di Torino nell’assistenza all’utenza straniera.	E’ stato costruito un questionario ad hoc, rivolto a medici, infermieri, logopedisti e personale di supporto del Dipartimento “Capo e Collo”, articolato in quattro sezioni: conoscenze, atteggiamenti e percezioni; vissuto e formazione; miglioramento della competenza culturale; dati anagrafici. E’ strutturato sotto forma di domande a risposta dicotomica sì/no, chiusa e aperta breve.	Hanno risposto 176/235 operatori (75%). Meno del 20% conosce la normativa che regolamenta l’utilizzo dei servizi sanitari da parte degli immigrati; le patologie indicate come più frequenti negli stranieri sono tubercolosi, malattie veneree e AIDS. Sesso femminile (p=0.008) e profilo professionale non medico (trend con p=0.051) sono associati in modo significativo all’importanza percepita di conoscere i valori dell’assistito, mentre una precedente formazione è associata al bisogno di approfondirli (p=0.0002). Gli aspetti di maggior bisogno formativo sono: significato di malattia e cura, senso della prevenzione, igiene e cura di sé e percezione delle pratiche di cura. Tra le strategie più efficaci: lezione e discussione, lavori di gruppo e filmografia.	L’analisi ha evidenziato le aree tematiche principalmente carenti e le strategie formative che gli operatori considerano più efficaci.	Immigration is growing and immigrants' presence is important also in the health care system, thereby services reorientation and a multicultural approach are needed.	To explore health care professionals' training needs of Turin Azienda Città della Salute e della Scienza in taking care of foreign users.	An ad hoc 4-sections questionnaire was built: (1) Knowledge, attitudes and perceptions; (2) Lived and Training; (3) Improvement in cultural competence; (4) Socio-demographic data. Questions were dichotomous (yes/no), closed and short open. Doctors, nurses, speech therapists and support staff of the "Head and Neck" Department were involved.	One hundred seventy-six operators answered (75%). Less than 20% (n=34) knew the normative concerning immigrants' health services use; tubercolosis, venereal diseases and AIDS were believed to be the most frequent diseases in foreign users. Female sex (p=0.008) and allied health care profile (trend p=0051) were significantly associated to consider clients' values important, while a previous training was associated to the need of improving their knowledge (p=0.0002). The most important training needs were: meaning of illness and care, perception of prevention, hygiene and self-care practices and perception of care. Among the most effective strategies: lecture and discussion, group work and filmography.	The analysis shows the main needing education areas and the training strategies which operators considered more effective.	
25835764	The concept of self-assess it's a central mechanism in human agency for behavior change and should translate to desirable practice patterns. There are no many studies that have investigated the relationship between the perception of the ability to perform cardiopulmonary resuscitation (CPR) and the quality of the same. The aim of this work is to investigate the relation between physiological and psychosocial variables in cardiac resuscitation in order to improve the involvement and motivation of professionals in training courses.During the year 2012, 322 medical staff of Ospedale-Universitario of Parma were trained to basic life support defibrillation (BLSD). Before started the course the partecipants were randomly selected among the staff working in the same department to create a team of two persons and involved in a simulation that reproduced the first five minutes that occurs for a cardiac arrest in a medical or surgical department in our hospital before the intervention of the hospital emergency team. Before and after simulation to each participant was asked to answer a self-efficacy questionnaire on a 10-point scale on the management of cardiac. During simulation were registered the activation time of the emergency response system, hands-on time, defibrillation time, number of compression and correct compression rate.	Activation time of the emergency response system was 70.52 ± 78.77 seconds. In 55 teams was not made the allert. The defibrillation time was 148.63 ± 58.43 seconds. In 44 teams the defibrillator were used within 120 seconds, in 36 (22.1%) it was not used. Hands-on time average was of 166.20 ± 62.9 seconds. The mean number of compression was 216.22 ± 115.57. The percentage of satisfactory compression was 9.97 ± 21.23 %. The level of self-efficacy was under the average for the 35.6%, while the 26.8% of the participants had a medium level of 5 and the 38.5% of the sample declared to feel an efficacy level included in 6-10. The sense of self efficacy after the simulation was constant in the 38.3% of the sample, while increased in the 30.5% and decreased in the 31.2%. We found no significant correlations between self-efficacy levels and specific results in scenario acting before simulation, instead, after the simulation the skills performances are much more correlated with self-efficacy.	The medical staff reported an individual's perception of good efficacy in the management of simulation of cardiac arrest, but it does not correspond to a high skills. An open question is if and how these psychosocial variables may play a role in improving the quality of CPR and if knowledge of the low capacity to manage a cardiac arrest can be translated into the need for the medical staff to be regularly engaged in BLSD retraining.	
25833900	Antidoping and medical care delivery programmes are required at all large international multisport events.To document and critique the novel antidoping and medical care delivery models implemented at the 2nd Summer Youth Olympic Games, Nanjing 2014.	The International Olympic Committee implemented two new models of delivery of antidoping and medical care at the YOG. A review of these models as well as the public health programme and two health educational initiatives in the Cultural and Educational Program was undertaken by the International Olympic Committee.	The implementation of the new antidoping model was feasible in the setting of the YOG. The antidoping rules and regulations of the International Olympic Committee were respected. This model enhanced the educational initiative and provided financial as well as human resource savings. The execution of the hospital-based venue model of medical care delivery at the YOG was also feasible in this setting. This model provided a practical infrastructure for the delivery of medical care at multisport events with the goal of providing optimum athlete healthcare. A public health prevention programme was implemented and no public health risks were encountered by the participants or the Nanjing citizens during the YOG. Finally, the implementation of the athlete health educational programmes within the Cultural and Educational Program provided athletes with an opportunity to improve their health and performance.	To achieve the goal of protecting athlete health, and of employing effective doping control and education, new alternate models of antidoping and medical care delivery can be implemented.	
25830492	Self-agency is the recognition of one's own movement and plays a vital role in purposeful, voluntary movement. A sense of self-agency can be elicited in individuals who view their own simple finger movements as they are projected onto a screen and aligned with their actual hand position. Here, we examined whether individuals perceived self-agency when they viewed a video of a hand grasping a wooden cylinder and whether the perception of self-agency correlated with simultaneous changes in oxy-hemoglobin in the parietal or the prefrontal cortical areas. All participants reported the perception of self-agency, which was correlated with oxy-hemoglobin increases in the right prefrontal area. We conclude that self-agency also relates to hand-held objects displayed on video. 
25826347	Previous studies have found deployment to combat areas to be associated with an increased risk of post-traumatic stress disorder (PTSD), depression, and alcohol abuse, but many previous studies were limited by samples that were not representative of the deployed military as a whole. This study presents an overview of these three mental health problems associated with deployment among Air Force, Army, Marine Corp, and Navy service members returning from deployment to Iraq and Afghanistan between January 2007 and March 2008. With postdeployment health data on over 50,000 service men and women, including diagnostic information, we were able to estimate prevalence of those who screened positive for risk of each disorder in self-report data at two time points, as well as prevalence of diagnoses received during health care encounters within the military health care system. The prevalence ranges of the three disorders were consistent with previous studies using similar measures, but service members in the Navy had higher rates of screening positive for all three disorders and higher prevalence of depression and PTSD diagnoses compared to the other branches. Further, PTSD risk was higher for service members returning from Afghanistan compared to Iraq, in contrast to previous findings. 
25810060	Patients with schizophrenia can sometimes report strange face illusions when staring at themselves in the mirror; such experiences have been conceptualized as anomalous self-experiences that can be experienced with a varying degree of depersonalization. During adolescence, anomalous self-experiences can also be indicative of increased risk to develop schizophrenia-spectrum disorders. To date however, the Mirror-Gazing test (MGT), an experimentally validated experiment to evaluate the propensity of strange face illusions in nonclinical and clinical adults, has yet to be investigated in an adolescent sample. The first goal of the present study was to examine experimentally induced self-face illusions in a nonclinical sample of adolescents, using the MGT. The second goal was to investigate whether dimensions of adolescent trait schizotypy were differentially related to phenomena arising during the MGT. One hundred and ten community adolescents (59 male) aged from 12 to 19 years (mean age = 16.31, SD age = 1.77) completed the MGT and Schizotypal Personality Questionnaire. The results yielded 4 types of strange face illusions; 2 types of illusions (slight change of light/color [20%] and own face deformation [45.5%]) lacked depersonalization-like phenomena (no identity change), while 2 other types (vision of other identity [27.3%], and vision of non-human identity [7.3%]) contained clear depersonalization-like phenomena. Furthermore, the disorganization dimension of schizotypy associated negatively with time of first illusion (first press), and positively with frequency of illusions during the MGT. Statistically significant differences on positive and disorganized schizotypy were found when comparing groups on the basis of degree of depersonalization-like phenomena (from slight color changes to non-human visions). Similarly to experimentally induced self-face illusions in patients with schizophrenia, such illusions in a group of nonclinical adolescents present significant associations to schizotypy dimensions. 
25805714	The aim of this study was to explore the correlation of hope and self-efficacy with job satisfaction, job stress, and organizational commitment for correctional officers in the Taiwan prison system while controlling for the shared effects of the nature of the institution (i.e., for male or female inmates) and personal characteristics of the officers (i.e., gender, age, and years of work experience). Hope in the context of this study refers to a cognitive set and motivational state that involves reciprocal interaction between goal-directed energy (agency) and planned pathways to meet the goals (pathway). It is a personality trait of hopefulness, rather than having hope for the prisoners restructuring their future. Self-efficacy refers to the belief that individuals have regarding their ability to perform necessary tasks to achieve goals. Although they share similar constructs, hope theory places emphasis on cross-situational goal-directed thought, whereas the concept of self-efficacy focuses on situation-specific goals. The participants were 133 correctional personnel from two correctional institutions, one with male inmates and the other with female inmates, in central Taiwan. The results of ordinary least squares regression analysis indicated that hope had a significant positive association with job satisfaction and a significant negative association with job stress. Self-efficacy had a significant positive association with job satisfaction and organizational commitment. Finally, job satisfaction had a significant positive association with organizational commitment. 
25792444	No previous study has simultaneously examined body ownership and agency in healthy subjects during mirror self-observation. We used a moving rubber hand illusion to examine how both body ownership and agency are affected by seeing (i) the body moving in a mirror, compared with (ii) directly viewing the moving hand, and (iii) seeing a visually identical hand rotated by 180°. We elicited ownership of the hand using direct visual feedback, finding this effect was further enhanced when looking at the hand in a mirror, whereas rotating the hand 180° abolished ownership. Agency was similarly elicited using direct visual feedback, and equally so in the mirror, but again reduced for the 180° hand. We conclude that the reflected body in a mirror is treated as 'special' in the mind, and distinct from other external objects. This enables bodies and actions viewed in a mirror to be directly related to the self. 
25762175	Hematopoietic stem cell (HSC) research took hold in the 1950s with the demonstration that intravenously injected bone marrow cells can rescue irradiated mice from lethality by reestablishing blood cell production. Attempts to quantify the cells responsible led to the discovery of serially transplantable, donor-derived, macroscopic, multilineage colonies detectable on the spleen surface 1 to 2 weeks posttransplant. The concept of self-renewing multipotent HSCs was born, but accompanied by perplexing evidence of great variability in the outcomes of HSC self-renewal divisions. The next 60 years saw an explosion in the development and use of more refined tools for assessing the behavior of prospectively purified subsets of hematopoietic cells with blood cell-producing capacity. These developments have led to the formulation of increasingly complex hierarchical models of hematopoiesis and a growing list of intrinsic and extrinsic elements that regulate HSC cycling status, viability, self-renewal, and lineage outputs. More recent examination of these properties in individual, highly purified HSCs and analyses of their perpetuation in clonally generated progeny HSCs have now provided definitive evidence of linearly transmitted heterogeneity in HSC states. These results anticipate the need and use of emerging new technologies to establish models that will accommodate such pluralistic features of HSCs and their control mechanisms. 
25751718	This article presents 2 longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults' life stories were assessed for several narrative themes. Participants' mental health and physical health were assessed concurrently with the narratives and annually for the subsequent 4 years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental health. Longitudinal analyses indicated that these same 3 themes were significantly associated with participants' trajectories of mental health over the course of 4 years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and 6 months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants' mental health and physical health were assessed every 6 months for 2 years. In this study, the themes of agency, communion, redemption, and contamination in participants' life narratives collected at baseline (before any participant became sick) were significantly associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these 2 studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time.
25748604	This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. 
25721020	Our folk psychology includes intuitions about free will; we believe that our intentional acts are choices and that, when such actions are not constrained, we are free to act otherwise. In a series of five experiments, we ask children about their own and others' freedom of choice and about the physical and mental circumstances that place limitations on that freedom. We begin with three experiments establishing a basis for this understanding at age four. We find that 4-year-olds endorse their own and others' ability to "do otherwise" only when they or others are free to choose a course of action, but not when others' actions are physically impossible (Experiment 1), their own actions are physically constrained (Experiment 2), and their own actions are epistemically constrained (Experiment 3). We then examine developmental changes in children's understanding of actions and alternatives that lead to more adult-like free will intuitions. Across two experiments, 6-year-olds, but not 4-year-olds, endorse another person's (Experiment 4) or their own (Experiment 5) freedom to act against stated desires. These age-related changes suggest relationships between a belief in free will and other cognitive and conceptual developments in theory of mind, self-control and self-awareness that take place in early childhood. 
25717491	The paper presents the study of narrations of schizophrenic patients focused on the description of activities characteristics. The aim is to answer the question of how experiencing of psychotic crisis influences the perception of their authorship. Do the inherent characteristics of the activity differ with reference to the period of life which they relate to: the time before getting sick, or after falling ill with schizophrenia?The material consisted of narrations of 26 people with schizophrenia about their life prior to the illness and after the psychotic crisis. Linguistic categories that make up the patterns of activity have been distinguished. The frequency of the occurrence was compared in both narrations.	Self-descriptions after falling ill are more saturated with patterns of avoidance, motivation internally localized connected with attempts of coping with the disease and externally localized action control connected with a decreased sense of authorship in relation to experiencing symptoms and reduction of social competence.	The change of self-image after psychotic experience concerns the deeper planes of narrative, i.e. the patterns of activity hidden in connection between the content and narrative form. The research showed the decrease of the sense of agency associated with the disease experience.	
25716612	Awareness of our own bodies (sense of body-ownership) and actions (sense of agency) is fundamental for self-consciousness. In the rubber hand illusion, watching a rubber hand being stroked synchronously as one's own unseen hand is also stroked causes the observer to attribute the rubber hand to their own body. The findings of the series of experiments reported here suggest that body-ownership, measured using proprioceptive drift, is elicited by the external acting proxy that drives the sense of agency. While participants clasped and unclasped their left hand for 60 s, they focused on video feedback on a monitor in front of them. Proprioceptive drift was observed only under the conditions, including synchronized conditions, where the sense of agency for the acting proxy occurred, suggesting an essential interaction between body-ownership and agency.
25698952	When an individual estimates the temporal interval between a voluntary action and a consequent effect, their estimates are shorter than the real duration. This perceived shortening has been termed "intentional binding", and is often due to a shift in the perception of a voluntary action forward towards the effect and a shift in the perception of the effect back towards the action. Despite much work on binding, there is virtually no consideration of individual/personality differences and how they affect it. Narcissism is a psychological trait associated with an inflated sense of self, and individuals higher in levels of subclinical narcissism tend to see themselves as highly effective agents. Conversely, lower levels of narcissism may be associated with a reduced sense of agency. In this exploratory study, to assess whether individuals with different scores on a narcissism scale are associated with differences in intentional binding, we compared perceived times of actions and effects (tones) between participants with high, middle, and low scores on the narcissistic personality inventory (NPI). We hypothesized that participants with higher scores would show increased binding compared to participants with lower scores. We found that participants in our middle and high groups showed a similar degree of binding, which was significantly greater than the level of binding shown by participants with the lowest scores. To our knowledge, these results are the first to demonstrate that different scores on a personality scale are associated with changes in the phenomenological experience of action, and therefore underscore the importance of considering individual/personality differences in the study of volition. Our results also reinforce the notion that intentional binding is related to agency experience. 
25655206	Humans regularly feel a sense of agency (SoA) over events where the causal link between action and outcome is extremely indirect. We have investigated how intermediate (here, a robotic hand) events that intervene between action and outcome may alter SoA, using intentional binding measures. The robotic hand either performed the same movement as the participant (active congruent), or performed a similar movement with another finger (active incongruent). Binding was significantly reduced in the active incongruent relative to the active congruent condition, suggesting that altered embodiment influences SoA. However, binding effects were comparable between a condition where the robot hand made a congruent movement, and conditions where no robot hand was involved, suggesting that intermediate and embodied events do not reduce SoA. We suggest that human sense of agency involves both statistical associations between intentions and arbitrary outcomes, and an effector-specific matching of sensorimotor means used to achieve the outcome. 
25651315	Currently, 80% of adults over the age of 65 have at least one chronic disease. The Chronic Disease Self-management Program (CDSMP) focuses on increasing self-efficacy for managing chronic disease. Few studies have evaluated the effectiveness of CDSMP when offered by multiple agencies, as a collaborative effort, in community-based settings. Seven agencies delivered 108 CDSMP workshops at 81 sites from October 1, 2008, to December 31, 2010. A total of 811 participants were eligible for analysis. Participants completed surveys at baseline and week 6, the end of instruction. Controlling for agency effect and general health at baseline, the general linear model was used to assess the significance of outcomes at 6 weeks. Outcomes showing significant improvement included self-efficacy to manage disease (p = .001), self-efficacy to manage emotions (p = .026), time spent walking (p = .008), and perceived social/role activities limitations (p = .001). Findings showed that CDSMP is an effective program at improving self-efficacy, increasing physical activity, and decreasing limitations. 
25644692	The emotional consequences of our own and others' actions can influence our agentive self-awareness in social contexts. Positive outcomes are usually linked to the self and used for self-enhancement, whereas negative outcomes are more often attributed to others. In most situations, these causal attribution tendencies seem to be immediately present instead of involving reflective interpretations of the action experience. To address the question at which level of the cognitive hierarchy emotions and action perception interact, we adopted a social reward anticipation paradigm. Here, participants or their interaction partner received positive or negative action outcomes and performed speeded attribution choices regarding causation of the action outcome. Event-Related Potential (ERP) results showed that the emotional value of an outcome already influenced the classical N1 self-attenuation effect, with reduced embodied agentive self-awareness for negative outcomes at initial sensorimotor stages. At the level of the N300, the degree of updating and affective evaluation associated with the respective attributive decision was reflected and particularly associated to attribution tendencies for positive events. Our results show an early interaction between emotion and agency processes, and suggest that self-serving cognition can be grounded in embodied knowledge from low-level sensorimotor mechanisms. 
25636323	A conflict of interest arises by having two conflicting goals in one's research. The primary goal of research relevant to public health is to produce impartial evidence on health hazards for humans. Several entities - including industry - may have public health as a goal among others, but this is not their primary goal. Primary goals are in those cases profit or career, that conflict with the goal of health. It is a role of the State to foster research whose primary goal is impartial evidence on factors affecting population health. Disclosure of conflicts of interest is not enough: the view that disclosure solves all problems amounts to say that a declaration of having produced unbiased evidence is a self-fulfilling guarantee that the evidence will not be affected by conflicts of interest. This concept is seriously misleading. A conflict of interest arises from the circumstances in which research occurs and does not exist only in the opinion of some people or groups (or the authors of a paper). 
25624386	Young adults born preterm at very low birth weight start families later. Whether less severe immaturity affects adult social outcomes is poorly known.The study "Preterm birth and early life programming of adult health and disease" (ESTER, 2009-2011) identified adults born early preterm (<34 weeks' gestation, N = 149), late preterm (≥ 34 to <37 weeks' gestation, N = 248), and at term (≥ 37 weeks' gestation, N = 356) from the Northern Finland Birth Cohort 1986 and the Finnish Medical Birth Register (1987-1989), with perinatal data, medical and family history, socioeconomic status, and lifestyle from routine visits or questionnaires. Cox, logistic, and ordinal regressions estimated the hazard and odds ratios (HR and OR) with 95% confidence intervals of outcomes related to preterm birth.	Compared with term-born subjects, those born early and late preterm were less likely to have cohabited with a romantic partner (HR, 0.79; [0.61-1.03] and HR, 0.80; [0.65-0.99], respectively) or experienced sexual intercourse (HR, 0.83; [0.66-1.05] and HR, 0.76; [0.63-0.92], respectively) by young adulthood. They also had higher odds of obtaining a 1-point lower score in a visual analog scale of self-perceived sexual attractiveness (OR, 1.45; [1.09-1.98] and OR, 1.44; [1.06-1.97] for early and late preterm birth, respectively). No difference was observed in the likelihood of departing from childhood home and number of individuals having their own families.	Young adults born preterm experience more social challenges, which may affect their romantic relationships and future family planning.	
25622472	This article presents an emergent heuristic framework for the core environmental gerontology concept of "place." Place has been a central concern in the field since the 1970s (Gubrium, 1978) for its hypothesized direct relationship to identity, the self, and agency--suggestive of the appropriateness of lateral theoretical linkages with developmental science. The Ecological Framework of Place (EFP) defines place as a socio-physical milieu involving people, the physical setting, and the program of the place, all catalyzed by situated human activity and fully acknowledging that all four may change over time. The article begins with a concise overview of the EFP before moving on to consider it within three theoretical terrains: place theory, developmental science theory, and environmental gerontology theory. The EFP will be argued to be a place theory which subsumes themes of emergent environmental gerontology theories within a developmental science perspective. Implications for theory, method and practice are discussed. One of the strengths of the model is its ability to serve both research and practice, as is exhibited in its ability to incorporate applied design research and inform architectural decision-making so often lacking in other environmental gerontology models. Place should be viewed as an integrative concept providing opportunities for both environmental gerontology and developmental science to more critically concern the profound role places have in terms of agency, identity and sense of self over the life course.
25618006	The mental representation of one's body typically implies the continuity of its parts. Here, we used immersive virtual reality to explore whether mere observation of visual discontinuity between the hand and limb of an avatar could influence a person's sense of ownership of the virtual body (feeling of ownership, FO) and being the agent of its actions (vicarious agency, VA). In experiment 1, we tested whether placing different amounts of visual discontinuity between a virtual hand and limb differently modulate the perceived FO and VA. Participants passively observed from a first-person perspective four different versions of a virtual limb: (1) a full limb; a hand detached from the proximal part of the limb because of deletion of (2) the wrist; (3) the wrist and forearm; (4) and the wrist, forearm and elbow. After observing the static or moving virtual limb, participants reported their feeling of ownership (FO) and vicarious agency (VA) over the hand. We found that even a small visual discontinuity between the virtual hand and arm significantly decreased participants' FO over the hand during observation of the static limb. Moreover, in the same condition, we found that passive observation of the avatar's actions induced a decrease in both FO and VA. We replicated the same results in a second study (experiment 2) where we investigated the modulation of FO and VA by comparing the visual body discontinuity with a condition in which the virtual limb was partially occluded. Our data show that mere observation of limb discontinuity can change a person's ownership and agency over a virtual body observed from a first-person perspective, even in the absence of any multisensory stimulation of the real body. These results shed new light on the role of body visual continuity in modulating self-awareness and agency in immersive virtual reality. 
25594535	In this study, the relationship between agency, communion, and the active, passive, and revenge forms of entitlement is examined. Results indicate that active entitlement was positively related to agency, negatively to communion (Study 1), and unrelated to unmitigated agency and communion (Study 2). Passive entitlement was positively related to communion (in regular and unmitigated forms) and negatively related to agency (in both forms). Revenge entitlement was positively related to agency (unmitigated and regular), and negatively related to both regular and unmitigated communal orientations. Detected relationships were independent from self-esteem (Study 1). The findings are discussed in relation to distinctions between narcissistic and healthy entitlement, and within the context of the three-dimensional model of entitlement. 
25568200	Promoting mental health and emotional wellbeing (EWB) in children and young people (YP) is vitally important for their psycho-social development. Critical review of the literature reveals a dearth of research that has explored the perspective of the child, adolescent or adult in this concept, with much research being intervention focused and promoted at crisis level. The current study aims to address this gap in understanding of young persons' and parents' perspectives.A small-scale, exploratory qualitative study was conducted with YP, and parents of YP aimed at exploring the meaning of EWB and how it could be promoted. Data were collected via focus groups with 15 YP (aged 18-24 years) and 15 interviews with parents of a different group of YP.	Study participants identified key constructs for good EWB as stability, coping ability, happiness, confidence, balance, empathy and being grounded. Feeling comfortable with self, managing and controlling emotions and having the confidence to persevere with challenges were all felt to contribute to a positive sense of EWB. Sources of support were overwhelmingly cited as family and friends, with schools identified as a potentially good environment for supporting and promoting the EWB of pupils. Participants stressed the need for a positive attitude change towards YP, advocating this as promoting a sense of belonging and community citizenship. A lay-informed 'recipe' for successful EWB promotion is drawn out, centred on the core goal of raising awareness and understanding of YP's EWB, in the YP themselves, their parents, schools and the wider community.	This research provides key messages for society, policy makers, education and public health and healthcare practitioners for integration into the delivery of services for YP and families that include education on supporting EWB, activities for YP and a multi-agency approach to supporting families within the community.	
25567420	Patients with Parkinson's disease have difficulties with self-initiating a task and maintaining a steady task performance. We hypothesized that these difficulties relate to reorganization in the sensorimotor execution, cingulo-opercular task-set maintenance, and frontoparietal adaptive control networks. We tested this hypothesis using graph theory-based network analysis of a composite network including a total of 86 nodes, derived from the three networks of interest. Resting-state functional magnetic resonance images were collected from 30 patients with Parkinson's disease (age 42-75 years, 11 females; Hoehn and Yahr score 2-3, average 2.4 ± 0.4) in their off-medication state and 30 matched control subjects (age 44-75 years, 10 females). For each node, we calculated strength as a general measure of connectivity, global efficiency and betweenness centrality as measures of functional integration, and clustering coefficient and local efficiency as measures of functional segregation. We found reduced node strength, clustering, and local efficiency in sensorimotor and posterior temporal nodes. There was also reduced node strength and betweenness centrality in the dorsal anterior insula and temporoparietal junction nodes of the cingulo-opercular network. These nodes are involved in integrating multimodal information, specifically related to self-awareness, sense of agency, and ultimately to intact perception of self-in-action. Moreover, we observed significant correlations between global disease severity and averaged graph metrics of the whole network. In addition to the well-known task-related frontostriatal mechanisms, we propose that the resting-state reorganization in the composite network can contribute to problems with self-initiation and task-set maintenance in Parkinson's disease.
25566155	Weakening belief in the concept of free will yields pronounced effects upon social behavior, typically promoting selfish and aggressive over pro-social and helping tendencies. Belief manipulations have furthermore been shown to modulate basic and unconscious processes involved in motor control and self-regulation. Yet, to date, it remains unclear how high-level beliefs can impact such a wide range of behaviors. Here, we tested the hypothesis that priming disbelief in free will diminishes the sense of agency, i.e., the intrinsic sensation of being in control of one's own actions. To this end, we measured participants' implicit and explicit self-agency under both anti-free will and control conditions. Priming disbelief in free will reduced implicit but not explicit components of agency. These findings suggest that free will beliefs have a causal impact on the pre-reflective feeling of being in control of one's actions, and solidify previous proposals that implicit and explicit agency components tap into distinct facets of action awareness. 
25544108	The study is a qualitative film analysis. It seeks to determine the semiotic and cinematic structures that make gambling appealing in films based on analysis of 72 film scenes from 28 narrative fiction films made from 1922 to 2003 about gambling in North American and West European mainstream cinema. The main game types include card games, casino games, and slot machines. The theme of self-control and competence was identified as being central to gambling's appeal. These images are strongly defined by gender. The study was funded by ELOMEDIA, financed by the Finnish Ministry of Education and Culture as well as the Finnish Foundation for Alcohol Studies. The limitations of the study are noted. 
25480855	Understanding the relationship between women's political participation and health has eluded researchers and cannot be adequately studied using traditional epidemiological or social scientific methodologies. We employed a health capability framework to understand dimensions of health agency to illuminate how local political economies affect health. Exploiting a cluster-randomized controlled trial of a community-based behavior change management intervention in northern India, we conducted a qualitative study with semistructured, in-depth focus groups in both intervention and nonintervention villages. We presented scenarios to each group regarding the limitations and motivations involved in women's political participation and health. Thematic analysis focused on four domains of health agency -- participation, autonomy, self-efficacy, and health systems -- relevant for understanding the relationship between political participation and health. Elder women demonstrated the greatest sense of self-efficacy and as a group cited the largest number of successful health advocacy efforts. Participation in an associated community-based neonatal intervention had varying effects, showing some differences in self-efficacy, but only rare improvements in participation, autonomy, or health system functioning. Better understanding of cultural norms surrounding autonomy, the local infrastructure and health system, and male and female perceptions of political participation and self-efficacy are needed to improve women's health agency. For a community-based participatory health intervention to improve health capability effectively, explicit strategies focused on health agency should be as central as health indicators.
25461109	The EU Directive on the sustainable use of pesticides (EU128/2009/EC) requires European Member States to develop training activities targeting occupational exposure to pesticides, and communication material aimed at residents and bystanders. Risk perceptions, knowledge and attitudes associated with passive and occupational exposure to pesticide potentially influence the extent to which different stakeholders adopt self-protective behaviour. A methodology for assessing the link between attitudes, adoption of self-protective behaviours and exposure was developed and tested. A survey was implemented in the Greece, Italy and the UK, and targeted stakeholders associated with pesticide exposure linked to orchards, greenhouse crops and arable crops respectively. The results indicated that the adoption of protective measures is low for residents and bystanders, with the exception of residents in Greece, when compared to operators and workers, who tend to follow recommended safety practices. A regression analysis was used to examine the factors affecting the probability of adopting protective measures as well the as the level of exposure in the case of operators and workers where data are available. The results indicate that the likelihood of engaging in self-protective behaviour is not significantly affected by perceptions of own health being affected by pesticides for residents and bystanders. However, operators who perceive that their heath has been negatively affected by the use of pesticides are found to be more likely to adopt self-protective behaviours. Gender and country differences, in perceptions, attitudes and self-protection are also observed. Recommendations for improved communication, in particular for vulnerable groups, are provided. 
25460244	The present moment is of infinitesimally brief duration. In the brain, however, there are perceptual processes that bind together events occurring at different times, on a time scale of milliseconds, into a coherent and integrated temporal representation. These processes include temporal integration, as in perception of biological motion, synchronisation, and change detection. These processes are also responsible for temporal integration and coherence in inner mental life, such as in mental imagery. I argue that this gives rise to the pre-reflective experience of the self as a continuously existing being. Temporal integration is also a feature of the experience of action-outcome relations, and I argue that this produces a pre-reflective experience of the self, not just as continuously existing, but also as the doer of both physical and mental actions. This is the foundation on which the idea of the self as continuously existing on longer time scales--the narrative self--is built.
25456620	In late modern circumstances, aging individuals are confronted with the task of creating a meaningful individual life trajectory. However, these personal narratives are situated in the context of broader cultural narratives. It is argued that current cultural narratives about aging are often stereotyping and demeaning, being based on either a decline ideology or an age-defying ideology. This complicates the ascription of meaning to later life. We argue that narrative gerontology could profit from integrating a more cultural critical stance in its investigations. Dominant cultural narratives need to be challenged by viable counter narratives aimed at repairing and strengthening the moral agency of aging individuals. We discuss the criteria such counter narratives have to answer to and consider how the moral discourse on self-realization can provide an ideological foundation for meaning-generating cultural counter narratives on aging. 
25422444	When we carry out an act, we typically attribute the action to ourselves, the sense of agency. Explanations for agency include conscious prior intention to act, followed by observation of the sensory consequences; brain activity that involves the feed-forward prediction of the consequences combined with rapid inverse motor prediction to fine-tune the action in real time; priming where there is, e.g., a prior command to perform the act; a cause (the intention to act) preceding the effect (the results of the action); and common-sense rules of attribution of physical causality satisfied. We describe an experiment where participants falsely attributed an act to themselves under conditions that apparently cannot be explained by these theories. A life-sized virtual body (VB) seen from the first-person perspective in 3D stereo, as if substituting the real body, was used to induce the illusion of ownership over the VB. Half of the 44 experimental participants experienced VB movements that were synchronous with their own movements (sync), and the other half asynchronous (async). The VB, seen in a mirror, spoke with corresponding lip movements, and for half of the participants this was accompanied by synchronous vibrotactile stimulation on the thyroid cartilage (Von) but this was not so for the other half. Participants experiencing sync misattributed the speaking to themselves and also shifted the fundamental frequency of their later utterances toward the stimulus voice. Von also contributed to these results. We show that these findings can be explained by current theories of agency, provided that the critical role of ownership over the VB is taken into account. 
25397856	Much research has been conducted to describe medical mistakes resulting in patient harm using databases that capture these events for medical organizations. The objective of this study was to describe patients' perceptions regarding disclosure and their actions after harm.We analyzed a patient harm survey database composed of responses from a voluntary online survey administered to patients by ProPublica, an independent nonprofit news organization, during a 1-year period (May 2012 to May 2013). We collected data on patient demographics and characteristics related to the acknowledgment of patient harms, the reporting of patient harm to an oversight agency, whether the patient or the family obtained the harm-associated medical records, as well as the presence of a malpractice claim.	There were 236 respondents reporting a patient harm (mean age, 49.1 y). In 11.4% (27/236) of harms, an apology by the medical organization or the clinician was made. In 42.8% (101/236) of harms, a complaint was filed with an oversight agency. In 66.5% (157/236) of harms, the patient or the family member obtained a copy of the pertinent medical records. A malpractice claim was reported in 19.9% (47/236) of events.	In this sample of self-reported patient harms, we found a perception of inadequate apology. Nearly half of patient harm events are reported to an oversight agency, and roughly one-fifth result in a malpractice claim.	
25394654	The concept of addiction as a disease is becoming firmly established in medical knowledge and practice at the same time as the logics of the harm reduction approach are gaining broader acceptance. How health care practitioners understand and intervene upon drug use among their patients is complicated by these two models. While harm reduction can be understood as a form of governmentality wherein drug-taking individuals express their regulated autonomy through self-governance, the notion of addiction as a disease removes the option of self-governance through negating the will of the individual. Through analysis of qualitative interviews conducted with 13 health care practitioners who provide care for economically marginalized people who use drugs in New York City, it was found that the absence of will articulated in constructions of addiction as disease offered a gateway through which health care practitioners could bring in ideological commitments associated with harm reduction, such as the de-stigmatization of drug use. Despite differences in the attribution of agency, sewing together these two approaches allowed health care practitioners to work with drug-using patients in practical and compassionate ways. This resembles the strategic deployment of diverse subjectivities found in feminist, post-structural liberatory projects wherein differential subjectification proves tactical and productive. Although drug-using patients may enjoy the benefits of practical and compassionate health care, the conjoint facilitation and denouncement of their will occasioned by the use of both harm reduction and the disease model of addiction imply their management by both pastoral and disciplinary technologies of power. 
25385077	According to agency memory theory, individuals decide whether "I did it" based on a memory trace of "I am doing it". The purpose of this study was to validate the agency memory theory. To this end, several hand actions were individually presented as samples, and participants were asked to perform the sample action, observe the performance of that action by another person, or imagine performing the action. Online feedback received by the participants during the action was manipulated among the different conditions, and output monitoring, in which participants were asked whether they had performed each hand action, was conducted. The rate at which respondents thought that they themselves had performed the action was higher when visual feedback was unaltered than when it was altered (Experiment 1A), and this tendency was observed across all types of altered feedback (Experiment 1B). The observation of an action performed by the hand of another person did not increase the rate at which respondents thought that they themselves had performed the action unless the participants actually did perform the action (Experiments 2A and 2B). In Experiment 3, a relationship was observed between the subjective feeling that "I am the one who is causing an action" and the memory that "I did perform the action". These experiments support the hypothesis that qualitative information and sense of "self" are tagged in a memory trace and that such tags can be used as cues for judgements when the memory is related to the "self". 
25380304	Before implementing a new oral health promotion program in the French overseas territory of Nouvelle Calédonie, the health authorities needed recent data about dental status of the New Caledonian child population.This study aimed to describe the dental status of 6, 9 and 12-yr-old New Caledonian children and to investigate the environmental and behavioural risk factors related to oral health.	A randomly selected sample of 2734 children (744 6-yr-olds, 789 9-yr-olds, and 1201 12-yr-olds) was examined clinically by seven calibrated investigators and participants responded to a questionnaire. The main variables were objective criteria about dental status and subjective criteria about experience of dental care, dental fear, self-perception of oral health, cultural or ethnic identity and environmental and behavioural risk factors.	Overall, most of the children had infectious oral diseases: more than 50% had gingivitis, and 60% of 6- and 9 yr-olds had at least one deciduous or permanent tooth with untreated caries. The mean 12-yr-old number of decayed missing and filled teeth (DMFT) was 2.09±2.82. The number of carious lesions was related to the unfavourable lifestyle, deprived social status and no preventive dental care. Kanak, Polynesians and Caledonians (respectively 27%, 18% and 45% of the study sample) were more affected by caries than metropolitan French and Asian children. Children with many untreated carious lesions had negative perceptions of their oral health; they complained of chewing difficulty and had higher scores for dental anxiety.	This study highlights the need for new strategies aimed at improving oral health and at reducing inequalities in New Caledonia. An oral health promotion program would need to be developed in connection with other health programmes using the common risk factor approach within the context of the local environment.	
25369067	The sense of agency (SoA) refers to the phenomenal experience of initiating and controlling an action, whereas the sense of ownership (SoO) describes the feeling of myness an agent experiences towards his or her own body parts. SoA has been investigated with intentional binding paradigms, and the sense of ownership (SoO) with the rubber-hand illusion (RHI). We investigated the relationship between SoA and SoO by incorporating intentional binding into the RHI. Explicit and implicit measures of agency (SoA-questionnaire, intentional binding) and ownership (SoO-questionnaire, proprioceptive drift) were used. Artificial hand position (congruent/incongruent) and mode of agent (self-agent/other-agent) were systematically varied. Reported SoO varied mainly with position (higher in congruent conditions), but also with agent (higher in self-agent conditions). Reported SoA was modulated by agent (higher in self-agent conditions), and moderately by position (higher in congruent conditions). Implicit and explicit agency measures were not significantly correlated. Finally, intentional binding tended to be stronger in self-generated than observed voluntary actions. Results provide further evidence for a partial double dissociation between SoA and SoO, empirically distinct agency levels, and moderate intentional binding differences between self-generated and observed voluntary actions. 
25331646	Recent public health policies have re-endorsed the key role all health and social care professionals have in tackling the social determinants of health inequalities. With inequalities firmly entrenched, and much theorising focused on reproduction rather than transformation, sustaining practitioner commitment and engagement with this work and maintaining confidence in achieving change is challenging. One increasingly popular way to intervene in practice to begin to address inequalities has been the use of resilience, even though resilience is frequently critiqued for its collusion with neoliberal imperatives in favouring individualised rather than socio-political responses. This article examines these concerns through the use of the practice turn and specifically 'slim-line' practice theory and 'tinkering' to explore the potential for reframing resilience theory and practice. Using an original data set derived from evaluations of resilience-based programmes, held with parents and practitioners between 2008 and 2012, this article re-examines participants' understandings of resilience. We show how practice theory reveals entangled and emergent meanings, competencies and materials that constitute resilience as a social practice comprised of resilient moves. The implications of this reframing are discussed in relation to ontology, agency and change; but also for resilience theory and practice and public health practices more generally. In conclusion, we argue practice theory's attention to context as more than mere backdrop to action helps shift inequality theorising beyond the individual and reproduction towards deeper, detailed social understandings of transformation and change. 
25330184	The sense of agency (SoA) refers to perceived causality of the self, i.e. the feeling of causing something to happen. The SoA has been probed using a variety of explicit and implicit measures. Explicit measures include rating scales and questionnaires. Implicit measures, which include sensory attenuation and temporal binding, use perceptual differences between self- and externally generated stimuli as measures of the SoA. In the present study, we investigated whether the different measures tap into the same self-attribution processes by determining whether individual differences on implicit and explicit measures of SoA are correlated. Participants performed tasks in which they triggered tones via key presses (operant condition) or passively listened to tones triggered by a computer (observational condition). We replicated previously reported effects of sensory attenuation and temporal binding. Surprisingly the two implicit measures of SoA were not significantly correlated with each other, nor did they correlate with the explicit measures of SoA. Our results suggest that some explicit and implicit measures of the SoA may tap into different processes. 
25327970	This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions.This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method.	The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues.	This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.	
25321488	Every day we make attributions about how our actions and the actions of others cause consequences in the world around us. It is unknown whether we use the same implicit process in attributing causality when observing others' actions as we do when making our own. The aim of this research was to investigate the neural processes involved in the implicit sense of agency we form between actions and effects, for both our own actions and when watching others' actions. Using an interval estimation paradigm to elicit intentional binding in self-made and observed actions, we measured the EEG responses indicative of anticipatory processes before an action and the ERPs in response to the sensory consequence. We replicated our previous findings that we form a sense of implicit agency over our own and others' actions. Crucially, EEG results showed that tones caused by either self-made or observed actions both resulted in suppression of the N1 component of the sensory ERP, with no difference in suppression between consequences caused by observed actions compared with self-made actions. Furthermore, this N1 suppression was greatest for tones caused by observed goal-directed actions rather than non-action or non-goal-related visual events. This suggests that top-down processes act upon the neural responses to sensory events caused by goal-directed actions in the same way for events caused by the self or those made by other agents. 
25314232	Narcissistic personality disorder has been challenging to diagnose in psychiatric and general clinical practice. Several circumstances and personality factors related to the nature of pathological narcissism and NPD contribute. NPD is usually a moderately impairing condition, often accompanied by specific capabilities and high level of functioning. Comorbidity of other urgent and recognizable psychiatric conditions, such as mood and substance use disorders or suicidality, can override even significant narcissistic personality functioning. Patients' limited ability to recognize own contribution to problems or impact on other people, their hypersensitivity and defensive reactivity, and compromised ability for self-disclosure, self-reflection, and emotional empathy can make initial evaluations difficult. The aim of this study is to integrate recent clinical and empirical knowledge on the underpinnings of pathological narcissism and narcissistic personality functioning, and distinguish narcissistic self-regulatory patterns that are affecting diagnostic traits. A more flexible, exploratory, and collaborative diagnostic process is proposed that integrates the patients subjective experiences and interpersonal functioning in terms of self-regulation, agency, and traits in a way that is informative and meaningful for both the patient and the clinician.
25313336	To date, research has shown an increasing use of the term "ecohealth" in literature, but few researchers have explicitly described how it has been used. We investigated a project on health and environmental sanitation (the conceptual framework of which included the pillars of ecohealth) to identify the impediments and enablers of ecohealth and investigate how it can move from concept to practice.A case study approach was used. The interview questions were centred on the nature of interactions and the sharing of information between stakeholders.	The analysis identified nine impediments and 15 enablers of ecohealth. Three themes relating to impediments, in particular-integration is not clear, don't understand, and limited participation-related more directly to the challenges in applying the ecohealth pillars of transdisciplinarity and participation. The themes relating to enablers-awareness and understanding, capacity development, and interactions-facilitated usage of the research results. By extracting information on the environmental, social, economic, and health aspects of environmental sanitation, we found that the issue spanned multiple scales and sectors.	The challenge of how to integrate these aspects should be considered at the design stage and throughout the research process. We recommend that ecohealth research teams include a self-investigation of their processes in order to facilitate a comparison of moving from concept to practice, which may offer insights into how to evaluate the process.	
25298615	This paper describes the conceptual development of a multi-domain, psychosocial model of 'Inner Wellbeing' (IWB) and assesses the construct validity of the scale designed to measure it. IWB expresses what people think and feel they are able to be and do. Drawing together scholarship in wellbeing and international development it is grounded in field research in marginalised, rural communities in the global South. Results from research in India at two points in time (2011 and 2013) are reported. At Time 1 (n = 287), we were unable to confirm an eight-factor, correlated model as distinct yet interrelated domains. However, at Time 2 (n = 335), we were able to confirm a revised, seven-factor correlated model with economic confidence, agency and participation, social connections, close relationships, physical and mental health, competence and self-worth, and values and meaning (five items per domain) as distinct yet interrelated domains. In particular, at Time 2, a seven-factor, correlated model provided a significantly better fit to the data than did a one-factor model.
25295000	The feeling of acting voluntarily is a fundamental component of human behavior and social life and is usually accompanied by a sense of agency. However, this ability can be impaired in a number of diseases and disorders. An important example is apraxia, a disturbance traditionally defined as a disorder of voluntary skillful movements that often results from frontal-parietal brain damage. The first part of this article focuses on direct evidence of some core symptoms of apraxia, emphasizing those with connections to agency and free will. The loss of agency in apraxia is reflected in the monitoring of internally driven action, in the perception of specifically self-intended movements and in the neural intention to act. The second part presents an outline of the evidences supporting the functional and anatomical link between apraxia and agency. The available structural and functional results converge to reveal that the frontal-parietal network contributes to the sense of agency and its impairment in disorders such as apraxia. The current knowledge on the generation of motor intentions and action monitoring could potentially be applied to develop therapeutic strategies for the clinical rehabilitation of voluntary action. 
25287720	Juvenile idiopathic arthritis (JIA) is one of the most common diseases of childhood causing pain, swelling of joints and reduced mobility. Previous research has focused on the challenges and psychosocial impact of JIA, but there has been limited attention given to how young people adjust and adapt to living with a long-term condition such as JIA. The aim of this qualitative study was therefore to explore adolescents' experiences of living with JIA, with particular focus on the process of adjustment.Ten adolescents (7 female, 3 male) aged 13-17 years with good treatment adherence were recruited from an adolescent arthritis clinic. In-depth interviews were conducted, and data were analysed by two researchers independently using interpretative phenomenological analysis.	These adolescents described the physical and psychosocial 'burden of living with JIA' and the challenges faced by an underlying preoccupation 'to be a normal teenager'. However, their accounts also revealed ways in which they regained agency and developed 'resilience through taking control' over their lives. This resilience helped the adolescents re-establish a sense of well-being through an ongoing process of 'acceptance and self-growth'.	Although much research has adopted a deficit model that focuses on adjustment problems, the current study highlights the resourcefulness of young people in managing the challenges of living with a long-term condition. These experiences of successful adjustment can be used as the basis of positive, strength-based intervention approaches for adolescents with arthritis to enhance resilience and well-being.	
25286241	The rubber hand illusion (RHI) is a perceptual illusion in which participants perceive a model hand as part of their own body. Here, through the use of one questionnaire experiment and two proprioceptive drift experiments, we investigated the effect of distance (12, 27.5, and 43cm) in the vertical plane on both the moving and classical RHI. In both versions of the illusion, we found an effect of distance on ownership of the rubber hand for both measures tested. Our results further suggested that the moving RHI might follow a narrower spatial rule. Finally, whereas ownership of the moving rubber hand was affected by distance, this was not the case for agency, which was present at all distances tested. In sum, the present results generalize the spatial distance rule in terms of ownership to the vertical plane of space and demonstrate that also the moving RHI obeys this rule. 
25286172	The objective of the study was to evaluate a motivational model of core self-evaluations (CSE), hope (agency and pathways thinking), participation, and life satisfaction in persons with spinal cord injuries.A cross-sectional, correlational design with path analysis was used to evaluate the model.	187 adults with spinal cord injuries participated in this study.	The results indicated an excellent fit between the data and the proposed model. Specifically, CSE was found to directly predict agency and pathways thinking, participation, and life satisfaction. CSE was also found to indirectly predict participation and life satisfaction through agency thinking.	Although CSE contributes directly to participation and life satisfaction, it also has a unique role in increasing individuals' motivation to pursue goals, which also predicts participation and life satisfaction. Counseling interventions should be multifaceted and address the components of CSE to increase hope, participation, and life satisfaction.	
25234319	Animal work implicates the brain-derived neurotrophic factor (BDNF) in function of the ventral striatum (VS), a region known for its role in processing valenced feedback. Recent evidence in humans shows that BDNF Val66Met polymorphism modulates VS activity in anticipation of monetary feedback. However, it remains unclear whether the polymorphism impacts the processing of self-attributed feedback differently from feedback attributed to an external agent. In this study, we emphasize the importance of the feedback attribution because agency is central to computational accounts of the striatum and cognitive accounts of valence processing. We used functional magnetic resonance imaging and a task, in which financial gains/losses are either attributable to performance (self-attributed, SA) or chance (externally-attributed, EA) to ask whether BDNF Val66Met polymorphism predicts VS activity. We found that BDNF Val66Met polymorphism influenced how feedback valence and agency information were combined in the VS and in the right inferior frontal junction (IFJ). Specifically, Met carriers' VS response to valenced feedback depended on agency information, while Val/Val carriers' VS response did not. This context-specific modulation of valence effectively amplified VS responses to SA losses in Met carriers. The IFJ response to SA losses also differentiated Val/Val from Met carriers. These results may point to a reduced allocation of attention and altered motivational salience to SA losses in Val/Val compared to Met carriers. Implications for major depressive disorder are discussed. 
25194692	Bodily self-consciousness depends on the processing of interoceptive and exteroceptive signals. It can be disrupted by inducing signal conflicts. Breathing, at the crossroad between interoception and exteroception, should contribute to bodily self-consciousness. We induced visuo-respiratory conflicts in 17 subjects presented with a virtual body or a parallelepidedal object flashing synchronously or asynchronously with their breathing. A questionnaire detected illusory changes in bodily self-consciousness and breathing agency (the feeling of sensing one's breathing command). Changes in self-location were tested by measuring reaction time during mental ball drop (MBD). Synchronous illumination changed the perceived location of breathing (body: p=0.008 vs. asynchronous; object: p=0.013). It resulted in a significant change in breathing agency, but no changes in self-identification. This was corroborated by prolonged MBD reaction time (body: +0.045s, 95%CI [0.013; 0.08], p=0.007). We conclude that breathing modulates bodily self-consciousness. We also conclude that one can induce the irruption of unattended breathing into consciousness without modifying respiratory mechanics or gas exchange. 
25170021	Building on the recent findings that the experience of self-agency over actions and corresponding outcomes can also rely on cognitive inferential processes, rather than motor prediction processes, this study aims to investigate the brain areas involved in agency inference processing in a setting where action and outcome are independent. Twenty-three right-handed subjects were scanned using functional MRI while performing an agency inference task, in which action outcomes matched or mismatched goals. The experience of self-agency was associated with increased activation in the inferior parietal lobule as well as the bilateral (medial) superior frontal cortex and medial prefrontal cortex. These findings provide new and exciting insights in the processing of inferential self-agency, providing a first look at the neural correlates of self-agency processing independent of motor-prediction processes. 
25161643	The Circle of Security Parenting (COS-P) is an early attachment based intervention that can be used with groups, dyads, and individuals. Created in the USA and now used in many countries, COS-P is a visually based approach that demonstrates its central principles through videos of parent/child interactions. The core purpose of the COS-P is to provide an opportunity for caregivers to reflect on their child's needs and on the challenges each parent faces in meeting those needs. Even though there is a wide range of clinical settings in which child/parent attachment is an important component of assessment there is limited empirical data on when and how attachment based interventions are appropriate for specific clinical profiles and contexts. The aim of this paper is to present a clinical application of COS-P in order to explore and reflect on some specific therapeutic tasks where it works and on some clinical indicators and contexts appropriate for its application. A single case study of a father, "M." (43 years old) in conflict for the custody of his 5 years old daughter is reported. The Adult Attachment Projective Picture System (AAP), the Parenting Stress Index, the Strengths and Difficulties Questionnaire, and the Parental Alliance Measure, were administered pre- and post-intervention. The clinical significance analysis method revealed that numerous changes occurred in the father. The AAP showed improvements in the level of agency of self. M. made gains in his capacity to use internal resources and to increase his agency of self. M. was classified as recovered in his perception of the child's functioning and as improved in his parenting stress and parenting alliance with the mother. Considerations on specific contexts and clinical indicators for the application of COS-P are proposed. 
25161616	The sense of agency (SoA) (i.e., the registration that I am the initiator and controller of my actions and relevant events) is associated with several affective dimensions. This makes it surprising that the emotion factor has been largely neglected in the field of agency research. Current empirical investigations of the SoA mainly focus on sensorimotor signals (i.e., efference copy) and cognitive cues (i.e., intentions, beliefs) and on how they are integrated. Here we argue that this picture is not sufficient to explain agency experience, since agency and emotions constantly interact in our daily life by several ways. Reviewing first recent empirical evidence, we show that self-action perception is in fact modulated by the affective valence of outcomes already at the sensorimotor level. We hypothesize that the "affective coding" between agency and action outcomes plays an essential role in agency processing, i.e., the prospective, immediate or retrospective shaping of agency representations by affective components. This affective coding of agency be differentially altered in various neuropsychiatric diseases (e.g., schizophrenia vs. depression), thus helping to explain the dysfunctions and content of agency experiences in these diseases. 
25155299	This work aims to analyze the relations between psychology as social engineering and self-reflective citizenship from a historiogenetic point of view. Such a connection was founded during modernity; hence our proposal is to study its operative continuity in the postmodern world, taking into account the mismatches due to the new global, multicultural, and technological conditions. Based both on the theory of activity and the concept of semiosphere, the interaction and discussions of a group of Spanish students of psychology in a virtual forum were analyzed. They were asked to negotiate and co-construct their double condition of citizens and future psychologists in connection with the controversial exhibition of religious symbols in Spanish schools. Results show that students segregate both conditions. On one hand, they agree and consolidate the neutral image of a professional psychologist being respectful with the multicultural world. On the other hand, they argue about the citizen and religious topics from a personal or ideological point of view, establishing limits to multiculturalism. Neither the interchange of ideas nor the writing-reading features of the virtual artefacts improved the reflexivity on the close dependencies and contradictions of the two identity domains. This great resilience is due to a sociocultural context -the Western World- where psychology has been constituted as a neutral, objective Science World, one of whose socio-historical products - reflective citizenship- has evolved until proclaiming his/her autonomous agency, forgetting any root in the social engineering. 
25139618	The objective of this evidence-based structured review was to determine if there is consistent evidence that pain interferes with achieving antidepressant treatment response/remission of depression in patients with depression and pain.After exclusion criteria were applied, of 2,801 studies/reports, 17 studies addressed this question. They were sorted into the four hypotheses outlined herein after. The percentage of studies supporting/not supporting each hypothesis was calculated. The strength and consistency of the evidence for each hypothesis were rated according to the Agency for Health Care Research and Quality (AHRQ) guidelines.	For the first hypothesis (pretreatment pain levels will predict antidepressant depression response), nine out of 10 (90%) studies supported it. For the second hypothesis (treatment decreases in pain will be associated with antidepressant depression response), two out of two (100%) studies supported it. For the third hypothesis (pretreatment pain levels will predict antidepressant depression remission), six out of six (100%) studies supported it. For the fourth hypothesis (treatment decreases in pain will be associated with antidepressant depression remission), five out of five (100%) supported it. Utilizing these percentages and AHRQ guidelines, hypotheses 1, 3, and 4 received an A rating for consistency of studies in supporting them. A consistency rating for hypothesis 2 could not be generated because of too few studies in that group.	Consistent evidence was found that antidepressant treatment of depression in patients with depression and pain can be negatively impacted by pain for achieving depression response/remission. However, the overall number of studies supporting each hypothesis was small. In addition, several potential confounders of the results of this study were identified.	
25138312	There is a growing body of empirical evidence on demographic and psychosocial predictors of doping intentions and behaviors utilizing a variety of variables and conceptual models. However, to date there has been no attempt to quantitatively synthesize the available evidence and identify the strongest predictors of doping.Using meta-analysis, we aimed to (i) determine effect sizes of psychological (e.g. attitudes) and social-contextual factors (e.g. social norms), and demographic (e.g. sex and age) variables on doping intentions and use; (ii) examine variables that moderate such effect sizes; and (iii) test a path analysis model, using the meta-analyzed effect sizes, based on variables from the theory of planned behavior (TPB).	Articles were identified from online databases, by contacting experts in the field, and searching the World Anti-Doping Agency website.	Studies that measured doping behaviors and/or doping intentions, and at least one other demographic, psychological, or social-contextual variable were included. We identified 63 independent datasets.	Study information was extracted by using predefined data fields and taking into account study quality indicators. A random effects meta-analysis was carried out, correcting for sampling and measurement error, and identifying moderator variables. Path analysis was conducted on a subset of studies that utilized the TPB.	Use of legal supplements, perceived social norms, and positive attitudes towards doping were the strongest positive correlates of doping intentions and behaviors. In contrast, morality and self-efficacy to refrain from doping had the strongest negative association with doping intentions and behaviors. Furthermore, path analysis suggested that attitudes, perceived norms, and self-efficacy to refrain from doping predicted intentions to dope and, indirectly, doping behaviors.	Various meta-analyzed effect sizes were based on a small number of studies, which were correlational in nature. This is a limitation of the extant literature.	This review identifies a number of important correlates of doping intention and behavior, many of which were measured via self-reports and were drawn from an extended TPB framework. Future research might benefit from embracing other conceptual models of doping behavior and adopting experimental methodologies that will test some of the identified correlates in an effort to develop targeted anti-doping policies and programs.	
25134684	Sense of agency refers to the feeling of controlling an external event through one's own action. On one influential view, sense of agency is inferred after an action, by "retrospectively" comparing actual effects of actions against their intended effects. However, it has been recently shown that earlier processes, linked to action selection, may also contribute to sense of agency, in advance of the action itself, and independently of action effects. The inferior parietal cortex (IPC) may underpin this "prospective" contribution to agency, by monitoring signals relating to fluency of action selection in dorsolateral prefrontal cortex (DLPFC). Here, we combined transcranial stimulation (TMS) with subliminal priming of action selection to investigate the causal role of these regions in the prospective coding of agency. In a first experiment, we showed that TMS over left IPC at the time of action selection disrupts perceived control over subsequent effects of action. In a second experiment, we exploited the temporal specificity of single-pulse TMS to pinpoint the exact timing of IPC contribution to sense of agency. We replicated the reduction in perceived control at the point of action selection, while observing no effect of TMS-induced disruption of IPC at the time of action outcomes. 
25134032	Very little research exists on how self-perceived emerging adult status is associated with substance use among low-income emerging adults. The Inventory of Dimensions of Emerging Adulthood (IDEA) was administered to emerging adults (EAs) ages 18-25 screened for substance use problems (n = l05) in a state-subsidized, not-for-profit treatment agency. We examined whether the defining dimensions of Arnett's (2000a) emerging adulthood theory were associated with substance use frequency and substance-related problems, including: identity exploration, self-focus, possibilities, optimism, negativity/instability, and feeling in-between. In multivariate models, feeling in-between was positively associated with substance-related problems. An interaction term between minority status and feeling in-between approached statistical significance (p = .057). Further, IDEA scale score means were comparable to those found in college student samples. Implications for theory revision are discussed.
25123298	In addition to traditional clinical parameters, the need to include patient-reported assessments into dental implant research has been emphasized.The aim of this study was to evaluate patient-reported outcomes following implant-supported restorative therapy in a randomly selected patient sample.	Four thousand seven hundred and sixteen patients were randomly selected from the data register of the Swedish Social Insurance Agency. A questionnaire containing 10 questions related to implant-supported restorative therapy was mailed to each of the individuals about 6 years after therapy. Associations between questionnaire data, and (i) patient-related, (ii) clinician-related and (iii) therapy-related variables were identified by multivariate analyses.	Three thousand eight hundred and twenty-seven patients (81%) responded to the questionnaire. It was demonstrated that the overall satisfaction among patients was high. Older patients presented with an overall more positive perception of the results of the therapy than younger patients and males were more frequently satisfied in terms of esthetics than females. While clinical setting did not influence results, patients treated by specialist dentists as opposed to general practitioners reported a higher frequency of esthetic satisfaction and improved chewing ability. In addition, patients who had received extensive implant-supported reconstructions, in contrast to those with small reconstructive units, reported more frequently on improved chewing ability and self-confidence but also to a larger extent on implant-related complications.	It is suggested that patient-perceived outcomes of implant-supported restorative therapy are related to (i) age and gender of the patient, (ii) the extent of restorative therapy and (iii) the clinician performing the treatment.	
25120179	The projected hand illusion (PHI) is a variant of the rubber hand illusion (RHI), and both are commonly used to study mechanisms of self-perception. A questionnaire was developed by Longo et al. (2008) to measure qualitative changes in the RHI. Such psychometric analyses have not yet been conducted on the questionnaire for the PHI. The present study is an attempt to validate minor modifications of the questionnaire of Longo et al. to assess the PHI in a community sample (n = 48) and to determine the association with selected demographic (age, sex, years of education), cognitive (Digit Span), and clinical (psychotic-like experiences) variables. Principal components analysis on the questionnaire data extracted four components: Embodiment of "Other" Hand, Disembodiment of Own Hand, Deafference, and Agency-in both synchronous and asynchronous PHI conditions. Questions assessing "Embodiment" and "Agency" loaded onto orthogonal components. Greater illusion ratings were positively associated with being female, being younger, and having higher scores on psychotic-like experiences. There was no association with cognitive performance. Overall, this study confirmed that self-perception as measured with PHI is a multicomponent construct, similar in many respects to the RHI. The main difference lies in the separation of Embodiment and Agency into separate constructs, and this likely reflects the fact that the "live" image of the PHI presents a more realistic picture of the hand and of the stroking movements of the experimenter compared with the RHI. 
25113128	This review article provides a summary of the findings from empirical studies that investigated recognition of an action's agent by using music and/or other auditory information. Embodied cognition accounts ground higher cognitive functions in lower level sensorimotor functioning. Action simulation, the recruitment of an observer's motor system and its neural substrates when observing actions, has been proposed to be particularly potent for actions that are self-produced. This review examines evidence for such claims from the music domain. It covers studies in which trained or untrained individuals generated and/or perceived (musical) sounds, and were subsequently asked to identify who was the author of the sounds (e.g., the self or another individual) in immediate (online) or delayed (offline) research designs. The review is structured according to the complexity of auditory-motor information available and includes sections on: 1) simple auditory information (e.g., clapping, piano, drum sounds), 2) complex instrumental sound sequences (e.g., piano/organ performances), and 3) musical information embedded within audiovisual performance contexts, when action sequences are both viewed as movements and/or listened to in synchrony with sounds (e.g., conductors' gestures, dance). This work has proven to be informative in unraveling the links between perceptual-motor processes, supporting embodied accounts of human cognition that address action observation. The reported findings are examined in relation to cues that contribute to agency judgments, and their implications for research concerning action understanding and applied musical practice. 
25112565	Mental-physical multimorbidity (the co-existence of mental and physical ill health) is highly prevalent and associated with significant impairments and high healthcare costs. While the sociology of chronic illness has developed a mature discourse on coping with long term physical illness the impact of mental and physical health have remained analytically separated, highlighting the need for a better understanding of the day-to-day complexities encountered by people living with mental-physical multimorbidity. We used the phenomenological paradigm of the lived body to elucidate how the experience of mental-physical multimorbidity shapes people's lifeworlds. Nineteen people with chronic obstructive pulmonary disease (COPD) and depression (defined as a score ≥8 on depression scale of Hospital Anxiety and Depression Scale) were recruited from secondary NHS care and interviewed at their homes. Data were analysed phenomenologically using van Manen's lifeworld existential framework of the lived body, lived time, lived space, lived relations. Additionally, we re-analysed data (using the same framework) collected from 13 people recruited from secondary NHS care with either COPD, rheumatoid arthritis, heart disease, or type 1 or type 2 diabetes and depression. The phenomenology of mental-physical multimorbidity was articulated through embodied and emotional encounters with day-to-day life in four ways: [a] participants' perception of lived time and lived space contracted; [b] time and [c] space were experienced as liminal categories, enforcing negative mood and temporal and spatial contraction; and [d] time and space could also be customised to reinstate agency and self-determination. Mental-physical multimorbidity negatively impacts on individuals' perceptions of lived time and lived space, leading to a loss of agency, heightened uncertainty, and poor well-being. Harnessing people's capacity to modify their experience of time and space may be a novel way to support people with mental-physical multimorbidity to live well with illness. 
25108418	The sense of self-agency results from monitoring the relationship between prior thoughts and action plans, sensorimotor information, and perceived outcomes. It is thought to be an important factor underlying self-recognition and self-awareness. Three experiments investigated the sense of self-agency in humans and rhesus macaques (Macaca mulatta). First, humans were asked to move a cursor with a joystick while several distractor cursors also moved on-screen. They were asked to identify either the cursor they were controlling, or a distractor using visual cues alone. Six rhesus macaques were then given a similar task in which they needed to identify a self-controlled cursor that was paired with several different types of distractors. Both groups were able to identify the self-controlled cursor, and monkeys performed best when the oppositely moving cursor was the distractor. A third experiment showed that humans, like macaques, use both perceptual and self-agency information to make decisions. 
25108279	This study examined strategies employed to support a positive self-image in the face of dissonant self-related memories, especially focusing on the role of gender. Participants (N=498) were recruited online and identified a self-descriptive trait. They then reported a memory of a time when they did or did not act according to that trait. Participants distanced themselves from dissonant, self-related memories by downplaying the event's importance and relevance to identity and by emphasizing their lack of agency and the degree to which they had changed. Additionally, participants reported dissonant events from further in the past than consonant events, a tendency displayed more strongly amongst women than men. Women also rated events as more pertinent to the self on questionnaire measures. Findings demonstrate ways that autobiographical memories are reported and organized to support a positive self-image, and deepen an understanding of the role of gender in this process.
25106768	The purpose of this study was to conduct elicitation, semistructured interviews with adolescent boys to document their attitudes, perceived norms, personal agency, intentions, and actions about their weight. The boys indicated that they liked and disliked certain body parts and were in charge of their weight. Almost half of the boys did not want to change their weight. Most of the parents were inaccurate when asked to self-report their sons' heights and weights. A screening procedure that adds adolescents' perceptions of their bodies to BMI classification can aid in the referral and treatment of weight management. 
25103418	The rubber hand illusion (RHI), in which a visible artificial hand is touched (or moves) synchronously with the participant's unseen own hand, indicates that body representations can undergo rapid changes. While several constraints for this illusion have been described, some reports highlight a remarkable flexibility of body representations, even contradicting a priori assumptions regarding body appearance and anatomy (e.g., the subjective embodiment of a third arm). Here we examine the impact of congruence between touches at (or movements of) the real and the artificial hand, as well as the role of predictability of touches (or movements). We implemented two versions of the RHI paradigm, based on passive tactile stimulation and active voluntary movements. The results show that (a) predictability does not modulate perceived embodiment, and that (b) congruent mapping between real and artificial fingers is a necessary condition for both the tactile and the motor RHI. Together with previously reported constraints for bodily illusions, these results are reduced to four principles, which determine subjective embodiment: temporal synchrony, congruence of mapping between real and artificial body parts, body unity and body shape. 
25090370	The Dispositional Hope Scale (DHS; Snyder et al., 1991) is composed of items assessing an individual's perception of his or her agency and pathways. This study examined support for the bifactor structure and relation of the factors in this model with depressive symptoms. It also examined cross-gender measurement invariance for the bifactor model. A community sample of 413 women and 257 men completed the DHS. Confirmatory factor analysis indicated more support for the bifactor model than the 1- and 2-factor models. Results also indicated full measurement invariance across gender for the bifactor and the 2-factor models. The general and the specific agency factors, but not the specific pathways factor, correlated with depressive symptoms. The better support for the bifactor model suggests that ideally hope has to be measured and examined by factors reflecting high covariance for agency and pathways, and also factors reflecting unique variances for agency and pathways. The support for full cross-gender measurement invariance indicated that there are no differences in measurement and scaling properties for the DHS across ratings provided by women and men, and therefore the DHS ratings can be scored in the same way for women and men. 
25059478	Containment level 4 (CL4) laboratories studying biosafety level 4 viruses are under strict regulations to conduct nonhuman primate (NHP) studies in compliance of both animal welfare and biosafety requirements. NHPs housed in open-barred cages raise concerns about cross-contamination between animals, and accidental exposure of personnel to infectious materials. To address these concerns, two NHP experiments were performed. One examined the simultaneous infection of 6 groups of NHPs with 6 different viruses (Machupo, Junin, Rift Valley Fever, Crimean-Congo Hemorrhagic Fever, Nipah and Hendra viruses). Washing personnel between handling each NHP group, floor to ceiling biobubble with HEPA filter, and plexiglass between cages were employed for partial primary containment. The second experiment employed no primary containment around open barred cages with Ebola virus infected NHPs 0.3 meters from naïve NHPs. Viral antigen-specific ELISAs, qRT-PCR and TCID50 infectious assays were utilized to determine antibody levels and viral loads. No transmission of virus to neighbouring NHPs was observed suggesting limited containment protocols are sufficient for multi-viral CL4 experiments within one room. The results support the concept that Ebola virus infection is self-contained in NHPs infected intramuscularly, at least in the present experimental conditions, and is not transmitted to naïve NHPs via an airborne route. 
25051499	The sense of agency is suggested to occur at both low and high levels by the involvement of sensorimotor processes and the contribution of retrospective inferences based on contextual cues. In the current study, we recruited western and non-western participants and examined the effect of pleasantness of action outcomes on both feeling of control ratings and intentional binding which refers to the perceived compression of the temporal delay between actions and outcomes. We found that both western and non-western groups showed greater feeling of control ratings for the consonant (pleasant) compared to dissonant (unpleasant) outcomes. The intentional binding effect, on the other hand, was stronger for the consonant compared to dissonant outcomes in the western group only. We discuss the results in relation to how cultural background might differentially influence the effect of outcome pleasantness on low and high levels of the sense of agency. 
25019590	Sensory attenuation is typically observed for self-generated compared to externally generated action effects. In the present study we investigated whether auditory sensory suppression is modulated as a function of sounds being generated by the upper or lower limbs. We report sensory attenuation, as reflected in a reduced auditory N1 component, which was comparable for sounds generated by the lower and the upper limbs. Increasing temporal delays between actions and sounds did not modulate suppression of the N1 component, but did have an effect on the latency of the N1 component. In contrast, for the P2 component sensory suppression was only observed for sounds generated by the hands and presented at short latencies. These findings provide new insight into the functional and neural dynamics of sensory suppression and suggest the existence of comparable agency mechanisms for both the upper and the lower limbs. 
25018710	People perceive the consequences of their own actions differently to how they perceive other sensory events. A large body of psychology research has shown that people also consistently overrate their own performance relative to others, yet little is known about how these "illusions of superiority" are normally maintained. Here we examined the visual perception of the sensory consequences of self-generated and observed goal-directed actions. Across a series of visuomotor tasks, we found that the perception of the sensory consequences of one's own actions is more biased toward success relative to the perception of observed actions. Using Bayesian models, we show that this bias could be explained by priors that represent exaggerated predictions of success. The degree of exaggeration of priors was unaffected by learning, but was correlated with individual differences in trait optimism. In contrast, when observing these actions, priors represented more accurate predictions of the actual performance. The results suggest that the brain internally represents optimistic predictions for one's own actions. Such exaggerated predictions bind the sensory consequences of our own actions with our intended goal, explaining how it is that when acting we tend to see what we want to see. 
25009949	To explore how patients who refuse referral to pulmonary rehabilitation (PR) appraise acute exacerbations of chronic obstructive pulmonary disease (COPD), in the context of having considered and declined PR.Six participants recently hospitalized with an acute exacerbation COPD who refused a referral to PR subsequent to hospital discharge participated in in-depth interviews. Transcripts were subjected to interpretative phenomenological analysis (IPA).	Three conceptual themes emerged comprising: "Construction of the self", reflecting the impact of the acute exacerbation on personal identity; "Relinquishing control", describing participants" struggle to maintain agency following an acute event; and "Engagement with others", embodying participants' sensitivity and responsiveness to interactions with others.	Prominent in theses participants' narratives are self-conscious cognitions which appear founded in shame and stigmatization. These cognitions seem to reflect challenges to self-worth and appear associated with reduced help-seeking and isolation. Perceived personal culpability for COPD appears to sensitize participants' towards their interactions with health care professionals, construed as critical and judgmental which may increase avoidant behaviors, such as refusal of PR. When introducing PR, professionals should be aware of such sensitivities and facilitate open discussion which offers, time, compassion and understanding as a means of facilitating uptake.	Patients who decline referral to pulmonary rehabilitation report self-conscious cognitions (i.e., shame, guilt, fear of others evaluation) associated with lowered self-worth and reduced help-seeking. When introducing pulmonary rehabilitation health care professionals need to be mindful of patients' sensitivities to being shamed which stem from perceived culpability for COPD. Professionals should facilitate an open discussion with patients which offers, time, compassion and understanding as a means of facilitating pulmonary rehabilitation uptake. Compassion focused interventions which encourage trust and safety may promote active partnership working and facilitate engagement in pulmonary rehabilitation.	
24984909	Appearance and the work invested in it by and for people with dementia are a neglected issue within dementia studies. In policy and practice there exists an assumption that the role of supporting a person to manage their appearance is easily assumed by another within caring encounters, only to be subsumed within the daily task-oriented provision of care. This paper reports on interviews conducted as part of the Hair and Care project, which explored questions of appearance and the meanings it holds with people with dementia. The research used 'appearance biographies', a method which allows for a range of topics to be considered about appearance throughout the life course, acting as a conduit for reminiscence and life story work. The paper reports on the key themes and findings from these interviews, discussing them in the context of a wider debate on dementia, self-expression and agency. A key question posed by the authors is whether appearance and the work invested in it are legitimate considerations for dementia care policy and practice. And if so, how should we make sense of this work and what significance should we attach to it? In seeking to answer these questions the authors position the perspectives and experiences of people with dementia as central to their analysis. A narrative framework is suggested as a useful basis on which to understand the work of managing appearance over the life course. The implications for policy and practice are outlined. 
24974617	The luminosity of Carl Friedrich von Weizsäcker's holistic thinking in the former German Democratic Republic (DDR) is reviewed. Broad-minded academics sought, in accordance with the modern paradigm of self-organization, beyond the ideological template for ways out of the dead end of incrustations of society and innovation blockages under the constraints of a dictatorship. Right after the fall of the wall, Weizsäcker willingly backed a "community of free researchers for self-organization" (Freie Forschungsgemeinschaft Selbstorganisation, FFGSO). This group, conceived as a nonpartisan "think tank" of civil activism, is also discussed. At a number of its meetings Weizsäcker debated the dangers of ideologically influenced science. The effectiveness of the dual leadership at his own Starnberg Institute, for instance, was stymied by the tensions arisen out of such conflicting aims. Against the voluntaristic anticipations of the mainstream in sociology, precisely that system proved to be more viable that was meant to be overcome: faulty and purportedly futureless capitalism. Weizsäcker repudiated social prognoses made in the absence of rules for their falsification resp. verification. Weizsäcker acted as a leading figure at the FFGSO's Potsdam conference, opened on 30 Mar. 1990, on the "DDR--and afterwards?". Its intention was in order to trigger a nationwide discussion of scientific scenarios in designing German unification in the face of gross practical disparities between East and West Germany. The Trust Agency inspired by the FFGSO at the Round Table between opposition and old government was supposed to transfer the national public property "Volkseigentum" of the DDR into private property of the East German citizens, to enable them to realize a role as subject through self-organization. At the group's request, Weizsäcker mediated the readiness by the Lutheran World Federation to assume the role of ombudsman in anticipation of conflicts of interest within the Trust Agency in processing the total assets of an entire country. Weizsäcker also opened contacts with competent earlier fellows from his Starnberg institute on practical cooperative projects at the beginning of the 1990s.
24955502	The question how agent and patient roles are assigned to causal participants has largely been neglected in the psychological literature on force dynamics. Inspired by the linguistic theory of Dowty (1991), we propose that agency attributions are based on a prototype concept of human intervention. We predicted that the number of criteria a participant in a causal interaction shares with this prototype determines the strength of agency intuitions. We showed in two experiments using versions of Michotte's (1963) launching scenarios that agency intuitions were moderated by manipulations of the context prior to the launching event. Altering features, such as relative movement, sequence of visibility, and self-propelled motion, tended to increase agency attributions to the participant that is normally viewed as patient in the standard scenario. 
24945265	Treatment for breast cancer causes uncertainty in the face of new and distressing experiences and often results in the need for self-care. Identifying how uncertainty influences self-care behavior is essential to design interventions that enhance self-care capacity and improve patient outcomes.The aims of this study were to describe the levels of uncertainty, self-efficacy, and self-care behavior in Chinese women receiving chemotherapy for breast cancer and to determine if self-efficacy mediates the relationship between uncertainty and self-care behavior.	A cross-sectional descriptive correlational design was used. Ninety-seven participants completed the Generalized Self-efficacy Scale, the Mishel Uncertainty in Illness Scale, and the Appraisal of Self-care Agency Scale-Revised. Descriptive statistics were used to analyze the levels of uncertainty, self-efficacy, and self-care behaviors in the sample. Multiple regression was used to test the mediating effect of self-efficacy in the relationship between uncertainty and self-care behavior.	Mean ratings of uncertainty (76.70), self-efficacy (27.15), and self-care behavior (53.96) all fell in the moderate range. Both uncertainty and self-efficacy independently predicted self-care behavior, explaining 18.2% of the variance, but self-efficacy did not mediate the relationship between uncertainty and self-care behavior.	Research is needed to further evaluate the proposed relationships using instruments specific to/related to cancer and evaluate change over time. Self-care interventions that have been efficacious in Western populations could be revised to assist Chinese women to reduce uncertainty and enhance self-efficacy in coping with breast cancer.	Self-care intervention programs should include strategies to reduce uncertainty and enhance self-efficacy in coping with breast cancer treatment.	
24942249	The rubber hand illusion is an experimental paradigm in which participants consider a fake hand to be part of their body. This paradigm has been used in many domains of psychology (i.e., research on pain, body ownership, agency) and is of clinical importance. The classic rubber hand paradigm nevertheless suffers from limitations, such as the absence of active motion or the reliance on approximate measurements, which makes strict experimental conditions difficult to obtain. Here, we report on the development of a novel technology-a robotic, user- and computer-controllable hand-that addresses many of the limitations associated with the classic rubber hand paradigm. Because participants can actively control the robotic hand, the device affords higher realism and authenticity. Our robotic hand has a comparatively low cost and opens up novel and innovative methods. In order to validate the robotic hand, we have carried out three experiments. The first two studies were based on previous research using the rubber hand, while the third was specific to the robotic hand. We measured both sense of agency and ownership. Overall, results show that participants experienced a "robotic hand illusion" in the baseline conditions. Furthermore, we also replicated previous results about agency and ownership. 
24935884	The relationship between an individual's sense of self-efficacy, motivation to change, and the implementation of improvement programs has been reported. This research reports the relationship among self-efficacy, motivation to change, and intent to implement continuing medical education (CME) activity learnings.The measure of individual sense of self-efficacy was a 4-item scale. The measure of motivation was a 4-item scale following on the work of Johnson, et al. The self-efficacy scale has been confirmed for structure, and together the 2 scales provide indicators of 3 underlying variables-2 self-efficacy constructs and a motivation variable. In addition, a global intent to implement measure was collected.	Preliminary analysis demonstrates a significant relationship between a self-efficacy construct, the motivation to change construct, and global intent to change. Specifically, the sense of efficacy in effecting change in the practice environment is predictive of a high level of motivation to change, which, in turn, is predictive of formation of an intent to change practice patterns.	Further inspection of the motivation to change construct suggests that it mediates the self-efficacy constructs' effect on intent. This is consistent with an earlier report on the relationship among self-efficacy, barriers to change, and stated intent. This new finding suggests that the proximal construct motivation completely masks an important underlying causal relationship that appears to contribute to practice change following CME: self-efficacy. A focus on the participants' sense of self-agency may provide a path to practice change.	
24929557	One of the key concepts of the German philosopher Max Scheler (1874-1928) is his concept of spirit. He understands spirit as one of several naturally functioning human mental agencies, such as consciousness, will, memory, etc. That is, he treats the mental agency of spirit in a scientific way and avoids any esoteric or religious connotations that this peculiar term may involve. The nature of human spirit, according to Scheler, is the ability to withstand and deliberately redirect biological imperatives and instinctive drives, up to the point of purposefully throwing away one's own life. The presence of spirit constitutes the essence of the human being that differentiates him qualitatively from all animals. In this article, I argue that it is human spirit that plays the determinative role in causing heroic and self-sacrificial behavior. I also argue that the individual human spirit experiences its inherent development, thus having several rather dissimilar stages and manifestations. I discuss the meaning that the term 'spirit' has in the English and the American philosophical and psychological traditions and the meaning of the corresponding term 'der Geist' in the German traditions. The specific English-language understanding of the term 'spirit', compared to its German counterpart 'der Geist', namely, less scientific and more religious and esoteric and metaphorical for the former, makes it alien and almost unusable in the English and American traditions. The linguistic difference leads to the misunderstanding of some very important ideas brought by the concept of spirit as introduced by Scheler. My purpose is to overcome this discrepancy and omission and to introduce the notion and the concept of spirit, in their scientific understanding, into the arsenal of modern English-language cognitive science, psychology, and philosophy in order to provide for the full explanatory force of the hitherto neglected concept of spirit. 
24924875	Bodily self-consciousness has become an important topic in cognitive neuroscience aiming to understand how the brain creates a unified sensation of the self in a body. Specifically, full body illusion (FBI) in which changes in bodily self-consciousness are experimentally introduced by using visual-tactile stimulation has led to improve understanding of these mechanisms. This paper introduces a novel approach to the classic FBI paradigm using a robotic master-slave system which allows us to examine interactions between action and the sense of body ownership in behavioral and MRI experiments. In the proposed approach, the use of the robotic master-slave system enables unique stimulation in which experimental participants can administer tactile cues on their own back using active self-touch. This active self-touch has never been employed in FBI experiments and it allows to test the role of sensorimotor integration and agency (the feeling of control over our actions) in FBI paradigms. The objective of this study is to propose a robotic-haptic platform allowing a new FBI paradigm including the active self-touch in MRI environments. This paper, first, describes the design concept and the performance of the prototype device in the fMRI environment (for 3T and 7T MRI scanners). In addition, the prototype device is applied to a classic FBI experiment, and we verify that the use of the prototype device succeeded in inducing the FBI. These results indicate that the proposed approach has a potential to drive advances in our understanding of human body ownership and agency by allowing novel manipulation and paradigms. 
24920354	Children (0-18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow's model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner's ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children's academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively or negatively influence the educational outcomes of maltreated children. The theoretical, research, and applied implications stemming from the findings are considered. 
24920157	The concept of life-stage orientation is proposed. Youth is a period of time characterised by strong feelings and emotions, but weak reasoning and cognitive skill. Conversely, adulthood is characterised by strong rationality, but weak emotionality. Two studies revealed that merely bringing these concepts to mind changes real-time feelings and behaviour. Participants who were instructed to act like their "adult" selves exhibited greater self-control in a cold pressor test than control participants and those who acted like their "youth" selves (Experiment 1). However, being induced to feel connected to youth enhanced enjoyment for fun videos (Experiment 2). Hence, the extent to which people are oriented towards youth versus adulthood has asymmetric costs and benefits for the present. Connecting to youth boosts experiential capacities (in this case, enjoying oneself) at the cost of agency, whereas connecting to adulthood boosts agentic capacities (in this case, exerting will-power) at the cost of experience. 
24907892	Family stress models illustrate how communities affect youth outcomes through effects on parents and studies consistently show the enduring effects of early community context. The present study takes a different approach identifying human agency during adolescence as a potentially significant promotive factor mediating the relationship between community, parenting, and mental health. While agency is an important part of resilience, its longitudinal effects are unknown, particularly based on gender and race/ethnicity. The purpose of this research was to model the long-term effects of community structural adversity and social resources as predictors of adolescent depressive symptom trajectories via indirect effects of parental happiness, parent-child relationships, and human agency. Latent growth analyses were conducted with 1,796 participants (53% female; 56% White) across four waves of the National Longitudinal Study of Adolescent Health spanning adolescence (Wave 1) through adulthood (Wave 4). The results identified agency as an important promotive factor during adolescence with long-term mental health benefits, but only for White and male participants. For these individuals, community social resources and the quality of the parent-child relationship were related to higher levels of agency and more positive mental health trajectories. Although community social resources similarly benefitted parenting and agency among females and non-White participants, there were no significant links between agency and depressive symptoms for these youth. The results suggest that agency remains an important, but poorly understood concept and additional work is necessary to continue unpacking its meaning for diverse groups of youth.
24888534	From birth, infants move their bodies in order to obtain information and stimulation from their environment. Exploratory movements are important for the development of an infant's understanding of the world and are well established as being key to cognitive advances. Newly acquired motor skills increase the potential actions available to the infant. However, the way that infants employ potential actions in environments with multiple potential targets is undescribed. The current work investigated the target object selections of infants across a range of self-produced locomotor experience (11- to 14-month-old crawlers and walkers). Infants repeatedly accessed objects among pairs of objects differing in both distance and preference status, some requiring locomotion. Overall, their object actions were found to be sensitive to object preference status; however, the role of object distance in shaping object encounters was moderated by movement status. Crawlers' actions appeared opportunistic and were biased towards nearby objects while walkers' actions appeared intentional and were independent of object position. Moreover, walkers' movements favoured preferred objects more strongly for children with higher levels of self-produced locomotion experience. The multi-target experimental situation used in this work parallels conditions faced by foraging organisms, and infants' behaviours were discussed with respect to optimal foraging theory. There is a complex interplay between infants' agency, locomotor experience, and environment in shaping their motor actions. Infants' movements, in turn, determine the information and experiences offered to infants by their micro-environment.
24802646	In this essay I discuss a passage from William Styron's memoir of his long struggle with chronic severe depression, from the standpoint of a Spinozian understanding of agency and self-worth. In this passage Styron relates how in hearing a piece of music he was abruptly struck by a recollection of "all the joys [his] house had known" and how this brought a realization that it would be wrong for him to kill himself: wrong because it would be an abandonment of those who had shared in those joys and a "desecration" of himself. He tells how this realization led him to admit himself to hospital for treatment and thereby to a slow and difficult recovery. This, I propose, illustrates the Spinozian idea that the value of an individual life is properly understood in terms of that individual's participation in the actualization of a shared value and that individual agency is empowered by the knowledge of such value. 
24802000	Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL) is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere) walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed. 
24800078	We report a 14-week post-marketing experience on 20 patients with multiple sclerosis (MS) who started prolonged-release (PR) oral dalfampridine 10 mg twice daily according to European Medicine Agency criteria. They underwent serial static posturography assessments and the dizziness handicap inventory (DHI) to investigate whether PR dalfampridine could impact standing balance and self-reported perception of balance. The incidence of accidental falls per person per month was also recorded throughout the study. Eight (40%) patients, who had a relevant improvement in walking speed, were defined as treatment responders. They showed a significant improvement of standing balance (with respect to pretreatment assessment) when contrasted with 12 (60%) nonresponders (F [4,15] = 3.959, P = 0.027). No significant changes in DHI score, as well as in its functional, physical, and emotional subscales, were found in both responders and nonresponders at the end of study (all P values are ≥0.2). Treatment response did not affect the incidence of accidental falls. Future studies based on larger sample sizes, and with longer followup, are required to confirm the beneficial effect of PR dalfampridine on standing balance. 
24793253	Patient reported health status, which includes symptom burden, functional status and quality of life, is an important measure of health. Differences in health status between diagnostic groups within cardiology have only been sparsely investigated. These outcomes may predict morbidity, mortality, labour market affiliation and healthcare utilisation in various diagnostic groups. A national survey aiming to include all cardiac diagnostic groups from a total Heart Centre population has been designed as the DenHeart survey.DenHeart is designed as a cross-sectional survey with a register-based follow-up. All diagnostic groups at the five national Heart Centres are included during 1 year (15 April 2013 to 15 April 2014) and asked to fill out a questionnaire at hospital discharge. The total eligible population, both responders and non-responders, will be followed in national registers. The following instruments are used: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire (B-IPQ), HeartQoL and Edmonton Symptom Assessment Scale. The following variables are collected from national registers: action diagnosis, procedures, comorbidity, length of hospital stay, type of hospitalisation, visits to general practitioners and other agents in primary healthcare, dispensed prescription medication, vital status and cause of death. Labour market affiliation, sick leave, early retirement pension, educational degree and income will be collected from registers. Frequency distributions and multiple logistic regression analyses will be used to describe and assess differences in patient reported outcomes at hospital discharge between diagnostic groups and in-hospital predicting factors. Cox proportional hazards regression models with age as the time scale will be used to investigate associations between patient reported outcomes at baseline and morbidity/mortality, labour market affiliation and healthcare utilisation after 1 year.	
24777489	Speech is usually assumed to start with a clearly defined preverbal message, which provides a benchmark for self-monitoring and a robust sense of agency for one's utterances. However, an alternative hypothesis states that speakers often have no detailed preview of what they are about to say, and that they instead use auditory feedback to infer the meaning of their words. In the experiment reported here, participants performed a Stroop color-naming task while we covertly manipulated their auditory feedback in real time so that they said one thing but heard themselves saying something else. Under ideal timing conditions, two thirds of these semantic exchanges went undetected by the participants, and in 85% of all nondetected exchanges, the inserted words were experienced as self-produced. These findings indicate that the sense of agency for speech has a strong inferential component, and that auditory feedback of one's own voice acts as a pathway for semantic monitoring, potentially overriding other feedback loops. 
24776791	The self is constructed in cooperation with other people and social context influences how people perceive and express it. People with Alzheimer's disease (AD) often receive insufficient support in constructing their preferred selves, but little is known about how they express themselves together with other people with AD. In accordance with Harré's social constructionist theory of self, this study aimed to describe how five people with mild and moderate AD express their Self 2 (i.e., their personal attributes and life histories) in a support group with a facilitator experienced in communicating with people with AD. The participants' expressions of their Self 2 were analyzed with qualitative abductive content analysis and interpreted in terms of agency and communion and a lack of agency and communion. The findings highlight the importance of supporting a sense of agency and communion when assisting people with AD in constructing their self. 
24768281	Good practices in emergency preparedness and response for chemical incidents include practices specific to the different functions of exposure assessment (e.g., within the monitoring function, the use of mobile monitoring equipment; within the modelling function, the use of rapid dispersion models with integrated mapping software) and generic practices to engage incident response stakeholders to maximise exposure assessment capabilities (e.g., sharing protocols and pre-prepared information and multi-agency training and exercising). Such practices can optimise cross-border collaboration. A wide range of practices have been implemented across MSs during chemical incident response, particularly during incidents that have cross-border and trans-boundary impacts. This paper proposes a self-assessment methodology to enable MSs, or organisations within MSs, to examine exposure assessment capabilities and communication pathways between exposure assessors and public health risk assessors. Where gaps exist, this methodology provides links to good practices that could improve response, communication and collaboration across local, regional and national borders. A fragmented approach to emergency preparedness for chemical incidents is a major obstacle to improving cross-border exposure assessment. There is no one existing body or structure responsible for all aspects of chemical incident preparedness and response in the European Union. Due to the range of different organisations and networks involved in chemical incident response, emergency preparedness needs to be drawn together. A number of recommendations are proposed, including the use of networks of experts which link public health risk assessors with experts in exposure assessment, in order to coordinate and improve chemical incident emergency preparedness. The EU's recent Decision on serious cross-border threats to health aims to facilitate MSs' compliance with the International Health Regulations, which require reporting and communication regarding significant chemical incidents. This provides a potential route to build on in order to improve chemical incident preparedness and response across Europe. 
24753396	Effective adaptive behavior rests on an appropriate understanding of how much responsibility we have over outcomes in the environment. This attribution of agency to ourselves or to an external event influences our behavioral and affective response to the outcomes. Despite its special importance to understanding human motivation and affect, the neural mechanisms involved in self-attributed rewards and punishments remain unclear. Previous evidence implicates the anterior insula (AI) in evaluating the consequences of our own actions. However, it is unclear if the AI has a general role in feedback evaluation (positive and negative) or plays a specific role during error processing. Using functional magnetic resonance imaging and a motion prediction task, we investigate neural responses to self- and externally attributed monetary gains and losses. We found that attribution effects vary according to the valence of feedback: significant valence × attribution interactions in the right AI, the anterior cingulate cortex (ACC), the midbrain, and the right ventral putamen. Self-attributed losses were associated with increased activity in the midbrain, the ACC and the right AI, and negative BOLD response in the ventral putamen. However, higher BOLD activity to self-attributed feedback (losses and gains) was observed in the left AI, the thalamus, and the cerebellar vermis. These results suggest a functional lateralization of the AI. The right AI, together with the midbrain and the ACC, is mainly involved in processing the salience of the outcome, whereas the left is part of a cerebello-thalamic-cortical pathway involved in cognitive control processes important for subsequent behavioral adaptations.
24749739	The self-concept is constituted by a series of context-specific self-aspects. Researchers have considered the manner in which personality traits vary across these self-aspects. Here, we examined self-aspects corresponding to professional and relational contexts at the goal and narrative levels of personality. In each of two studies, participants provided lists of goals and recounted self-defining narratives, corresponding to the aforementioned contexts. Goals and narratives were coded for themes of agency and communion. At both descriptive levels, agency more characterized the professional self-aspect and communion, the relational self-aspect. A consideration of context-specific goals and narratives informs understanding regarding the nature of the self in its multifaceted form. 
24748083	Patients with schizophrenia often experience aberrant bodily self including depersonalization and cenesthopathy, especially in its prodromal and early stage. These symptoms are regarded as the beginning of self-disturbances (i.e. the core psychopathology of the illness). Thus, an understanding of schizophrenic bodily experiences could provide insight into the pathophysiology of schizophrenia. Recently, in the field of cognitive neuroscience, research on self-awareness during intentional actions has focused on examining sense of body ownership (SoO) and sense of agency (SoA). The most critical factor for the emergence of those higher-order senses of self is subject's intention for actions. Intentional signals could integrate multiple bodily sensory feedbacks during actions, and lead to develop a coherent sense of self. Empirical studies using behavioral and neuroimaging experiments have demonstrated that schizophrenic patients exhibit specific patterns of abnormal SoO and SoA. Thus, from a clinical standpoint, the detection of specific nature of schizophrenic bodily experiences could provide evidence for early diagnosis and intervention for schizophrenia.
24712868	Suicides in the U.S. military continue to rise at a rapid rate. Identification of protective factors that reduce risk for suicidal thoughts and behaviors among military personnel are therefore needed. Agency--the sense that one is competent, effective, and in control of one's life--has shown to reduce the effects of hopelessness and emotional distress on suicidal thoughts and attempts in non-military populations. The current study explores the association of agency with suicidal ideation in a sample (n = 273) of active duty Air Force Security Forces personnel. Results of generalized regression modeling suggest that agency is directly associated with decreased emotional distress and severity of suicidal ideation, but does not moderate the effect of emotional distress on suicidal ideation.
24709971	The large-scale assembly of asymmetric colloidal particles is used in creating high-performance fibres. A similar concept is extended to the manufacturing of thin films of self-assembled two-dimensional crystal-type materials with enhanced and tunable properties. Here we present a spray-coating method to manufacture thin, flexible and transparent epoxy films containing zirconium phosphate nanoplatelets self-assembled into a lamellar arrangement aligned parallel to the substrate. The self-assembled mesophase of zirconium phosphate nanoplatelets is stabilized by epoxy pre-polymer and exhibits rheology favourable towards large-scale manufacturing. The thermally cured film forms a mechanically robust coating and shows excellent gas barrier properties at both low- and high humidity levels as a result of the highly aligned and overlapping arrangement of nanoplatelets. This work shows that the large-scale ordering of high aspect ratio nanoplatelets is easier to achieve than previously thought and may have implications in the technological applications for similar materials. 
24705182	The rubber hand illusion is a perceptual illusion in which a model hand is experienced as part of one's own body. In the present study we directly compared the classical illusion, based on visuotactile stimulation, with a rubber hand illusion based on active and passive movements. We examined the question of which combinations of sensory and motor cues are the most potent in inducing the illusion by subjective ratings and an objective measure (proprioceptive drift). In particular, we were interested in whether the combination of afferent and efferent signals in active movements results in the same illusion as in the purely passive modes. Our results show that the illusion is equally strong in all three cases. This demonstrates that different combinations of sensory input can lead to a very similar phenomenological experience and indicates that the illusion can be induced by any combination of multisensory information. 
24680787	Although many studies have elucidated the neurocognitive mechanisms supporting the processing of externally generated sensory signals, less is known about the processing of interoceptive signals related to the viscera. Drawing a parallel with research on agency and the perception of self-generated action effects, in the present EEG study we report a reduced auditory N1 component when participants listened to heartbeat-related sounds compared to externally generated sounds. The auditory suppression for heartbeat sounds was robust and persisted after controlling for ECG-related artifacts, the number of trials involved and the phase of the cardiac cycle. In addition, the auditory N1 suppression for heartbeat-related sounds had a comparable scalp distribution as the N1 suppression observed for actively generated sounds. This finding indicates that the brain automatically differentiates between heartbeat-related and externally generated sounds through a process of sensory suppression, suggesting that a comparable predictive mechanism may underlie the processing of heartbeat and action-related information. Extending recent behavioral data about cardio-visual integration, the present cardio-auditory EEG data reveal that the processing of sounds in auditory cortex is systematically modulated by an interoceptive cardiac signal. The findings are discussed with respect to theories of interoceptive awareness, emotion, predictive coding, and their relevance to bodily self-consciousness. 
24642834	Unraveling the mechanisms underlying self and agency has been a difficult scientific problem. We argue for an event-control approach for naturalizing the sense of agency by focusing on the role of perception-action regularities present at different hierarchical levels and contributing to the sense of self as an agent. The amount of control at different levels of the control hierarchy determines the sense of agency. The current study investigates this approach in a set of two experiments using a scenario containing multiple agents sharing a common goal where one of the agents is partially controlled by the participant. The participant competed with other agents for achieving the goal and subsequently answered questions on identification (which agent was controlled by the participant), the degree to which they are confident about their identification (sense of identification) and the degree to which the participant believed he/she had control over his/her actions (sense of authorship). Results indicate a hierarchical relationship between goal-level control (higher level) and perceptual-motor control (lower level) for sense of agency. Sense of identification ratings increased with perceptual-motor control when the goal was not completed but did not vary with perceptual-motor control when the goal was completed. Sense of authorship showed a similar interaction effect only in experiment 2 that had only one competing agent unlike the larger number of competing agents in experiment 1. The effect of hierarchical control can also be seen in the misidentification pattern and misidentification was greater with the agent affording greater control. Results from the two studies support the event-control approach in understanding sense of agency as grounded in control. The study also offers a novel paradigm for empirically studying sense of agency and self. 
24615808	A growing number of studies have highlighted impairments in the ability of individuals with autism spectrum disorders to recall specific, personally experienced material. These difficulties have been related to underlying problems with autonoetic consciousness, namely the subjective awareness of one's own existence in subjective time. The current paper describes the manifestation of these difficulties in three individuals diagnosed with Asperger syndrome. For the people described, lifelong collecting and hoarding behaviours appeared to serve the function of constituting and maintaining aspects of their sense of self, particularly the sense of continuity and agency over time. On the basis of this clinical information and previous research into self-related processes in people with autism spectrum disorders, an initial model of collecting and hoarding behaviours amongst individuals with Asperger syndrome was formulated. The implications of this formulation for both clinical practice and future research are discussed.People with Asperger syndrome can have problems in developing a functional sense of self. Collecting and hoarding behaviour by people with Asperger syndrome may reflect such underlying difficulties in their sense of self rather than being symptoms of comorbid mental illness. Interventions need to take account of the function of such behaviours rather than solely regarding them as discrete pathological signs.	
24601909	In three experimental studies, with managers and students as participants, we explore in this paper the relation between two kinds of responsibility judgments, called Responsibility 1 (R1) and Responsibility 2 (R2). Decision makers can be viewed as being more or less responsible for their choice and its consequences (R1). Their actions can also be evaluated, from a normative point of view, as instances of more or less responsible behavior (R2). Experiment 1 showed that managers who depart from the default or "normal" course of action, by choosing a new (versus familiar) alternative, changing (versus sticking to) an initial decision, or going against (versus following) the advice of a management team, are rated as more responsible (R1) for the outcomes of their decision. At the same time, they are perceived to act in a less responsible way (R2). Experiment 2 compared decision makers choosing between more or less risky options. High risk takers were held more responsible (R1) for their choice and for its consequences, but were again viewed as behaving in a less responsible way (R2) than low risk takers. In Experiment 3, participants judged decision makers who followed or opposed others' advice by choosing either a high or a low risk option. Opposing others' advice led to higher R1 and lower R2 scores, especially when choosing the high risk option, moderated by outcome (successful decisions appearing more responsible than those that went wrong). Thus R1 and R2 judgments should be distinguished as having different and sometimes even opposite determinants. 
24594468	The objective of this study is to compare post-training self-efficacy between artificial simulators and live animal training for the performance of emergency medical procedures. Volunteer airmen of the 81st Medical Group, without prior medical procedure training, were randomly assigned to two experimental arms consisting of identical lectures and training of diagnostic peritoneal lavage, thoracostomy (chest tube), and cricothyroidotomy on either the TraumaMan (Simulab Corp., Seattle, Washington) artificial simulator or a live pig (Sus scrofa domestica) model. Volunteers were given a postlecture and postskills training assessment of self-efficacy. Twenty-seven volunteers that initially performed artificial simulator training subsequently underwent live animal training and provided assessments comparing both modalities. The results were first, postskills training self-efficacy scores were significantly higher than postlecture scores for either training mode and for all procedures (p < 0.0001). Second, post-training self-efficacy scores were not statistically different between live animal and artificial simulator training for diagnostic peritoneal lavage (p = 0.555), chest tube (p = 0.486), and cricothyroidotomy (p = 0.329). Finally, volunteers undergoing both training modalities indicated preference for live animal training (p < 0.0001). We conclude that artificial simulator and live animal training produce equivalent levels of self-efficacy after initial training, but there is a preference in using a live animal model to achieve those skills. 
24592664	Clients in substance abuse treatment need, in addition to evidence-based and sensitive treatment services in general, a system of care that takes into account the impact of trauma and violence in so many of their lives. In addition, services need to be delivered in a way that avoids triggering trauma memories or causing unintentional re-traumatization. To that end, this article describes an agency self-assessment process that combines a trauma-informed assessment, a NIATx process of "walking-through" and use of the Institute of Healthcare Improvement's Plan-Do-Study-Act (PDSA) cycles, and a user-friendly format. The trauma-informed assessment is designed to address issues of safety of clients and staff members, reduction of re-traumatization, consistency in practice, and client empowerment. It brings a non-judgmental, collaborative approach to process and practice improvement. The article describes how the assessment process can be--and has been--used to develop an Action Plan, including trainings and the identification of "trauma champions"; i.e., staff who will continue to spread trauma-informed changes and new evidence-based practices throughout the agency. As we enter a period of healthcare reform, addressing trauma as an integral part of addiction treatment also allows us to better deal with the totality of our clients' health problems.
24556946	Self-agency is the recognition of one's own movement and plays a vital role in purposeful, voluntary movement. Self-agency can occur in individuals who view their own finger movements as they are projected onto a screen and aligned with their actual hand position. Self-agency can also occur when tools are assimilated into the body schema. Here, we examined whether participants perceived self-agency when they viewed a video of a tool that they manipulated and whether the perception of self-agency correlated with simultaneous changes in oxyhemoglobin in the parietal or prefrontal cortical areas. All participants reported the perception of self-agency, which was correlated with oxyhemoglobin increases in the right inferior prefrontal area. We conclude that self-agency also relates to hand-held tools displayed by video. 
24517266	Prehospital emergency providers (emergency medical technicians [EMTs] and paramedics) who respond to emergency calls for patients near the end of life (EOL) make critical decisions in the field about initiating care and transport to an emergency department.To identify how a sample of prehospital providers learned about EOL care, their perceived confidence with and perspectives on improved preparation for such calls.	This descriptive study used a cross-sectional survey design with mixed methods.	One hundred seventy-eight prehospital providers (76 EMT-basics and 102 paramedics) from an emergency medical services agency participated.	Multiple choice and open-ended survey questions addressed how they learned about EOL calls, their confidence with advance directives, and perspectives on improving care in the field.	The response rate was 86%. Education about do-not-resuscitate (DNR) orders was formal (92%), experiential (77%), and self-directed (38%). Education about medical orders for life-sustaining treatment (MOLST) was formal (72%), experiential (67%), and self-directed (25%). Ninety-three percent were confident in upholding a DNR order, 87% were confident interpreting MOLST, and 87% were confident sorting out conflict between differing patient and family wishes. Qualitative data analysis yielded six themes on improving preparation of prehospital providers for EOL calls: (1) prehospital provider education; (2) public education; (3) educating health care providers on scope of practice; (4) conflict resolution skills; (5) handling emotional families; and (6) clarification of transfer protocols.	These study results suggest the need for addressing the potential interrelationship between prehospital and EOL care through improved education and protocols for care in the field.	
24504195	Knowledge about the effects of our actions is an underlying feature of voluntary behavior. Given the importance of identifying the outcomes of our actions, it has been proposed that the sensory outcomes of self-made actions are inherently different from those of externally caused outcomes. Thus, the outcomes of self-made actions are likely to be more motivationally significant for an agent. We used event-related potentials to investigate the relationship between the perceived motivational significance of an outcome and the attribution of agency in the presence of others. In our experiment, we assessed agency attribution in the presence of another agent by varying the degree of contiguity between participants' self-made actions and the sensory outcome. Specifically, we assessed the feedback correct-related positivity (fCRP) and the novelty P3 measures of an outcome's motivational significance and unexpectedness, respectively. Results revealed that both the fCRP and participants' agency attributions were significantly influenced by action-outcome contiguity. However, when action-outcome contiguity was ambiguous, novelty P3 amplitude was a reliable indicator of agency attribution. Prior agency attributions were also found to influence attribution in trials with ambiguous and low action-outcome contiguity. Participants' use of multiple cues to determine agency is consistent with the cue integration theory of agency. In addition to these novel findings, this study supports growing evidence suggesting that reinforcement processes play a significant role in the sense of agency. 
25949256	The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community.A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect.	The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect.	The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being.	
24469583	'Sensing the self' relies on the ability to distinguish self-generated from external stimuli. It requires functioning mechanisms to establish feelings of agency and ownership. Agency is defined causally, where the subjects action is followed by an effect. Ownership is defined by the features of the effect, independent from the action. In our study, we manipulated these qualities separately. 13 right-handed healthy individuals performed the experiment while 76-channel EEG was recorded. Stimuli consisted of visually presented words, read aloud by the subject. The experiment consisted of six conditions: (a) subjects saw a word, read it aloud, heard it in their own voice; (b) like a, but the word was heard in an unfamiliar voice; (c) subject heard a word in his/her own voice without speaking; (d) like c, but the word was heard in an unfamiliar voice; (e) like a, but subjects heard the word with a delay; (f) subjects read without hearing. ERPs and difference maps were computed for all conditions. Effects were analysed topographically. The N100 (86-172 ms) displayed significant main effects of agency and ownership. The topographies of the two effects shared little common variance, suggesting independent effects. Later effects (174-400 ms) of agency and ownership were topographically similar, suggesting common mechanisms. Replicating earlier studies, significant N100 suppression was observed, with a topography resembling the agency effect. 'Sensing the self' appears to recruit from at least two very distinct processes: an agency assessment that represents causality and an ownership assessment that compares stimulus features with memory content.
24466634	Contemporary immunology has established its fundamental theory as a biological expression of personal identity, wherein the "immune self" is defended by the immune system. Protection of this agent putatively requires a cognitive capacity by which the self and the foreign are perceived and thereby discriminated; from such information, discernment of the environment is achieved and activation of pathways leading to an immune response may be initiated. This so-called cognitive paradigm embeds such functions as "perception," "recognition," "learning," and "memory" to characterize immune processes, but the conceptual character of such functions has meanings that vary with the particular theory adopted. When different formulations of cognition are considered, immunology's conceptual infrastructure shifts: Extensions of conventional psychological understanding of representational cognition based on a subject-object dichotomy support notions of immune agency; alternatively, formulations of perception that dispense with representations and attendant notions of agency reconfigure the predicate epistemology dominating current immune theory. Reviewing immunological literature of the past five decades, these two understandings of perception--representational and non-representational (considered here from ecological, enactivist, and autopoietic perspectives)--offer competing views of immune cognitive functions. These, in turn, provide competing philosophical understandings of immunology's conceptual foundations, which reflect parallel controversies dominating current debates in philosophy of mind and attendant discussions about personal identity.
24447960	For the gamete and embryo donation community, it is well recognized that the implementation of a gamete and embryo donor registry (GEDR) represents a good initiative to ensure the best possible health conditions for donor-conceived individuals. Be they national, institutional or independent, GEDR can play a major role in the transmission of health-related genetic and medical information. However, from a bioethical analysis standpoint, GEDR raise many questions regarding the extent of their beneficent nature. Based on the recent Canadian GEDR aborted attempt, this article will focus on bioethical issues and paradoxes that can impact the wellbeing of donor-conceived individuals, half-siblings, donors and parents. On one hand, the implementation of a GEDR can be ethically justified as a beneficent action towards lessening harm associated with the transmission of hereditary disease and increasing the effectiveness of preventive and therapeutic approaches. On the other hand, examined through the concept of nonpaternalistic beneficence, GEDR challenge us to recognize beneficiaries' free agency, as well as the importance to transmit reliable and pertinent information. Ultimately, beyond an individualistic application of the principle of beneficence, socioethics invite us to consider consistency with societal values as a prerequisite for achieving a common good. Because the issue of whether or not to protect the donor's anonymity occupies the forefront of the discussion surrounding gamete and embryo donation, there is less interest in other initiatives, which may be implemented to ensure the best possible medical and psychosocial conditions for donor-conceived individuals. In this article, we propose a bioethical analysis of the use of gamete and embryo donor registries (GEDR) from the angle of the principle of beneficence. More specifically, we will concentrate on the Canadian situation regarding GEDR. We will look at the strengths and pitfalls of this mechanism and suggest a solution to maximize the benefits of a GEDR. Many have suggested that such an initiative could have a beneficial impact on the wellbeing of donor-conceived individuals, half-siblings, donors and parents, by ensuring the constant flow of health-related medical and genetic information. As self-evident as the social acceptability of a GEDR may seem, we wish to show the limitations of the benefits that a registry is supposed to provide. We argue that a GEDR has to do more than simply transmit health-related information between parties. It also has to be based on pertinent and reliable data, be useful for health promotion and recognize beneficiaries' free agency. Ultimately, the implementation of a GEDR has to take into consideration wider social values. 
24421638	The aim of this study was to evaluate the effects of a telephone-based self-care intervention among urban living individuals 75+ years of age by comparing self-reported perceived health, mental health, sense of coherence, self-care ability, and self-care agency before and after the intervention.In a randomized controlled study, 15 persons answered a questionnaire about perceived health, mental health, sense of coherence, self-care ability, and self-care agency. In a sex- and age-matched control group (n=15), the same questions were answered. Data were collected before and after intervention. An open-ended question about experiences of the intervention was included in the last questionnaire. The intervention consisted of a first meeting with health professionals and additional five self-care telephone calls. The control group did not receive any intervention or attention except for the questionnaires. Descriptive statistics were used to describe the study group. To compare the intervention group and control group on nominal and ordinal levels, the McNemar test and the Wilcoxon signed-rank test, respectively, were chosen.	Thirty individuals (14 females and 16 males) participated in the study, ranging in age between 75 and 93 years. A significant difference was obtained in the intervention group regarding mental health. Mental health improved significantly in the intervention group (P=0.037). In the control group, mental health, sense of coherence, self-care ability, and self-care agency showed worse outcome results after the intervention (19 weeks).	Self-care telephone talks improved mental health significantly in our sample, and mental health focus could be understood as a possible condition for health promotion to take place. Structured self-care telephone talks have proved to be successful and a relevant method to use in practice.	
24413892	Many psychiatric disorders and symptoms have been associated with impaired metabolic control in type 2 diabetes; several studies focused on non-pathological psychological features. Aims of this observational, longitudinal study are: the assessment of the impact of a wide range of psychological factors on metabolic control in type 2 diabetes; and the development and validation of a simple questionnaire to assess the impact of psychological factors on therapeutic success. To identify psychological factors interfering with attainment of glycemic targets, a prospective 1-year study was performed on a sample of 250 patients with type 2 diabetes. The impact of identified factors on therapeutic outcome was then subsequently verified on a further, independent sample of 200 patients. The first phase of the study allowed the development of a 19-items questionnaire, the Psychological Predictors of Therapeutic success in Diabetes (PPTD) questionnaire. Validation analyses showed that the questionnaire was able to predict therapeutic success. Patients with HbA1c ≤7% (53 mmol/mol) at follow-up showed higher test scores than those with HbA1c >7% [31.0 (26.2; 35.0) vs 28.0 (23.0; 32.0); p = 0.016]. The attainment and maintenance of therapeutic goals in patients with type 2 diabetes depend on a wide range of factors. The PPTD is an attempt at condensing the complexity of psychological factors affecting glycemic control in a simple and easy-to-use self-reported questionnaire, which can be used in wide-scale research.
24376765	Previous research suggests that bodily self-identification, bodily self-localization, agency, and the sense of being present in space are critical aspects of conscious full-body self-perception. However, none of the existing studies have investigated the relationship of these aspects to each other, i.e., whether they can be identified to be distinguishable components of the structure of conscious full-body self-perception. Therefore, the objective of the present investigation is to elucidate the structure of conscious full-body self-perception. We performed two studies in which we stroked the back of healthy individuals for three minutes while they watched the back of a distant virtual body being synchronously stroked with a virtual stick. After visuo-tactile stimulation, participants assessed changes in their bodily self-perception with a custom made self-report questionnaire. In the first study, we investigated the structure of conscious full-body self-perception by analyzing the responses to the questionnaire by means of multidimensional scaling combined with cluster analysis. In the second study, we then extended the questionnaire and validated the stability of the structure of conscious full-body self-perception found in the first study within a larger sample of individuals by performing a principle components analysis of the questionnaire responses. The results of the two studies converge in suggesting that the structure of conscious full-body self-perception consists of the following three distinct components: bodily self-identification, space-related self-perception (spatial presence), and agency. 
24367303	The consequences of vestibular disorders on balance, oculomotor control, and self-motion perception have been extensively described in humans and animals. More recently, vestibular disorders have been related to cognitive deficits in spatial navigation and memory tasks. Less frequently, abnormal bodily perceptions have been described in patients with vestibular disorders. Altered forms of bodily self-consciousness include distorted body image and body schema, disembodied self-location (out-of-body experience), altered sense of agency, as well as more complex experiences of dissociation and detachment from the self (depersonalization). In this article, I suggest that vestibular disorders create sensory conflict or mismatch in multisensory brain regions, producing perceptual incoherence and abnormal body and self perceptions. This hypothesis is based on recent functional mapping of the human vestibular cortex, showing vestibular projections to the primary and secondary somatosensory cortex and in several multisensory areas found to be crucial for bodily self-consciousness. 
24339086	This study is underpinned by social constructionist epistemology, which points to the socially constructed character of our worlds, in that we co-create and are co-created by (including experience and identity) our social realities. Through narrative analysis of some poems from the words of people given a diagnosis of dementia, this study engaged in the process of meaning-making in relation to Self-construct and the wider social world. Some narratives evidenced speakers' lack of agency over their experiences, not because of the 'dementia' but due to treatment and care contexts. Some narratives provided instances in which others positioned speakers into identity constructions contradictory to their life-long Self-constructs. Other narratives demonstrated that, through acknowledging and supporting 'personhood', speakers retained a sense of well-being and purpose in their social worlds. It is hoped that focusing on the words of individuals given dementia diagnoses, away from predominant bio-medical discourses, may facilitate professionals' continuous reflection and person-centred practice. 
24339066	There is increasing recognition that dementia in people under 65 years represents a unique challenge to sufferers and services alike. However, by either ignoring this population or sampling them together with older adults, current research has failed to reflect this. This study explored the specific experience of living and coping with Alzheimer's disease in younger life from the perspective of those diagnosed. Semi-structured interviews were analysed using interpretive phenomenological analysis, and four themes were identified: 'disruption of the life-cycle', 'identity', 'social orientation' and 'agency'. The experience of living and coping with young onset Alzheimer's disease was strongly situated within an individual's social context. Most significantly, participants felt too young to develop the disease and felt out of time with age-related psychological tasks. Coping strategies that attempted to redress and normalise the life-cycle were identified. The contributions of the study are discussed in the context of the human development literature. 
24333650	Social and emotional problems have been implicated in the development and maintenance of eating disorders (ED). This paper reviews the facets of social processing in ED according to the NIMH Research and Domain Criteria (NIMH RDoC) 'Systems for Social Processes' framework. Embase, Medline, PsycInfo and Web of Science were searched for peer-reviewed articles published by March 2013. One-hundred and fifty four studies measuring constructs of: attachment, social communication, perception and understanding of self and others, and social dominance in people with ED, were identified. Eleven meta-analyses were performed, they showed evidence that people with ED had attachment insecurity (d=1.31), perceived low parental care (d=.51), appraised high parental overprotection (d=0.29), impaired facial emotion recognition (d=.44) and facial communication (d=2.10), increased facial avoidance (d=.52), reduced agency (d=.39), negative self-evaluation (d=2.27), alexithymia (d=.66), poor understanding of mental states (d=1.07) and sensitivity to social dominance (d=1.08). There is less evidence for problems with production and reception of non-facial communication, animacy and action. 
24332794	The feeling of being the source and controller of one's actions and their effects in the outside world is an important aspect of our sense of self. Disturbances in this sense of agency (SoA) were observed in schizophrenia and have been linked to impairments in sensorimotor integration. We used a virtual-world action-monitoring paradigm to investigate the SoA in 20 schizophrenic patients and 18 healthy subjects. Participants continuously moved a virtual pen displayed on a computer screen using a touchpad device. The control they exceeded over the virtual pen was switched periodically between the participant and the computer. Participants were requested to monitor their actions and the effects on the virtual pen, and indicate loss or regain of control over the pen's movement by button presses. The numbers of erroneous external attribution of action effects (false negative agency judgements) and erroneous self-attribution (false positive agency judgements) were not significantly different in patients and healthy subjects. However, patients showed a significant increase in the duration of false negative agency judgements. Moreover, the number of false negative agency judgements as well as the number and the duration of false positive agency judgements were negatively correlated with the performance in cognitive tests (BACS) in the patient group only. Our findings indicate that the evaluation system to detect a mismatch between actions and their effects in the outside world is probably more rigid in schizophrenic patients, which leads to an increased self-attribution bias for action effects, as commonly found in delusions of control. The impairment in sensorimotor integration may be compensated for by stronger cognitive control. 
24330816	Energy intake under-reporting (UR) is a concern in nutritional epidemiological studies, as it may distort the relationships between dietary habits and health. Although UR is known to be associated with certain characteristics, few studies have investigated them in France. Therefore, the goal of the present study was to assess the prevalence and characteristics of UR in French adults. UR was defined according to Goldberg's classification. A sample of 1567 adults was drawn from the nationally representative French dietary survey (Individuelle Nationale des Consommations Alimentaires 2 2006-7). Food intake (7 d record), dietary habits, socio-economic status, region of residence, sedentary behaviour and weight perception variables were assessed. Multivariate logistic regression was used to investigate the associations between UR and a number of covariates. The overall prevalence of UR was 22.5%, similar in men and women. In both sexes, UR was positively associated with overweight and protein intake and inversely associated with age. In women, UR was associated with eating lunch in the office, poor perception of diet quality and sedentary behaviour and was inversely associated with educational level, residence in the Paris region, cereal product intake and eating lunch in a friend's or family member's home. In men, UR was positively associated with a history of slimming and inversely associated with dairy product intake and eating lunch at a staff canteen. In conclusion, UR is prevalent in French adults and is associated with several different characteristics. It is important to take account of UR when investigating diet-disease associations in adults.
24328818	Measures of impression management have yet to incorporate two-factor models of person perception. The 2 primary factors are often labeled agency and communion. In Study 1, we assembled a new measure of impression management—the Bidimensional Impression Management Index (BIMI): It comprises 2 subscales designed specifically to tap agentic and communal content. Both subscales showed adequate alpha reliabilities under both honest and faking conditions. In Study 2, the BIMI was cross-validated in a new sample: The subscales remained relatively independent, and their reliabilities remained solid. A coherent pattern of personality correlates also supported the validities of both subscales. In Study 3, the differential sensitivity of the 2 subscales was demonstrated by manipulating the job type in simulated job applications. Implications and applications of the BIMI are discussed.
24237208	Body-mind dualism and the consequent neglect of the body of the analyst can have important negative effects on the analytical process leading all too often to misinterpretations of the analysand's verbal and non-verbal communications and to disturbances of analytical temporality. This is intensified when we are dealing with individuals where disembodiment and states of psychic deadness are central features. The paper explores the philosophical roots of the idea of a disembodied mind and the way in which this impacts our relationship with the world. While André Green's concept of the dead mother and disturbances in the sense of self-agency have been held to play an important role in states of psychic deadness, I suggest that it is rather disturbances in the sense of body ownership and of the body image which are more central. The paper then discusses the particular kinds of countertransference that can be evoked in the analyst when we find ourselves dealing with this type of patient and suggests how we can use our embodied countertransference to become aware of and elaborate our own feelings of deadness in order to overcome the loss of temporality that is characteristic of such states. This is illustrated with reference to my work with a young man with a masochistic perversion and a severe disturbance of the body image with an accompanying profound sense of psychic deadness. 
24217393	Temporal contingency between motor commands and corresponding auditory feedback is crucial for perception of self-generated sound as well as external auditory events. The present study examined whether delay detection of self-generated sound was affected by the range of delayed auditory feedback used during the experiment. Participants pressed a button with their right index finger and judged whether auditory feedback was delayed compared with the sensation of finger movement. The range of auditory feedback delay was varied across conditions. To calculate the delay detection threshold (DDT), that is, the point at which the delay detection rate was 50%, we fitted a logistic function to the delay-detection probability curve. The DDT was significantly different across conditions (Tukey-Kramer's honestly significant difference test, P<0.01). Specifically, the DDT became longer as the mean delay of the range increased. However, this shift was not observed for the delay range with a minimum delay greater than 250 ms. We propose that the subjective simultaneity of auditory feedback and self-body movement is, to some extent, automatically recalibrated toward the mean delay of the delay range used in the experiment. 
24216027	Qualitative research using semi-structured interviews and key informant interviews were used to explore how women from low socioeconomic rural households in Queretaro State, Mexico perceived and reacted to their obesogenic environment. Reduced availability of healthy food options and household financial constraints along with reduced agency of women in this setting were factors that limited women's ability to access and consume diets consistent with the promotion of good health. The cultural values that emphasised obesity as a desirable state for women and the women's social networks that promoted these values were also identified as playing a role in reinforcing certain behaviours. Public health advocates wanting to design interventions in such settings need to be sensitive to the cultural as well as the environmental context described for rural Mexican women. 
24174893	Associer les études psychanalytiques et les neurosciences se révèle de plus en plus productif pour identifier et comprendre le fonctionnement de la personnalité. Cet article s'intéresse au narcissisme pathologique et au trouble de la personnalité narcissique (TPN) afin d'explorer deux aspects cliniquement pertinents du fonctionnement narcissique reconnus aussi en psychanalyse: la peur et la prise de décision. Des études neuroscientifiques sur des troubles associes, comme les psychopathies, ont montre qu'il existait des liens entre le fonctionnement affectif et cognitif pouvant influer sur le sens de l'acte intentionnel et de l'autorégulation narcissique. L'attention jouerait un rôle crucial dans la modération de la peur et des déficits d'autorégulation, l'interaction entre expérience et émotion pouvant être centrale pour la prise de décision. Nous analysons ici la peur comme facteur stimulant de la personnalité narcissique et son impact sur la prise de décision chez les sujets souffrant de narcissisme pathologique et de TPN. La compréhension des processus et des bases neurologiques de la peur et de la prise de décision pourrait influer à la fois sur le diagnostic et le traitement du TPN.Cada vez ha resultado más productiva la relaciòn entre los estudios psicoanalíticos y las neurociencias respecto a la identification y comprensiòn del funcionamiento de la personalidad. Este artículo se centra en el narcisismo paiològico y en el trastorno narcisista de la personalidad (TNP), con el objetivo de explorar dos aspectos clinicamente relevantes del funcionamiento narcisista que tambien se reconocen en el psicoanálisis como son el temor y la toma de decisiones. La evidencia que ha surgido de los estudios neurocientíficos de condiciones relacionadas, como la psicopatía, sugiere vinculaciones entre el funcionamiento afectivo y cognitivo, las que pueden influir en el sentido de auto-agencia y la auto-regulacion narcisista. La atenciòn puede jugar un papel esencial en la moderaciòn del temor y de los déficit auto-reguladores, y la interacciòn entre experiencia y emociòn puede ser central para la toma de decisiones. En esta revisiòn se explora el temor como un factor motivador en el funcionamiento de la personalidad narcisista y el impacto que puede tener el temor en la toma de decisiones en personas con un narcisismo patològico y en el TNP. La comprensiòn de los procesos y bases neurològicas del temor y la toma de decisiones puede influir potencíalmente tanto en el diagnòstico como en el tratamiento del TNP.	Linking psychoanalytic studies with neuroscience has proven increasingly productive for identifying and understanding personality functioning. This article focuses on pathological narcissism and narcissistic personality disorder (NPD), with the aim of exploring two clinically relevant aspects of narcissistic functioning also recognized in psychoanalysis: fear and decision-making. Evidence from neuroscientific studies of related conditions, such as psychopathy, suggests links between affective and cognitive functioning that can influence the sense of self-agency and narcissistic self-regulation. Attention can play a crucial role in moderating fear and self-regulatory deficits, and the interaction between experience and emotion can be central for decision-making. In this review we will explore fear as a motivating factor in narcissistic personality functioning, and the impact fear may have on decision-making in people with pathological narcissism and NPD. Understanding the processes and neurological underpinnings of fear and decision-making can potentially influence both the diagnosis and treatment of NPD.	
24128739	Recent fMRI studies indicate that the posterior superior temporal sulcus (pSTS) and the mirror system are involved in analyzing goal-directed actions performed by non-human objects. However, these studies have some limitations: the animations showed moving shapes that resemble humans and human movement, or showed the interaction of two moving shapes rather than one alone. This may have prompted participants to assume a human agent instead of an object. To avoid this potential confound, in this study, animations showed a small circular shape (agent) jumping toward a bigger circular shape (goal) with an obstacle separating them. We manipulated agency of the small circular shape by showing its movements as self-propelled (Agent condition) or as launched by a lever mechanism (Non-agent condition). The small shape succeeded in avoiding an obstacle and reaching the goal object or failed to do so. Our results showed that goal-directed actions performed by an agentic shape recruited the mirror system (the inferior parietal lobe and the premotor cortex) in comparison with shapes that were launched. Success or failure to avoid the obstacle had no effect on these areas. These results complement and further extend previous findings indicating that the mirror system does not appear to be selective for biological actions and their goals, nor does it require the presence of a human, human body parts or human-made objects. Instead, it seems to play a general role in representing goal-directed actions of agents regardless of their form. 
24127868	Identifying the "prosocial personality" is a classic project in personality psychology. However, personality traits have been elusive predictors of prosocial behavior, with personality-prosociality relations varying widely across sociocultural contexts. We propose the social motives perspective to account for such sociocultural inconsistencies. According to this perspective, a focal quality of agency (e.g., competence, independence, openness) is the motive to swim against the social tide-agentic social contrast. Conversely, a focal quality of communion (e.g., warmth, interdependence, agreeableness) is the motive to swim with the social tide-communal social assimilation. We report two cross-sectional studies. Study 1 (N = 131,562) defined social context at the country level (11 European countries), whereas Study 2 (N = 56,395) defined it at the country level (11 European countries) and the city level (296 cities within these countries). Communion predicted interest in prosocial behavior comparatively strongly in sociocultural contexts where such interest was common and comparatively weakly where such interest was uncommon. Agency predicted interest in prosocial behavior comparatively strongly in sociocultural contexts where such interest was uncommon and comparatively weakly where such interest was common. The results supported the social motives perspective. Also, the findings help to reestablish the importance of personality for understanding prosociality. 
24127101	This study presents the psychometric properties of the Brazilian version of the Appraisal of Self-Care Agency Scale - Revised (ASAS-R). The sample was made up of 627 subjects (69.8% women) aged between 18 and 88 years (mean = 38.3; SD = 13.26) from 17 Brazilian states. Exploratory factor analysis of part of the sample (n1 = 200) yielded a three-factor solution which showed adequate levels of reliability. Two confirmatory factor analyses of the other part of the sample (n2 = 427) tested both the exploratory and the original model. The analysis of convergent validity using the Subjective Happiness Scale, the Satisfaction with Life Scale, and the 36-item Short Form Health Survey Version 2 (SF-36v2) demonstrated adequate levels of validity. A significant correlation was found between levels of self-care agency and age, level of education and income. The analysis of sample members with chronic disease (n = 134) showed that higher levels of self-care agency indicated lower levels of negative impact of the chronic illness in the individual's everyday life. 
24122395	Youth–adult partnership (Y–AP) has emerged as a key practice for enacting two features of effective developmental settings: supportive adult relationships and support for efficacy and mattering. Previous studies have shown that when youth, supported by adults, actively participate in organizational and community decision making they are likely to show greater confidence and agency, empowerment and critical consciousness, and community connections. Most of the extant research on Y–AP is limited to qualitative studies and the identification of organizational best practices. Almost all research focuses on Western sociocultural settings. To address these gaps, 299 youth, age 15 to 24, were sampled from established afterschool and community programs in Malaysia to explore the contribution of Y–AP (operationalized as having two components: youth voice in decision-making and supportive adult relationships) to empowerment, agency and community connections. As hypothesized, hierarchical regressions indicated that program quality (Y–AP, safe environment and program engagement) contributed to agency, empowerment and community connections beyond the contribution of family, school and religion. Additionally, the Y–AP measures contributed substantially more variance than the other measures of program quality on each outcome. Interaction effects indicated differences by age for empowerment and agency but not for community connections. The primary findings in this inquiry replicate those found in previous interview and observational-oriented studies. The data suggests fertile ground for future research while demonstrating that Y–AP may be an effective practice for positive youth development outside of Western settings.
24118561	The objective of this study is to evaluate the effectiveness of a proprietary program for increasing self-efficacy among track and field athletes through vicarious experience and successful control over excitation and to determine the changes in the cognitive dimensions related to self-efficacy: dispositional optimism, hope of success and locus of control. An experimental two-group design with a pre-test and a post-test in the experimental and control groups was used. Forty-two athletes (29 women and 13 men) aged 17 to 24 years randomly assigned to the intervention and control groups took part in the study. The General Scale of Self-Efficacy, Hope for Success Questionnaire, Life Orientation Test Revised, and Internal-External Locus of Control Scale were used. The study's results indicate that the program was effective. Participants in the intervention group demonstrated a substantial increase in self-efficacy (P = 0.001). This was not observed in the control group (P = 0.732). After the completion of the program, athletes in the intervention group had significantly higher levels of self-efficacy (P = 0.001) and optimism (P = 0.017). They also had more internal locus of control compared to the control group (P = 0.001). Contrary to expectations, athletes in the intervention group demonstrated a substantially lower level of propensity in pathways (P = 0.001) as well as in agency (P = 0.001) (both components of the hope for success).
24114797	Accumulated evidence suggests that approximately one third of people with a serious mental illness (SMI) experience elevated self-stigma. Narrative enhancement and cognitive therapy (NECT) is a structured group-based intervention aimed to reduce self-stigma. The current study aims to examine the effectiveness of NECT. A quasi-experimental design.Baseline and follow-up data were collected and outcomes were compared between 63 persons with SMI who participated in NECT and 56 persons who received treatment as usual.	The NECT treatment group showed significant (p < .05) reductions in self-stigma and increases in self-esteem, quality of life, and Hope-Agency scores between pre- and posttreatment assessments, compared with the control group.	The current results provide preliminary support for the use of NECT as an effective treatment to reduce self-stigma and its implications for treatment and practice are discussed.	
24094850	Sense of agency (SoA) refers to the feeling that one's voluntary actions produce external sensory events [1, 2]. Several psychological theories hypothesized links between SoA and affective evaluation [3-6]. For example, people tend to attribute positive outcomes to their own actions, perhaps reflecting high-level narrative processes that enhance self-esteem [3]. Here we provide the first evidence that such emotional modulations also involve changes in the low-level sensorimotor basis of agency. The intentional binding paradigm [1] was used to quantify the subjective temporal compression between a voluntary action and its sensory consequences, providing an implicit measure of SoA. Emotional valence of action outcomes was manipulated by following participants' key-press actions with negative or positive emotional vocalizations [7], or neutral sounds. We found that intentional binding was reduced for negative compared to positive or neutral outcomes. Discriminant analyses identified a change in time perception of both actions and their negative outcomes, demonstrating that the experience of action itself is subject to affective modulation. A small binding benefit was also found for positive action outcomes. Emotional modulation of SoA may contribute to regulating social behavior. Correctly tracking the valenced effects of one's voluntary actions on other people could underlie successful social interactions. 
24069368	High-level cognitive factors, including self-awareness, are believed to play an important role in human visual perception. The principal aim of this study was to determine whether oscillatory brain rhythms play a role in the neural processes involved in self-monitoring attentional status. To do so we measured cortical activity using magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) while participants were asked to self-monitor their internal status, only initiating the presentation of a stimulus when they perceived their attentional focus to be maximal. We employed a hierarchical Bayesian method that uses fMRI results as soft-constrained spatial information to solve the MEG inverse problem, allowing us to estimate cortical currents in the order of millimeters and milliseconds. Our results show that, during self-monitoring of internal status, there was a sustained decrease in power within the 7-13 Hz (alpha) range in the rostral cingulate motor area (rCMA) on the human medial wall, beginning approximately 430 msec after the trial start (p < 0.05, FDR corrected). We also show that gamma-band power (41-47 Hz) within this area was positively correlated with task performance from 40-640 msec after the trial start (r = 0.71, p < 0.05). We conclude: (1) the rCMA is involved in processes governing self-monitoring of internal status; and (2) the qualitative differences between alpha and gamma activity are reflective of their different roles in self-monitoring internal states. We suggest that alpha suppression may reflect a strengthening of top-down interareal connections, while a positive correlation between gamma activity and task performance indicates that gamma may play an important role in guiding visuomotor behavior. 
24055201	Disturbances of the minimal self, characterized by abnormal sense of the body, body ownership and agency have been proposed as the phenomenological phenotype of schizophrenia. However, self-disturbances have not been extensively investigated, in part, due to the subjective nature of such processes, and the associated difficulty of studying these phenomena using empirical methodology. Of 115 potential studies on self-awareness in schizophrenia, a total of 25 studies met the inclusion criteria for the meta-analysis comprising 690 patients with schizophrenia and 979 healthy controls. We calculated Hedge's g to obtain a better estimate for the standardized mean difference in small samples. We identified significant basic self-disturbance in schizophrenia, as compared with healthy controls (25 studies, effect size=0.51). Additional comparison of three sub-categories of the sense of body ownership (4 studies, effect size=0.91), the sense of agency (15 studies, effect size=0.49), and self-reported subjective experiences (6 studies, effect size=0.57) also confirmed group differences. The complete set of 25 studies, and the studies in the sub-categories showed the statistical homogeneity of the characteristics. After a correction for potential publication bias using the trim-and-fill method, the main findings for all studies combined remained significant. Overall, patients with schizophrenia showed deficits in the sense of the minimal self, driven by abnormal sense of body ownership and sense of agency. Interestingly, the disturbed sense of agency in schizophrenia suggests an exaggerated self-consciousness rather than a diminished sense of self. Further research that utilizes sophisticated study designs is needed to examine the nature of self-disturbances in schizophrenia. 
24046734	Neuromodulation therapeutics-as repeated Transcranial Magnetic Stimulation (rTMS) and neurofeedback-are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals' autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device. 
24036357	In a series of experiments Marc Jeannerod revealed that we have very little awareness of the details and causes of our actions. We are, however, vividly aware of being in control of our actions and this gives us a sense of responsibility. These feelings arise, first, from intentional binding which creates a perception of agency, linking an intentional action to its outcome and, second, from the counterfactual reasoning that we could have chosen some other action. These feelings of responsibility play a critical role in creating social cohesion since they allow people to be held to account for deliberate antisocial behaviour. Jeannerod's studies also showed that we are unaware of how little we know about our actions and so are happy to make up stories about the nature and causes of our behaviour. These stories often do not correspond with the underlying cognitive and neural processes, but they can be changed through instructions and through discussion with others. Our experience of responsibility for action emerges during our upbringing through exposure to our culture. This creates consensus about the causes of behaviour, but not necessarily accuracy. 
24003134	What are the developmental origins of our concept of animal? There has long been controversy concerning this question. At issue is whether biological reasoning develops from earlier forms of reasoning, such as physical and psychological reasoning, or whether from a young age children endow animals with biological properties. Here we demonstrate that 8-mo-old infants already expect novel objects they identify as animals to have insides. Infants detected a violation when an object that was self-propelled and agentive (but not an object that lacked one or both of these properties) was revealed to be hollow. Infants also detected a violation when an object that was self-propelled and furry (but not an object that lacked one or both of these properties) either was shown to be hollow or rattled (when shaken) as although mostly hollow. Young infants' expectations about animals' insides may serve as a foundation for the development of more advanced biological knowledge. 
23988295	Mirroring has been almost exclusively analysed in motor terms with no reference to the body that carries the action. According to the standard view, one activates motor representations upon seeing other people moving. However, one does not only see movements, one also sees another individual's body. The following questions then arise. To what extent does one recruit body representations in social context? And does it imply that body representations are shared between self and others? This latter question is all the more legitimate since recent evidence indicates the existence of shared cortical networks for bodily sensations, including pain (e.g., Singer et al., 2004) and touch (e.g., Keysers et al., 2004; Blakemore, Bristow, Bird, Frith, & Ward, 2005). But if body representations are shared, then it seems that their activation cannot suffice to discriminate between one's body and other people's bodies. Does one then need a 'Whose' system to recognise one's body as one's own, in the same way that Jeannerod argues that one needs a 'Who' system to recognise one's actions as one's own? 
23987252	The prevalence and negative health effects of chronic diseases are disproportionately high among Hispanics, the largest minority group in the United States. Self-management of chronic conditions by older adults is a public health priority. The objective of this study was to examine 6-week differences in self-efficacy, time spent performing physical activity, and perceived social and role activities limitations for participants in a chronic disease self-management program for Spanish-speaking older adults, Tomando Control de su Salud (TCDS).Through the Healthy Aging Regional Collaborative, 8 area agencies delivered 82 workshops in 62 locations throughout South Florida. Spanish-speaking participants who attended workshops from October 1, 2008, through December 31, 2010, were aged 55 years or older, had at least 1 chronic condition, and completed baseline and post-test surveys were included in analysis (N=682). Workshops consisted of six, 2.5-hour sessions offered once per week for 6 weeks. A self-report survey was administered at baseline and again at the end of program instruction. To assess differences in outcomes, a repeated measures general linear model was used, controlling for agency and baseline general health.	All outcomes showed improvement at 6 weeks. Outcomes that improved significantly were self-efficacy to manage disease, perceived social and role activities limitations, time spent walking, and time spent performing other aerobic activities.	Implementation of TCDS significantly improved 4 of 8 health promotion skills and behaviors of Spanish-speaking older adults in South Florida. A community-based implementation of TCDS has the potential to improve health outcomes for a diverse, Spanish-speaking, older adult population.	
23977268	The sense of agency is the attribution of oneself as the cause of one's own actions and their effects. Accurate agency judgments are essential for adaptive behaviors in dynamic environments, especially in conditions of uncertainty. However, it is unclear how agency judgments are made in ambiguous situations where self-agency and non-self-agency are both possible. Agency attribution is thus thought to require higher-order neurocognitive processes that integrate several possibilities. Furthermore, neural activity specific to self-attribution, as compared with non-self-attribution, may reflect higher-order critical operations that contribute to constructions of self-consciousness. Based on these assumptions, the present study focused on agency judgments under ambiguous conditions and examined the neural correlates of this operation with functional magnetic resonance imaging. Participants performed a simple but demanding agency-judgment task, which required them to report on whether they attributed their own action as the cause of a visual stimulus change. The temporal discrepancy between the participant's action and the visual events was adaptively set to be maximally ambiguous for each individual on a trial-by-trial basis. Comparison with results for a control condition revealed that the judgment of agency was associated with activity in lateral temporo-parietal areas, medial frontal areas, the dorsolateral prefrontal area, and frontal operculum/insula regions. However, most of these areas did not differentiate between self- and non-self-attribution. Instead, self-attribution was associated with activity in posterior midline areas, including the precuneus and posterior cingulate cortex. These results suggest that deliberate self-attribution of an external event is principally associated with activity in posterior midline structures, which is imperative for self-consciousness. 
23970556	Sense of self (SOS)--understood as the foundation upon which individuals experience their daily lives--has been increasingly investigated in schizophrenia. A disrupted SOS is thought to represent a platform for the experience of psychiatric symptoms, social cognitive deficits, and other abnormalities of consciousness. Few studies, however, have investigated the specificity of disrupted SOS to schizophrenia. The primary objective of the present study was to test the hypothesis that SOS is deficient in schizophrenia patients compared to both nonpsychiatric controls and patients with psychotic bipolar disorder. Using select scales from the Assessment of Self Descriptions, the present study assessed SOS from spontaneous narratives provided by schizophrenia patients (N = 50), bipolar patients with psychotic features (N = 17), and nonpsychiatric controls (N = 24). Our findings indicate that facets of SOS-in particular, certain aspects of agency and relatedness to others-are deficient in schizophrenia compared to nonpsychiatric controls and bipolar patients with psychotic features, even when overall level of functioning and psychiatric symptoms are accounted for. Implications of these results are discussed.
23963194	Between cancer treatment courses, children who have not developed any complications or neutropenia are sent home until the start of the next treatment protocol.The aim of this study was to describe the experiences of parents in the home care of children who had been recently diagnosed with cancer and were undergoing cancer treatment but had been discharged from the hospital between treatment protocols.	The study was carried out at Ege University, Turkey. Twelve parents of 12 children between 0 and 18 years of age participated in an in-depth interview. The data were analyzed according to Orem's Self-care Deficit Theory.	The main themes were basic conditioning factors, self-care agency, and self-care needs. Some parents changed their place of residence because of the cancer treatment, focused on the recovery of the child, and experienced fear, perception difficulties, and difficulties related to self-care needs.	Parents report difficulties with extreme emotions and dilemmas in maintaining their daily routines of life secondary to fear of infection and challenges with feeding their children.	A well-planned discharge education, home visits, and telephone consultation interventions are essential to meet the needs of children and their parents who are at home between treatment courses.	
23928891	Operators of a pair of robotic hands report ownership for those hands when they hold image of a grasp motion and watch the robot perform it. We present a novel body ownership illusion that is induced by merely watching and controlling robot's motions through a brain machine interface. In past studies, body ownership illusions were induced by correlation of such sensory inputs as vision, touch and proprioception. However, in the presented illusion none of the mentioned sensations are integrated except vision. Our results show that during BMI-operation of robotic hands, the interaction between motor commands and visual feedback of the intended motions is adequate to incorporate the non-body limbs into one's own body. Our discussion focuses on the role of proprioceptive information in the mechanism of agency-driven illusions. We believe that our findings will contribute to improvement of tele-presence systems in which operators incorporate BMI-operated robots into their body representations. 
23912695	The US FDA and the European Medicines Agency (EMA) have issued incentives and laws mandating clinical research in pediatrics. While guidances for the development and validation of patient-reported outcomes (PROs) or health-related quality of life (HRQL) measures have been issued by these agencies, little attention has focused on pediatric PRO development methods. With reference to the literature, this article provides an overview of specific considerations that should be made with regard to the development of pediatric PRO measures, with a focus on performing qualitative research to ensure content validity. Throughout the questionnaire development process it is critical to use developmentally appropriate language and techniques to ensure outcomes have content validity, and will be reliable and valid within narrow age bands (0-2, 3-5, 6-8, 9-11, 12-14, 15-17 years). For qualitative research, sample sizes within those age bands must be adequate to demonstrate saturation while taking into account children's rapid growth and development. Interview methods, interview guides, and length of interview must all take developmental stage into account. Drawings, play-doh, or props can be used to engage the child. Care needs to be taken during cognitive debriefing, where repeated questioning can lead a child to change their answers, due to thinking their answer is incorrect. For the PROs themselves, the greatest challenge is in measuring outcomes in children aged 5-8 years. In this age range, while self-report is generally more valid, parent reports of observable behaviors are generally more reliable. As such, 'team completion' or a parent-administered child report is often the best option for children aged 5-8 years. For infants and very young children (aged 0-4 years), patient rating of observable behaviors is necessary, and, for adolescents and children aged 9 years and older, self-reported outcomes are generally valid and reliable. In conclusion, the development of PRO measures for use in children requires careful tailoring of qualitative methods, and performing research within narrow age bands. The best reporter should be carefully considered dependent on the child's age, developmental ability, and the concept being measured, and team completion should be considered alongside self-completion and observer measures. 
23885969	This paper focuses on the experiences of women 15-24 years old living in one suburban district in Bangkok. Its objectives are to analyse processes of building and negotiating social identity and femininity in online spaces by young women; the ways in which young women express their sexuality using online technologies; connections between the 'online' and 'offline' worlds in terms of emotions as well as social and sexual networks; and traditional values regarding female sexuality reproduced through online media and how young women negotiate and resist these. Content and narrative analyses were conducted using qualitative data from 9 focus-group discussions and 14 narrative interviews. Findings indicated that the online media serve as tools that help young women develop and express their gender identities. Mobile phones and the Internet facilitate communication in order to express love, responsibility, intimacy and sexual desires. Discourse on women's chastity, which puts pressure on women to maintain their virginity, still influences online and mobile contents, messages and images among young women. However, women also exerted agency in negotiating and expressing their sexuality, both online and offline.
23881587	To examine the relationship between self-related agency beliefs and observed eating behavior in adolescent girls with loss of control (LOC) eating.One-hundred eleven adolescent girls (14.5 ± 1.7 years; BMI: 27.1 ± 2.6 kg/m(2)) were administered the General Self-Efficacy Scale and the Weight Efficacy Lifestyle Questionnaire (WEL). Adolescents then participated in a laboratory test meal.	Greater general and eating self-efficacy were associated with fewer episodes of LOC eating. General self-efficacy was inversely related to total intake at the meal (p < .01). Only the WEL availability subscale score, but not the other WEL subscales, was inversely related to total energy, snack, and dessert intake (ps < 0.05).	General self-related agency beliefs may be important in relation to energy consumption. Among girls susceptible to disordered eating and obesity, the domain-specific belief in one's ability to refrain from eating when food is widely available may be especially salient in determining overeating in the current food environment. Further research is therefore needed to assess the predictive validity of these beliefs on eating and weight outcomes.	
23881092	Autism spectrum disorders (ASDs) are neurodevelopmental conditions that severely affect social interaction, communication and several behavioural and cognitive functions, such as planning and monitoring motor actions. A renewed interest in intrapersonal cognition has recently emerged suggesting a putative dissociation between impaired declarative processes, such as autobiographical memory, and spared implicit processes, such as the sense of agency (SoA) in ASDs. However, so far only a few studies have investigated the integrity of SoA using tasks exclusively tapping reflective mechanisms. Since pre-reflective processes of SoA are based on the same predictive internal models that are involved in planning and monitoring actions, we hypothesized that pre-reflective aspects of SoA, as measured by the intentional binding effect, would be altered in adults with high functioning autism spectrum disorders, relative to volunteers with typical development. Here, in accordance with our hypothesis, we report reduced IB in participants with ASDs. 
23874308	Humans, even babies, perceive causality when one shape moves briefly and linearly after another. Motion timing is crucial in this and causal impressions disappear with short delays between motions. However, the role of temporal information is more complex: it is both a cue to causality and a factor that constrains processing. It affects ability to distinguish causality from non-causality, and social from mechanical causality. Here we study both issues with 3- to 7-year-olds and adults who saw two computer-animated squares and chose if a picture of mechanical, social or non-causality fit each event best. Prior work fit with the standard view that early in development, the distinction between the social and physical domains depends mainly on whether or not the agents make contact, and that this reflects concern with domain-specific motion onset, in particular, whether the motion is self-initiated or not. The present experiments challenge both parts of this position. In Experiments 1 and 2, we showed that not just spatial, but also animacy and temporal information affect how children distinguish between physical and social causality. In Experiments 3 and 4 we showed that children do not seem to use spatio-temporal information in perceptual causality to make inferences about self- or other-initiated motion onset. Overall, spatial contact may be developmentally primary in domain-specific perceptual causality in that it is processed easily and is dominant over competing cues, but it is not the only cue used early on and it is not used to infer motion onset. Instead, domain-specific causal impressions may be automatic reactions to specific perceptual configurations, with a complex role for temporal information. 
23871863	Self-initiated action effects are often perceived as less intense than identical but externally generated stimuli. It is thought that forward models within the sensorimotor system pre-activate cortical representations of predicted action effects, reducing perceptual sensitivity and attenuating neural responses. As self-agency and predictability are seldom manipulated simultaneously in behavioral experiments, it is unclear if self-other differences depend on predictable action effect contingencies, or if both self- and externally generated stimuli are modulated similarly by predictability. We factorially combined variation in (1) predictability of action effects, (2) spatial congruence, and (3) performance by the self or computer to dissociate these influences on a visual discrimination task. Participants performed 2AFC speed judgments. Self-initiated motion was judged to be slower than computer-initiated motion when action effect contingencies were predictable, while spatial congruence influenced speed judgments only when action effect contingencies were unpredictable. Results are discussed in relation to current theories of sensory attenuation. 
23871226	Teenagers in Sweden were given greater access as consumers of OTC drugs in 2009 after the reregulation of the pharmacy market, which allowed for the establishment of private pharmacies and sale of specific over-the-counter (OTC) drugs in retail stores and gas stations. Increased access to OTC drugs could provide new opportunities for self-care but attenuates the opportunity for the traditional expert surveillance of pharmacists, thus increasing the possibility of inappropriate OTC drug use.Views of 16-19 year old Swedish teenagers on OTC drugs, with special regard to analgesic drugs were explored and described, based on the following questions: How and where did they acquire their knowledge and attitudes regarding OTC drugs? What perceptions did they have about the use of OTC drugs?	A qualitative approach with a descriptive design was chosen. Data were collected in 2011 with 10 focus group discussions with high school students aged 16-19 years from different parts of Sweden. A total of 77 teenagers participated, 33 males and 44 females. A manifest qualitative content analysis was performed.	While most teenagers appeared to have responsible attitudes toward OTC drugs and their use, some teenagers had attitudes that ranged from casual to careless. The focus group discussions also revealed knowledge gaps among teenagers regarding OTC drugs, and the significant influence of parents and peers on their OTC drug use.	This study provides insight into how vulnerable some teenagers could be as new consumers of OTC drugs and suggested that educational efforts could be geared toward parents as well as teenagers.	
23863772	Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive underpinnings of basic self-disturbance. In these two theoretical papers (of which this is Part 2), we review some recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of "ownership" and "mineness" (the phenomenological notion of presence or self-affection) and 2. aberrant salience, and associated disturbances of memory, prediction and attention processes, which may contribute to hyper-reflexivity, disturbed "grip" or "hold" on perceptual and conceptual fields, and disturbances of intuitive social understanding ("common sense"). In this paper (Part 2) we focus on aberrant salience. Part 1 (this issue) addressed source monitoring deficits. Empirical studies are required in a variety of populations in order to test these proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive "levels" would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies. 
23834005	Relational, systems-oriented approaches are strongly positioned to advance theory and research in developmental science and to cement a process orientation to development at all levels of organization--from the biological to the psychological and sociocultural--despite continued prominence in the field of biologically reductionist explanatory accounts. However, the inclusive, explanatorily pluralistic ontological framework involved in adopting a relational perspective on developing systems is not always fully appreciated, explicitly articulated or even followed by devotees of the perspective. In this chapter, we highlight the importance of holistically couching interlevel relations--those that obtain vertically between levels of organization, such as between the biological and psychological levels--in terms of wholes and parts and of recognizing the different modes of causal explanation that obtain depending on whether the relations move from parts-to-whole or whole-to-parts. This, in turn, yields an explanatory pluralism under which all living systems, at any level of organization, exist as both subjects and objects. We ground this discussion by examining the ontological compatibility with a relational developmental systems perspective of two systems-oriented approaches to embodiment: the dynamic systems approach of Thelen and Smith (1994, 2006) and the enactive approach of Varela, Thompson, and Rosch (1991).
23810736	Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive underpinnings of basic self-disturbance. In these two theoretical papers (of which this is Part 1), we review some recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of "ownership" and "mineness" (the phenomenological notion of presence or self-affection) and 2. aberrant salience, and associated disturbances of memory, prediction and attention processes, which may contribute to hyper-reflexivity, disturbed "grip" or "hold" on the perceptual and conceptual field, and disturbances of intuitive social understanding ("common sense"). In this paper (Part 1) we focus on source monitoring deficits. Part 2 (this issue) addresses aberrant salience. Empirical studies are required in a variety of populations in order to test these proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive "levels" would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies. 
23805956	There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence. 
23745631	We examine community collectivization among female sex workers (FSWs) and high-risk men who have sex with men and transgenders (HR-MSM) following several years of HIV prevention programming with these populations, and its association with selected outcome indicators measuring individual behaviors (condom use with different partners and sexually transmitted infection [STI] treatment-seeking from government health facilities). Data for this study were collected from a large-scale cross-sectional survey conducted in 2010-2011 among FSWs (sample size: 3557) and HR-MSM (sample size: 2399) in Andhra Pradesh, India. We measured collectivization among FSWs in terms of three binary (low, high) indices of collective efficacy, collective agency, and collective action. Collectivization among HR-MSM was measured by participation in a public event (no, yes), and a binary (low, high) index of collective efficacy. Adjusted odds ratios (adjusted OR) and their 95% confidence intervals (CI) were computed to assess the relationships between collectivization and outcome indicators directly and through mediation of variables such as self-efficacy for condom use and utilization of government health facilities. Results show that among FSWs, high levels of collective efficacy (adjusted OR: 1.3, 95% CI: 1.1-1.7) and collective action (adjusted OR:1.3, 95% CI: 1.1-1.8) were associated with consistent condom use (CCU) with regular clients. Among HR-MSM, participation in a public event (adjusted OR: 2.7, 95% CI: 2.0-3.6) and collective efficacy (adjusted OR: 1.9, 95% CI: 1.5-2.3) were correlated with condom use with paying partners. The association between collectivization and outcome indicators continued to be significant in most cases even after adjusting for the potential mediators. Indicators of collectivization exhibited significant positive association with self-efficacy for condom use and service utilization from government health facilities among both FSWs and HR-MSM. The association of high levels of collectivization with CCU, STI treatment-seeking from government health facilities, ability to negotiate for condom use, and self-efficacy in utilizing government health facilities is relevant to effort to improve the effectiveness and sustainability of HIV prevention programs in India and beyond.
23744445	Active inference provides a simple and neurobiologically plausible account of how action and perception are coupled in producing (Bayes) optimal behaviour. This can be seen most easily as minimising prediction error: we can either change our predictions to explain sensory input through perception. Alternatively, we can actively change sensory input to fulfil our predictions. In active inference, this action is mediated by classical reflex arcs that minimise proprioceptive prediction error created by descending proprioceptive predictions. However, this creates a conflict between action and perception; in that, self-generated movements require predictions to override the sensory evidence that one is not actually moving. However, ignoring sensory evidence means that externally generated sensations will not be perceived. Conversely, attending to (proprioceptive and somatosensory) sensations enables the detection of externally generated events but precludes generation of actions. This conflict can be resolved by attenuating the precision of sensory evidence during movement or, equivalently, attending away from the consequences of self-made acts. We propose that this Bayes optimal withdrawal of precise sensory evidence during movement is the cause of psychophysical sensory attenuation. Furthermore, it explains the force-matching illusion and reproduces empirical results almost exactly. Finally, if attenuation is removed, the force-matching illusion disappears and false (delusional) inferences about agency emerge. This is important, given the negative correlation between sensory attenuation and delusional beliefs in normal subjects--and the reduction in the magnitude of the illusion in schizophrenia. Active inference therefore links the neuromodulatory optimisation of precision to sensory attenuation and illusory phenomena during the attribution of agency in normal subjects. It also provides a functional account of deficits in syndromes characterised by false inference and impaired movement--like schizophrenia and Parkinsonism--syndromes that implicate abnormal modulatory neurotransmission.
23740266	This study investigated whether gender-role related traits agency and communion contribute to successful health behavior change, in an interplay with domain-specific psychosocial factors, namely, agency, mediated by health-related self-efficacy, and communion, moderated by social support. Data from women (N = 282) participating in the GOAL Lifestyle Implementation Trial were analyzed using structural equation modeling. Agency and increase in self-efficacy both independently predicted waist circumference reduction in the 1-year follow-up. Individuals high in communion succeeded in waist reduction only if they received social support. Initial self-efficacy increase predicted 3-year waist reduction. Gender-role orientation, together with social environment, influences behavior change intervention outcomes. 
23730811	The aim of this study was to obtain a deeper understanding of patient's experiences and perspectives after dental caries treatment with Er:YAG laser technology.Twelve patients aged 15-30 years who had undergone at least one laser caries excavation agreed to participate in an interview study. All the interviews were tape recorded and transcribed by a transcription agency. The transcribed texts were analysed using manifest and latent qualitative content analysis.	The categories in this study were identified as choosing laser, understanding laser, encouraging dental care and my oral health. The motivation for laser treatment was described as dental fear in general, specific fear of needles or discomfort with the drill. The informants described the dentist's role as initiators of treatment and willing or unwilling facilitators. Laser treatment was described as safer and more carefully considered treatment. They felt generally safe with laser and were able to relax during the treatment. All interviewers described a positive impression of the laser, and words like 'up to date' and 'future-oriented' were used to describe laser. Laser treatment was considered less painful.	The results indicate that patients find laser a feasible and convenient treatment option.	
23685619	Two experiments report on the construction of the Sense of Agency Rating Scale (SOARS), a new measure for quantifying alterations to agency. In Experiment 1, 370 participants completed a preliminary version of the scale following hypnosis. Factor analysis revealed two underlying factors: Involuntariness and Effortlessness. In Experiment 2, this two factor structure was confirmed in a sample of 113 low, medium and high hypnotisable participants. The two factors, Involuntariness and Effortlessness, correlated significantly with hypnotisability and pass rates for ideomotor, challenge and cognitive items. Twelve week test-retest correlations showed that Involuntariness was highly stable, but Effortlessness only moderately stable. Analysis of the combined datasets from Experiments 1 and 2 showed both SOARS scores were significantly related to the derived factors of Woody, Barnier, and McConkey's (2005) 4-factor model of hypnotisability. This scale clarifies conceptual confusion around agentive action and provides empirical support for a multifactorial account of sense of agency. 
23656328	The purpose of this qualitative study was to explore the psychosocial changes revealed by persons living with HIV/AIDS (PLWHA) in western Uganda as a result of the introduction of highly active antiretroviral therapy (HAART). Fourteen participants were interviewed on two occasions. Two focus groups discussions were also conducted. Patients experienced important personal benefits as a result of HAART and the resulting clinical improvement. These benefits included a restoration of hope, self-esteem and personal agency. Patients were also relieved of the great fear which they had about the conditions of their death. The financial and social struggles introduced by AIDS illness continued after the introduction of HAART. The conclusion is that the HAART programs should provide more holistic care to patients to address the persistent family issues identified in this study. 
23649657	In this study, we examined metaphors invoked by people recovering from opioid dependence as they described the challenges and successes of using medication-assisted treatment. Metaphors provide linguistic tools for expressing issues that are confusing, complex, hidden, and difficult to state analytically or literally. Using data from eight focus groups with 68 participants representing four ethnic minority groups, we conducted a grounded analysis to show how recovering substance users communicatively constructed addiction and recovery. The primary medication, methadone, was framed as "liquid handcuffs" that allowed those in recovery to quit "hustling," get "straight," and find "money in their pockets." Nonetheless, methadone also served as a "crutch," leaving them still feeling like "users" with "habits" who "came up dirty" to friends and family. In this analysis, we tease out implications of these metaphors, and how they shed light on sensemaking, agency, and related racial- and class-based structural challenges in substance abuse recovery.
23647145	Consumer-oriented recovery has been discussed for more than two decades in the mental health field. Although there some qualitative recovery studies have shown important findings, few quantitative studies of this concept currently exist. This study examined the relationship between recovery and associated social-environmental and individual factors.A total of 159 people with psychiatric disabilities receiving services from a large community mental health agency participated in the study. Participants completed a self-report survey that assessed individual recovery status, social support, perceived recovery-oriented service quality, psychiatric symptoms, and demographics. One hundred twenty-four surveys were analyzed. Hierarchical multiple regression analysis was conducted to examine the relationship between recovery and associated factors.	Social support and perceived recovery-oriented service quality had significant positive relationships with recovery; psychiatric symptoms had a significant negative relationship with recovery. The final regression model accounted for 58% of the variance in recovery, F(9, 114) = 17.72, p < .001.	Social-environmental factors play an important role in people's recovery, even after taking into account psychiatric symptoms. Namely, people with psychiatric disabilities can pursue recovery with symptoms as long as they receive appropriate support and services. Mental health professionals should provide services adhering to recovery principles in order to help their clients achieve personal recovery.	
23619312	At the core of the sense of agency for self-produced action is the sense that I, and not some other agent, am producing and directing those actions. While there is an ever-expanding body of empirical research investigating the sense of agency for bodily action, there has, to date, been little empirical investigation of the sense of agency for thought. The present study uses the novel Mind-to-Mind paradigm, in which the agentive source of a target thought is ambiguous, to measure misattributions of agency. Seventy-two percent of participants made at least one misattribution of agency during a 5-min trial. Misattributions were significantly more frequent when the target thought was an arousing negative thought as compared to a neutral control. The findings establish a novel protocol for measuring the sense of agency for thought, and suggest that both contextual factors and emotional experience play a role in its generation.
23578326	Concerns with social justice have been traditionally associated with a modernist concept of the individual whose actions express an underlying, essential and unified self. This paper compares the usefulness of two methodologies (post-structuralist and narrative) that are based on a rejection of identity of a unified self and compares their usefulness in relation to the development of a social justice paradigm within mental health. It considers how professional forms of knowledge may be deconstructed by post-structural analyses, arguing that these have also been used by service users to articulate more enabling discursive alternatives. The notion of agency is central to our understanding of social justice. We question the commonly held assumption that although post-structuralism deconstructs power and challenges its legitimacy, it is nevertheless unsuited to facilitating the necessary agency to put forward viable alternatives. The second half of the paper considers how narrative research offers greater emancipatory potential by enabling the research subject to author their stories and thereby brings about their own subjective transformation. Nevertheless, the interpretation of people's stories by researchers may result in the imposition of narrative templates that erase complexities and contribute to the perpetuation of oppression. This raises ethical implications in relation to how people's stories are interpreted.
23575956	Sense of agency is the way in which we understand the causal relationships between our actions and sensory events. Agency is implicitly measured using intentional binding paradigms, where voluntary self-made actions and consequential sensory events are perceived as shifted closer together in time. However, a crucial question remains as to how we understand the relationship between others' actions and sensory events. Do we use similar binding processes as for our own actions? Previous attempts to investigate this phenomenon in others' have reached no clear consensus. Therefore, in an attempt to understand how we attribute the causal relationships between others' actions and sensory events, we investigated intentional binding in others' actions using an interval estimation paradigm. In a first experiment participants were required to make a button-press response to indicate the perceived interval between a self-made action and a tone, between a closely matched observed action and tone, and between two tones. For both self-made and observed actions, we found a significant perceived shortening of the interval between the actions and tones as compared with the interval between two tones, thus intentional binding was found for both self-made and observed actions. In a second experiment we validated the findings of the first by contrasting the perceived intervals between an observed action and tone with a matched visual-auditory stimulus and a tone. We again found a significant perceived shortening of the interval for observed action compared with the closely matched visual-auditory control stimulus. The occurrence of intentional binding when observing an action suggests we use similar processes to make causal attributions between our own actions, others' actions, and sensory events. 
23547686	According to the agency model of narcissism (Campbell, Brunell, & Finkel, 2006) narcissists view themselves as high on agentic traits but low on communal traits. To test if this self-view extends to recall, two experiments examined the extent to which narcissism was associated with self-ratings and recall of agentic and communal traits that varied in valence. Across both experiments a trait description task was followed by a surprise recall task for the trait words and then completion of the Narcissistic Personality Inventory (NPI; Raskin & Terry, 1988). Within the self-reference condition narcissism was related to higher selection in the trait description task and to higher recall of positive-agentic (e.g., clever) traits. This general pattern of results occurred for narcissism even while controlling for the related personality variables of self-esteem, agency, and communion. In contrast to narcissism, within the self-referent group self-esteem predicted higher recall for positive-communal traits (e.g., kind) but lower recall for negative-communal traits, a finding consistent with mnemic neglect. Overall, results supported the agency model of narcissism and extended this model to suggest that narcissists rate themselves more highly not only on positive-agentic traits but also on negative-communal traits. 
23531574	The aim of occupational health care management programs (OHMP) is to improve the health status of employees, increase work ability and reduce absence time. This includes better coping abilities, work-related self-efficacy and self-management which are important abilities that should be trained within OHMPs.To study the effectiveness of an OHMP including special interventions to enhance self-efficacy and self-management.	Employees from the German Federal Pension Agency.	Effects of an OHMP on sickness absence was studied by comparing an intervention group and two control groups. A core feature of the OHMP were group sessions with all members of working teams, focussing on self-efficacy and self management of the individual participant as well as the team as a group (focus groups). Participants in the OHMP were asked for their subjective evaluation of the focus groups. Rates of sickness absence were taken from the routine data of the employer.	Participants of the OHMP indicated that they had learned better ways of coping and communication and that they had generated intentions to make changes in their working situation. The rate of sickness absence in the intervention group decreased from 9.26% in the year before the OHMP to 7.93% in the year after the program, while there was in the same time anincrease of 7.9% and 10.7% in the two control groups.	The data suggest that OHMP with focus on self-efficacy and self management of individuals and teams are helpful in reducing work absenteeism.	
23520838	Given the high rates of partner abuse (PA) among sexual minority men with HIV, it is surprising that this phenomenon remains largely understudied in this group. The extant literature reveals little about the lived experiences of the men who experience abuse in their primary relationships. Furthermore, the role of meaning making in recovery from PA remains unclear for any demographic group. Knowledge of such appraisals may provide insight into the ways that sexual minority men with HIV understand or assign value to their abuse experiences. Here, we aim to qualitatively explore the ways in which such men (N = 28) find meaning following their experiences of PA. In general, most men reported a sense of personal strength from having endured and survived PA. Surprisingly, the men did not link their postabuse recovery experiences to their sexual minority identity nor to their HIV status. Some men mentioned an increased sense of agency and attention to their own needs in their postabuse lives. With the exception of positive relationships with providers, the men described little use of peer or family support and ongoing social isolation.
23500112	Previous studies have shown that contextually high-predictability ideas are essential for one to sense the authorship of thoughts and that having the sense that one came up with an idea of one's own, instead of through hearing of another's idea, results in the feeling that one has output the ideas. In this study, we investigated the effects of an idea's predictability on the misattribution of another's thought to oneself. The participants were asked to write down two original ideas about how to use various objects while avoiding the duplication of another's ideas that had been presented beforehand in an input-output phase. In the monitoring phase (1 week and 1 month after the input-output phase), the participants were asked whether each idea had been generated by them, by another, or not generated at all. We found that a high-predictability idea is likely to be regarded with the notion "I generated the idea." This tendency increased with time, suggesting that participants were more likely to have a sense of authorship when high-predictability ideas were presented. We also discovered that they were more likely to conclude that the source of high-predictability ideas was the "Self." We discussed the results from the viewpoint of the participant's sense of agency as well.
23484607	In Denmark, following psychiatric emergency admission, patients with depression, anxiety or personality disorders are discharged as early as possible due to pressure on psychiatric beds. However, the receiving out-patient units frequently have waiting time. The design of a brief, cognitive-based psychiatric aftercare service and the early treatment results are presented.This was a descriptive study of symptom levels before and after the individual therapy part of a new aftercare programme. The initial new intensive aftercare consisted of psychiatric consultations, telephone outreach and individual cognitive behavioural therapy-based therapy twice a week, in total five times. Focus was on collaborative goal setting and next-of-kin participation. Self-ratings (WHO-5 Well-Being Scale (WHO-5); Becks Depression Inventory-II (BDI)) were obtained at the first day and at end of individual therapy.	The self-ratings at discharge showed a high BDI rating in the patient sample (mean = 32.0 (standard deviation (SD) = 11.9; n = 105)), and much lower well-being at discharge than previously seen in a comparable Danish setting (mean WHO-5 at onset = 5.6 (SD = 4.8; n = 102)). Ratings improved by the end of the individual therapy (i.e. WHO-5 = 8.3 (SD = 5.6; n = 102); BDI = 26.1 (SD = 12.3; n = 105)).	Symptom reduction was evident in the first period after discharge, and the patients were satisfied with the contents and format of the service. However, the results are preliminary as we lack data from a comparable patient group receiving no treatment or treatment as usual.	not relevant.	Danish Data Protection Agency, The Capital Region 2007-58-0015.	
23445715	Preterm birth (PTB) places a considerable emotional, psychological, and financial burden on parents, families, health care resources, and society as a whole. Efforts to estimate these costs have typically considered the direct medical costs of the initial hospital and outpatient follow-up care but have not considered non-financial costs associated with PTB such as adverse psychosocial and emotional effects, family disruption, strain on relationships, alterations in self-esteem, and deterioration in physical and mental health. The aim of this inquiry is to understand parents' experience of PTB to inform the design of subsequent studies of the direct and indirect cost of PTB. The study highlights the traumatic nature of having a child born preterm and discusses implications for clinical care and further research.Through interviews and focus groups, this interpretive descriptive study explored parents' experiences of PTB. The interviews were audiotaped, transcribed, and analyzed for themes. Analysis was ongoing throughout the study and in subsequent interviews, parents were asked to reflect and elaborate on the emerging themes as they were identified.	PTB is a traumatic event that shattered parents' taken-for-granted expectations of parenthood. For parents in our study, the trauma they experienced was not related to infant characteristics (e.g., gestational age, birth weight, Apgar scores, or length of stay in the NICU), but rather to prolonged uncertainty, lack of agency, disruptions in meaning systems, and alterations in parental role expectations. Our findings help to explain why things like breast feeding, kangaroo care, and family centered practices are so meaningful to parents in the NICU. As well as helping to (re)construct their role as parents, these activities afford parents a sense of agency, thereby moderating their own helplessness.	These findings underscore the traumatic nature and resultant psychological distress related to PTB. Obstetrical and neonatal healthcare providers need to be educated about the symptoms of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) to better understand and support parents' efforts to adapt and to make appropriate referrals if problems develop. Longitudinal economic studies must consider the psychosocial implications of PTB to in order to determine the total related costs.	
23448413	Family-skills training programs prevent adolescent substance use, but few exist for immigrant Latino families. This study assesses the feasibility of a family-skills training intervention developed using a community-based participatory research framework, and explores parental traditional values as a modifier of preliminary effects.One-group pretest-posttest.	Four Latino youth-serving sites (school, clinic, church, social-service agency).	Immigrant Latino parents of adolescents aged 10 to 14 years (N  =  83).	Eight-session program in Spanish to improve parenting practices and parent-youth interpersonal relations designed with Latino parents and staff from collaborating organizations.	Feasibility was assessed through retention, program appropriateness, and group interaction quality. Preliminary outcomes evaluated were (1) parenting self-efficacy, discipline, harsh parenting, monitoring, conflict, attachment, acceptance, and involvement, and (2) parent perception of adolescent internalizing, externalizing, and substance use behaviors. Covariates included sociodemographics and parental endorsement of traditional values.	Feasibility outcomes were assessed with descriptive statistics. Paired t-tests measured changes in parenting outcomes. Adjusted multiple regression models were conducted for change in each outcome, and t-tests compared mean changes in outcomes between parents with high and low traditional values scores.	Program appropriateness and group interaction scores were positive. Improvement was noted for eight parenting outcomes. Parents perceived that adolescent internalizing behaviors decreased. Parents with lower endorsement of traditional values showed greater pretest-posttest change in attachment, acceptance, and involvement.	This intervention is feasible and may influence parenting contributors to adolescent substance use.	
23428442	This paper explores body ownership and control of an 'extended' humanoid avatar that features a distinct and flexible tail-like appendage protruding from its coccyx. Thirty-two participants took part in a between-groups study to puppeteer the avatar in an immersive CAVE™ -like system. Participants' body movement was tracked, and the avatar's humanoid body synchronously reflected this motion. However, sixteen participants experienced the avatar's tail moving around randomly and asynchronous to their own movement, while the other participants experienced a tail that they could, potentially, control accurately and synchronously through hip movement. Participants in the synchronous condition experienced a higher degree of body ownership and agency, suggesting that visuomotor synchrony enhanced the probability of ownership over the avatar body despite of its extra-human form. Participants experiencing body ownership were also more likely to be more anxious and attempt to avoid virtual threats to the tail and body. The higher task performance of participants in the synchronous condition indicates that people are able to quickly learn how to remap normal degrees of bodily freedom in order to control virtual bodies that differ from the humanoid form. We discuss the implications and applications of extended humanoid avatars as a method for exploring the plasticity of the brain's representation of the body and for gestural human-computer interfaces.
23416540	The sense of agency refers to an experience in which one's own action causes a change in environment. It is strongly modulated by both the contingency between action and its outcome and the consistency between predicted and actual action outcomes. Recent studies have suggested that the action outcome can retrospectively modulate action awareness. We suspect that the sense of agency can also be retrospectively modulated. This study examined whether the quantity of action outcome could influence the sense of agency. The participants' task was to trigger dot motion in a display and rate the extent to which they could control the initiation of dot motion. Independently of both the temporal contiguity between action and its outcome and the consistency between predicted and actual action outcomes, the speed of dot motion as an action's outcome strongly influenced the sense of agency rating. The present study suggests that the sense of agency stems partly from the inference of action efficiency based on the quantitative aspect of action outcome.
23407238	Self-agency--the awareness of one's own capacity to make decisions and to engage in deliberate action - is often interfered with or lost during the course of severe mental illness. Most existing literature on self-agency is either of experimental or qualitative nature, and empirical evidence is scanty.This paper draws on a subset of empirical data from a larger recovery study that involved 204 people with schizophrenia in the community. Structural equation models are built to contrast the models with and without the contribution of self-agency.	The self-agency factor loads significantly on variables from five major areas of recovery (hope, empowerment, resilience, self-responsibility and self-mastery). Structural equation models show that the incorporation of this self-agency construct has vastly improved the modeling of the adverse effect of stigma on the quality of life of these subjects. The model with self-agency fitted the criteria better, and explained more total variance (increased from 56 to 80%) for the quality of life of these subjects.	Cross-sectional empirical findings appear to support the claim that self-agency is an important construct that cuts through many dimensions of recovery. Initial discussions are made on the nature and function of self-agency, and its relations with recovery concepts and components.	
23372562	Recent research on human agency suggests that intentional causation is associated with a subjective compression in the temporal interval between actions and their effects. That is, intentional movements and their causal effects are perceived as closer together in time than equivalent unintentional movements and their causal effects. This so-called intentional binding effect is consistently found for one's own self-generated actions. It has also been suggested that intentional binding occurs when observing intentional movements of others. However, this evidence is undermined by limitations of the paradigm used. In the current study we aimed to overcome these limitations using a more rigorous design in combination with functional Magnetic Resonance Imaging (fMRI) to explore the neural underpinnings of intentional binding of observed movements. In particular, we aimed to identify brain areas sensitive to the interaction between intentionality and causality attributed to the observed action. Our behavioral results confirmed the occurrence of intentional binding for observed movements using this more rigorous paradigm. Our fMRI results highlighted a collection of brain regions whose activity was sensitive to the interaction between intentionality and causation. Intriguingly, these brain regions have previously been implicated in the sense of agency over one's own movements. We discuss the implications of these results for intentional binding specifically, and the sense of agency more generally.
23354664	Volition can be studied from two perspectives. From the third-person view, volitional behaviour is internally generated, rather than being determined by the immediate environmental context, and is therefore, to some extent, unpredictable. Such behaviour is not unique to humans, since it is seen in many other species including invertebrates. From the first-person view, our experience of volitional behaviour includes a vivid sense of agency. We feel that, through our intentions, we can cause things to happen and we can choose between different actions. Our experience of agency is not direct. It depends on sub-personal inferences derived from prior expectations and sensations associated with movement. As a result, our experiences and intuitions about volition can be unreliable and uncertain. Nevertheless, our experience of agency is not a mere epiphenomenon. Anticipation of the regret we might feel after making the wrong choice can alter behaviour. Furthermore, the strong sense of responsibility, associated with agency, has a critical role in creating social cohesion and group benefits. We can only study the experience of agency in humans who can describe their experiences. The discussion of the experience of volition, that introspection and communication make possible, can change our experience of volitional actions. As a result, agency, regret and responsibility are cultural phenomena that are unique to humans. 
23351116	Although there is increasing knowledge about how visual and tactile cues from the hands are integrated, little is known about how self-generated hand movements affect such multisensory integration. Visuo-tactile integration often occurs under highly dynamic conditions requiring sensorimotor updating. Here, we quantified visuo-tactile integration by measuring cross-modal congruency effects (CCEs) in different bimanual hand movement conditions with the use of a robotic platform. We found that classical CCEs also occurred during bimanual self-generated hand movements, and that such movements lowered the magnitude of visuo-tactile CCEs as compared to static conditions. Visuo-tactile integration, body ownership and the sense of agency were decreased by adding a temporal visuo-motor delay between hand movements and visual feedback. These data show that visual stimuli interfere less with the perception of tactile stimuli during movement than during static conditions, especially when decoupled from predictive motor information. The results suggest that current models of visuo-tactile integration need to be extended to account for multisensory integration in dynamic conditions.
23348665	The quality of life of male spouses of partners with breast cancer may determine the support they are able to give their wives. Little is known about the factors associated with their quality of life.The purpose of this study was to examine the relationship of the quality of life of male spouses of partners with breast cancer with the following factors: (a) demographic variables of male spouses and their partners, (b) levels of hope of male spouses and their partners, (c) self-efficacy and loss and grief of male spouses, and (d) quality of life of partners with breast cancer.	Six hundred surveys were mailed to women with breast cancer (stage 1-3) and their male spouses. A total of 110 surveys were completed.	With the use of generalized linear modeling, participating male spouses with higher quality of life scores: (a) were older (P = .01), (b) had higher hope scores (P = .01), (c) had lower feelings of guilt scores (P < .01) (subscale of loss and grief), (d) had higher general self-efficacy scores (P < .01), and (e) had partners with breast cancer with higher quality of life scores (P < .01).	Hope, self-efficacy, feelings of guilt, age, and their partners' quality of life were significantly related to quality of life of the male spouses of women with breast cancer.	The findings underscore the importance of assessing for and fostering hope and self-efficacy as well as decreasing guilt in male spouses of women with breast cancer to improve their quality of life.	
23345545	The International Agency for Research on Cancer and the National Cancer Institute have acknowledged human papillomavirus (HPV)-16 as an independent risk factor for oropharyngeal cancer (OPC). HPV-positive oropharyngeal cancer (HPVOPC) is a sexually transmitted entity that is on the rise; within the next 10 years, the annual number of HPV-associated OPC cases is projected to exceed the annual number of cervical cancer cases in the United States. Recognition of HPV status in OPC has broad implications beyond the traditional oncological concerns of timely diagnosis, accurate staging, and appropriate treatment of cancer patients. The National Comprehensive Cancer Network recommends testing the tumor site for HPV-status during OPC management; it is likely this will become a standard component of care for patients with high-probability tumors of the oropharynx. As the practice of HPV testing becomes more common, it behooves providers to be able to adequately address the concerns of patients with HPVOPC. Although there are currently few relevant studies focusing on this population, existing literature on HPV-infected women and patients with cervical cancer strongly supports the concept that patients with HPVOPC need education to optimally address concerns such as self-blame, guilt, intimacy, and interpersonal relationships. When HPV testing is done, it should be accompanied by evidence-driven and patient-centered counseling to best minimize negative psychosocial outcomes and ensure optimum health promotion. Based on the current state of the literature, this article is intended to be a reference for physicians to effectively manage psychosocial outcomes when diagnosing patients with HPV-associated OPC.
23339587	In Sweden, means-tested social assistance serves as a temporary, last resort safety net. However, increasing numbers of people are receiving it for longer periods and about a third has assistance for more than a year. The aim of this study was to explore the ways social assistance recipients manage long lasting adversity and their roles as active, rather than passive, agents in this process, using a resilience perspective.The study is based on thirteen in-depth interviews with long-term social assistance recipients from diverse areas in Stockholm County. The interviews were guided by narrative inquiry to interpret and construct stories of experiences and are part of a larger qualitative study exploring experiences of living on social assistance in Sweden.	Experiences of cumulative adversity during many years compounded recipients' difficulties in finding ways out of hardship. They had different strategies to deal with adversities, and many had underlying "core problems", including mental health problems, which had not been properly resolved. Recipients' showed resistance in adverse situations. Some made attempts to find ways out of hardship, whereas others struggled mainly to achieve a sense of mastering life. They received important support from individual professionals in different authorities, but mostly the help from the welfare system was fragmented.	Social assistance recipients in this study demonstrated agency in ways of managing long lasting difficulties, sometimes caused by "core problems", which were often accumulated into complex difficulties. Resilience was about keeping going and resisting these difficulties. To find ways out of social assistance required help from different welfare agencies and professionals and was hindered by the fragmentation of services. This study shows that there is a need for more long-term personalised, comprehensive support, including interventions both to increase individual well-being and self-esteem and to open up opportunities for education and employment. Adequate benefit levels and overall quality of welfare services such as health and social care, day care and schools, are of major importance for those in greatest need.	
23335291	Pregnancy among unmarried adolescents has been linked to negative personal control beliefs. In contrast, self-agency beliefs about control over future possibilities have been linked to delay in subsequent childbearing. In this secondary analysis, we examined factors associated with self-agency change in 429 unmarried adolescent mothers from intervention and control groups of a nurse home visitation study. Adolescent mothers who participated in a sustained relationship with a nurse made greater gains in self-agency than did control group mothers (p = .034). Adolescents with lower cognitive ability who were behind their age-appropriate grade level in school made the greatest self-agency gains.
23325298	Despite a paucity of scientific evidence, complementary and alternative medicines have been found to give rise to feelings of control, empowerment, and agency. These healing experiences call for the development of analytical frameworks beyond biomedical ideas of scientific effect. This article is premised on a phenomenological understanding of embodied subjectivity as paving way for more nuanced understanding into experiences of healing. As such, this article contends that ill health transcends the biomedical body. Healing experiences are also entwined with the values and ideals that are normalized in the complementary health sphere. Discourses of health and wellness thus also play a role in the generation of healing experiences. I draw on qualitative research with clients and practitioners involved in complementary and alternative medicines in England. I will first introduce phenomenological ideals of the body, and the methods underlying the data that are drawn on. I will then turn to interviewee perspectives on the interconnectedness of the mind and the body, before outlining client experiences of alternative health practices. I argue that ideals, such as awareness, that are emphasized in the holistic health domain are important for the generation of healing experiences. Healing experiences also, however, emerge through the caring touch of trusted practitioners. This article will finally turn to the intersections between embodied experience and social inscription. 
23322211	Neuromodulation consists in altering brain activity to restore mental and physical functions in individuals with neuropsychiatric disorders and brain and spinal cord injuries. This can be achieved by delivering electrical stimulation that excites or inhibits neural tissue, by using electrical signals in the brain to move computer cursors or robotic arms, or by displaying brain activity to subjects who regulate that activity by their own responses to it. As enabling prostheses, deep-brain stimulation and brain-computer interfaces (BCIs) are forms of extended embodiment that become integrated into the individual's conception of himself as an autonomous agent. In BCIs and neurofeedback, the success or failure of the techniques depends on the interaction between the learner and the trainer. The restoration of agency and autonomy through neuromodulation thus involves neurophysiological, psychological and social factors. 
23298728	The sense of agency (SA) is the perception of willfully causing something to happen. Wegner and Wheatley (1999) proposed three prerequisites for SA: temporal contiguity between an action and its effect, congruence between predicted and observed effects, and exclusivity (absence of competing causal explanations). We investigated how temporal contiguity, congruence, and the order of two human agents' actions influenced SA on a task where participants rated feelings of self-agency for producing a tone. SA decreased when tone onsets were delayed, supporting contiguity as important, but the order of the agents' actions (lead, follow, or simultaneous) also mattered. Relative contiguity was the main determinant of SA, as delayed tones were usually attributed to the most recent action. This was unaffected by contingencies between the two actors' actions (Experiment 2), showing that contiguity has a powerful influence on SA, even during joint action in the presence of other cues.
23297009	Attributions are constantly assigned in everyday life. A well-known phenomenon is the self-serving bias: that is, people's tendency to attribute positive events to internal causes (themselves) and negative events to external causes (other persons/circumstances). Here, we investigated the neural correlates of the cognitive processes implicated in self-serving attributions using social situations that differed in their emotional saliences. We administered an attributional bias task during fMRI scanning in a large sample of healthy subjects (n = 71). Eighty sentences describing positive or negative social situations were presented, and subjects decided via buttonpress whether the situation had been caused by themselves or by the other person involved. Comparing positive with negative sentences revealed activations of the bilateral posterior cingulate cortex (PCC). Self-attribution correlated with activation of the posterior portion of the precuneus. However, self-attributed positive versus negative sentences showed activation of the anterior portion of the precuneus, and self-attributed negative versus positive sentences demonstrated activation of the bilateral insular cortex. All significant activations were reported with a statistical threshold of p ≤ .001, uncorrected. In addition, a comparison of our fMRI task with data from the Internal, Personal and Situational Attributions Questionnaire, Revised German Version, demonstrated convergent validity. Our findings suggest that the precuneus and the PCC are involved in the evaluation of social events with particular regional specificities: The PCC is activated during emotional evaluation, the posterior precuneus during attributional evaluation, and the anterior precuneus during self-serving processes. Furthermore, we assume that insula activation is a correlate of awareness of personal agency in negative situations.
23293983	A total of thirty-two women admitted to a general hospital for medical treatment after self-harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self-harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women. Multinomial logistic regression analyses showed that those with lower scores on Instrumentality and Unmitigated Agency (positive and negative masculinity) and higher scores on Insecurity (negative femininity) had greater odds of self-harming. Relationships were weaker after accounting for generalized self-efficacy. Results are discussed in relation to previous findings and suggestions for prevention are made.
23285293	Sense of agency refers to the feeling that one's voluntary actions caused external events. Past studies have shown that compression of the subjective temporal interval between actions and external events, called intentional binding, is closely linked to the experience of agency. Current theories postulate that the experience of agency is constructed via predictive and postdictive pathways. One remaining problem is the source of human causality bias; people often make misjudgments on the causality of voluntary actions and external events depending on their rewarding or punishing outcomes. Although human causality bias implies that sense of agency can be modified by post-action information, convincing empirical findings for this issue are lacking. Here, we hypothesized that sense of agency would be modified by affective valences of action outcomes. To examine this issue, we investigated how rewarding and punishing outcomes following voluntary action modulate behavioral measures of agency using intentional binding paradigm and classical conditioning procedures. In the acquisition phase, auditory stimuli were paired with positive, neutral or negative monetary outcomes. Tone-reward associations were evaluated using reaction times and preference ratings. In the experimental session, participants performed a variant of intentional binding task, where participants made timing judgments for onsets of actions and sensory outcomes while playing simple slot games. Our results showed that temporal binding was modified by affective valences of action outcomes. Specifically, intentional binding was attenuated when negative outcome occurred, consistent with self-serving bias. Our study not only provides evidence for postdictive modification of agency, but also proposes a possible mechanism of human causality bias.
23273555	This paper problematizes anti-ageing discourse and interpretations that cosmetic surgery is an ageist practice and older people who undergo cosmetic surgery are denying ageing. It argues that conceptions of cosmetic surgery as anti-ageing are premised on an essentialist conception of the 'naturally ageing body'. Interview data and media texts are used to demonstrate how, through the notion of "re" suggested by terms such as rejuvenation, reversal and renewal, anti-ageing discourses inscribe 'ageing' in the practice of cosmetic surgery by older people. The oppressive interpretation that older people who undergo cosmetic surgery are 'denying ageing,' and associated subjection to moral critique, are effects of this discourse. To counter interpretations of cosmetic surgery as 'anti-ageing', the paper takes up the idea that cosmetic surgery is undertaken to look better not younger. To advance this argument, the paper suggests that the forms of rationality associated with cosmetic surgery constitute a contemporary regimen of 'care of the self' which enable ethical agency and creative self-stylisation. Through this framework cosmetic surgery can be re-imagined as a practice for designing 'older' rather than denying ageing.
23241470	Older persons have levels of frailty and disability that place them at far greater risk of harm in disasters than younger adults, making it crucial for all agency planners, public health workers, and health care providers to be aware of age-appropriate considerations of preparedness and response. This research evaluated the knowledge and utilization intentions of participants of a geriatric emergency preparedness and response (GEPR) continuing education program that was designed to provide this training.A qualitative training evaluation was conducted using course evaluation questionnaires from GEPR workshops offered in 2009 in 7 nationwide cities through a partnership of the University of Texas Center for Biosecurity and Public Health Preparedness with the Texas Consortium Geriatric Education Center at Baylor College of Medicine, Houston.	Evaluations were completed by 292 participants. Respondents were able to name specific information learned, give examples of applications of the material, and devise plans for further action. Participants believed that their ability to do their jobs had increased, and they provided insightful suggestions instructive to both trainers and to leaders of health care organizations.	The results of the evaluation suggest that GEPR workshops are effective in increasing the knowledge of participants and their intentions to use it. There is both a need and a demand for this training. Developers and trainers should provide participants with sufficient time for absorbing the information, consider tailoring the training to the local context, and provide opportunity for practical application, particularly planning exercises.	
23234195	The author attempted to elucidate some core psychological features of people with hikikomori (psycho-social withdrawal). He drew special attention to the agency seken, a unique Japanese concept which implicitly determines which social behaviors and conditions are orthodox and desirable from a public and interpersonal point of view. He analyzed the psychological attitude of people with hikikomori towards this agency, presenting several cases in which their psychological characteristics were explicitly manifested. The persons in the presented cases had a fundamental difficulty in being integrated into the public, for example, as an official full-time employee in companies. They also harbored a characteristic psychological attitude toward seken. They developed a delicate insight that seken is not a substantial agency but a pretended consensus. Nevertheless, they also felt an intensive pressure from this agency and were powerless to deal with it. The above-mentioned psychological characteristics do not explain all types of cases with hikikomori. The author also presented a case in which a taijin-kyofu (social anxiety) feature played a dominant role. The patient in this case gradually narrowed the social domain in which he was involved to preserve his narcissistic perfect self and was gradually dragged into the state of hikikomori. Then the author presented the view which contrasts a public aspect of encounter with its singular, private and existential aspect. Although our behavior and encounter in general can be articulated from public points of view, it can be assumed that there is a singular encounter between each individual and "objects" or "others" prior to the articulation. In the author's view, an individual captured in this singular encounter is an existential being. People with hikikomori appear to have difficulties in overcoming the point where this singular and public aspect intersect. He also suggested that one possible trajectory of recovering from the hikikomori state is to cultivate interpersonal tolerance and power in the public domain, maintaining a singular relation with others on the edge of public space. The author also took the opportunity to mention the debate over whether hikikomori is a culture-dependent syndrome or a pathological state whose worldwide manifestation is now beginning to be recognized. In his view, there is a subtle but great difference between the concept "seken" of Japanese origin and the concept "public" of Western origin. This difference may color the fundamental Japanese mentality, foster the incidence rates of hikikomori and determine the characteristics of its clinical manifestation in Japan.
23216396	Models of adult attachment have proven to be useful for understanding illness behavior, stress responses, susceptibility to disease processes, and psychotherapeutic approaches to difficult patients. Two methods of assessing patterns of attachment, using self-report instruments and using techniques such as the Adult Attachment Interview (AAI), are only weakly related and each has drawbacks for clinical use. We have previously assessed commonalities and differences in the descriptions of attachment patterns that emerge from these schools and synthesized them in empirically based attachment prototypes. In this companion article, we describe a prototype-based model of attachment. This model defines dimensions of attachment anxiety and attachment avoidance as composites of particular aspects of internal working models of self and other, behavior in current close relationships, patterns of expression of affect, and narrative coherence. The model emphasizes the clinical importance of the severity of attachment insecurity, defined as a dimension which incorporates problems in the previously listed domains of attachment as well as deficits in mentalizing, self-agency, and resolution of trauma. The model locates the central tendencies of prototypic ("textbook") descriptions of four patterns of attachment (secure, dismissing, preoccupied, and fearful/disorganized) while avoiding definitions of the boundaries between categories of attachment. We compare the prototype-based model to the two most prominent current models of attachment, the 4-category, 2-dimension model derived from self-report methods of assessment and categories of "attachment states of mind" derived from the Adult Attachment Interview. Finally, we discuss limitations of the prototype-based model and areas requiring further research.
23136182	Street-level prostitution is notoriously difficult to escape and rarely do women exit prostitution on their first attempt or without experiencing serious negative consequences to their physical or mental health. Unfortunately, few theories exist that explain the exiting process and those that do exist are difficult to test quantitatively. This article applies the integrative model of behavioral prediction to examine intentions to exit prostitution through attitudes, norms, and self-efficacy beliefs that underlie a woman's intention to exit prostitution. Constructs unique prostitution--agency and societal context--enhance the model. This theory may explain and predict an exit from street-level prostitution.
23110983	Home and garden pesticide use has been linked to cancer and other health outcomes in numerous epidemiological studies. Exposure has generally been self-reported, so the assessment is potentially limited by recall bias and lack of information on specific chemicals.As part of an integrated assessment of residential pesticide exposure, we identified active ingredients and described patterns of storage and use.	During a home interview of 500 residentially stable households enrolled in the Northern California Childhood Leukemia Study during 2001-2006, trained interviewers inventoried residential pesticide products and queried participants about their storage and use. U.S. Environmental Protection Agency registration numbers, recorded from pesticide product labels, and pesticide chemical codes were matched to public databases to obtain information on active ingredients and chemical class. Poisson regression was used to identify independent predictors of pesticide storage. Analyses were restricted to 259 participating control households.	Ninety-five percent (246 of 259) of the control households stored at least one pesticide product (median, 4). Indicators of higher sociodemographic status predicted more products in storage. We identified the most common characteristics: storage areas (garage, 40%; kitchen, 20%), pests treated (ants, 33%; weeds, 20%), pesticide types (insecticides, 46%; herbicides, 24%), chemical classes (pyrethroids, 77%; botanicals, 50%), active ingredients (pyrethrins, 43%) and synergists (piperonyl butoxide, 42%). Products could contain multiple active ingredients.	Our data on specific active ingredients and patterns of storage and use will inform future etiologic analyses of residential pesticide exposures from self-reported data, particularly among households with young children.	
23089161	The sense of agency, which is the awareness that "I am the one who causes action," is important in understanding passive schizophrenic symptoms and bodily self-consciousness. However, this potential linkage between subjective self-other attribution (explicit agency) and automatic self-monitoring of an action (implicit agency) has not been examined fully. The present study included two experiments conducted with the same group of healthy participants (N=48) in order to examine explicit (Exp. 1) and implicit (Exp. 2) measures of the sense of agency in speech. Exp. 1 suggested that participants who tend not to attribute a fed-back voice to themselves (the other-attribution group) might have a stronger tendency toward auditory hallucinations, as measured by the Auditory Hallucination Experience Scale 17 (AHES-17). Furthermore, the results of Exp. 2 suggested that this other-attribution group might not utilize auditory feedback during speech production, indicating the expected link between explicit and implicit agency. These results are discussed in relation to the sense-of-agency model, wherein people are understood to construct the online "self" monitoring of action.
23083395	To examine parental self-efficacy experiences for users of a parenting support programme and consider the pertinence of self-efficacy theory to health visiting (public health nursing) practice.Commonly, successful parenting training programmes are underpinned by social learning principles and aim to strengthen parental self-efficacy. However, research examining programme effectiveness rarely discusses how self-efficacy outcomes are achieved.	A descriptive survey was completed as the first part of a realistic evaluation study examining how a UK parenting support programme worked.	The first part of the realistic evaluation involved validating outcome measures (the Parenting Self-Agency Measure and Self-Efficacy for Parenting Tasks Index subscales) and administering a questionnaire survey. The questionnaire was completed by adults accessing a parenting support programme during a 10-month period (n = 168). Data were analysed using descriptive and inferential statistics.	  Women were the main users of the programme, which included informal drop-in groups as well as more formalised health visiting services and parenting training courses. The Parenting Self-Agency Measure results indicated good general parental self-efficacy; however, the task-specific Self-Efficacy for Parenting Tasks Indexes scales suggested that parents were less self-efficacious in disciplining children. Lower self-efficacy scores correlated with high ratings for 'feeling tired', 'receiving negative comments' and 'giving-in to a child's demands'.	Study results indicate that the domain general and task-specific measures provide different, but helpful, insights into parental self-efficacy experiences. By identifying factors associated with the levels of general and task-specific parental self-efficacy, health visitors can gain a fuller appreciation of support needs.	To maximise potential through parenting support, attention should be given to addressing factors associated with poorer self-efficacy experiences, including parental tiredness. Equally, practice should be directed at developing community environments that offer exposure to positive praise and the opportunity to practice new skills without facing criticism.	
23080533	Previous research regarding Early Intervention in Psychosis (EIP) services has mainly adopted quantitative methodologies, in order to study the effectiveness of EIP services. Research studies that have explored service-users' experiences of EIP services are small in number. This research aimed to explore service-users' experiences of being in contact with an EIP service, its impact of their experience of psychosis and current life situation.Interpretative Phenomenological Analysis (IPA) was used to conduct an in-depth qualitative study of a small sample of EIP service-users, in order to explore their experiences of being in contact with the service.	Flexibly guided interviews were conducted with eight service-users who had been receiving a service from an EIP team for more than 2 years and were recruited using a purposive sampling method. Verbatim interview transcripts were analysed using IPA.	Five super-ordinate themes, developed from the analysis, are discussed in sections: Stigma, Relationships, Understanding the experiences, Sense of agency, and Impact on sense of self. Sub-themes of these super-ordinate themes are also discussed.	The themes developed from the analysis were envisioned as representing an overarching theme of 'A personal journey of recovery', which was influenced by participants' involvement with the EIP service. Clinical implications include the need for EIP services, as with other mental health services, to find ways to promote recovery and create opportunities for agency and control. Future research directions are also discussed.	
23065104	This article posits an updated, broader perspective on the concept of learning disabilities (LDs) than that accepted in the local Israeli literature, revealing how it is immersed in class, ethnicity, and culture. This is shown through historical description, accreditation, and contrasting of the two special education discourses: the "cultural deprivation" discourse and the "LDs" discourse. There are three sections. Part One presents the theoretical, conceptual, and methodological background of the sociological and discursive debate about LDs. The social-constructivist model used in an analysis of the two categories is proposed as an alternative to the clinical-medical model. The definitions of LDs and cultural deprivation accepted in the Israeli discourse are presented in Part Two. The metamorphoses in the discourse about the category of LDs are uncovered through reference to their conceptual and historical antecedents. This part discusses the various understandings and constructions of learning difficulties. Part Three examines the textual representation of parents of children with disabilities in both cases, exploring the meanings of guilt, responsibility, and agency in each discourse. The conclusion clarifies the social and political significance of the distinct textual and rhetorical representations. It becomes evident that the discourse on LDs and the discourse on cultural deprivation are two special education tracks directed at different target audiences: the culturally enriched audience, well-off and educated on the one hand, and the Mizrahi audience of limited means and education on the other hand.
23054668	Advances in the neurosciences have many implications for a collective understanding of what it means to be human, in particular, notions of the self, the concept of volition or agency, questions of individual responsibility, and the phenomenology of consciousness. As the ability to peer directly into the brain is scientifically honed, and conscious states can be correlated with patterns of neural processing, an easy--but premature--leap is to postulate a one-way, brain-based determinism. That leap is problematic, however, and emerging findings in neuroscience can even be seen as compatible with some of the basic tenets of existentialism. Given the compelling authority of modern "science," it is especially important to question how the findings of neuroscience are framed, and how the articulation of research results challenge or change individuals' perceptions of themselves. Context plays an essential role in the emergence of human identity and in the sculpting of the human brain; for example, even a lack of stimuli ("nothing") can lead to substantial consequences for brain, behavior, and experience. Conversely, advances in understanding the brain might contribute to more precise definitions of what it means to be human, including definitions of appropriate social and moral behavior. Put another way, the issue is not simply the ethics involved in framing neurotechnology, but also the incorporation of neuroscientific findings into a richer understanding of human ethical (and existential) functioning.
23049653	Inner speech involvement in self-reflection was examined by reviewing 130 studies assessing brain activation during self-referential processing in key self-domains: agency, self-recognition, emotions, personality traits, autobiographical memory, and miscellaneous (e.g., prospection, judgments). The left inferior frontal gyrus (LIFG) has been shown to be reliably recruited during inner speech production. The percentage of studies reporting LIFG activity for each self-dimension was calculated. Fifty five percent of all studies reviewed indicated LIFG (and presumably inner speech) activity during self-reflection tasks; on average LIFG activation is observed 16% of the time during completion of non-self tasks (e.g., attention, perception). The highest LIFG activation rate was observed during retrieval of autobiographical information. The LIFG was significantly more recruited during conceptual tasks (e.g., prospection, traits) than during perceptual tasks (agency and self-recognition). This constitutes additional evidence supporting the idea of a participation of inner speech in self-related thinking.
23046799	We conducted a study to investigate the prevalence of human papillomavirus (HPV) infections in an opportunistic sample of women in Manitoba, Canada. We inquired about risk factors associated with HPV infections and linked the HPV typing results with the cervical cancer screening history of the participants.The study population included 592 women attending Papanicolaou (Pap) test clinics. After signing a consent form, participants were given a self-administered questionnaire on risk factors and received a conventional Pap test. Residual cells from the Pap tests were collected and sent for HPV typing.	The mean age of the population was 43 years. A total of 115 participants (19.4%) had an HPV infection, 89 of whom had a normal Pap test. Of those who were HPV-positive, 61 (10.3%) had high-risk (Group 1) HPV. HPV-16 was the most prevalent type (15/115: 13.0% of infections). The most consistent risk factors for HPV infection were young age, Aboriginal ethnicity, higher lifetime number of sexual partners and higher number of sexual partners in the previous year.	The prevalence of HPV types in Manitoba is consistent with the distributions reported in other jurisdictions. These data provide baseline information on type-specific HPV prevalence in an unvaccinated population and can be useful in evaluating the effectiveness of the HPV immunization program. An added benefit is in the validation of a proof of concept which links a population-based Pap registry to laboratory test results and a risk behaviour survey to assess early and late outcomes of HPV infection. This methodology could be applied to other jurisdictions across Canada where such capacities exist.	
23043556	This paper describes challenges that men living with HIV experience in negotiating condom use with sexual partners. After testing HIV-positive, the men in this study attended support groups of people living with HIV. Here they were taught to behave 'responsibly' by adopting safer sex measures. However, some men faced strong resistance from women concerning condom use, particularly from women with whom they had been sexually involved prior to testing HIV-positive. This paper explores the reasoning behind the rejection of condoms by women, focusing specifically on the nature of relationships, disclosure of HIV status and gender power dynamics. Analysis of the findings, which are taken from an ethnographic study conducted over 14 months, indicates that efforts to initiate condom use allowed women to challenge men's authority in sexual affairs and assert their own (limited) agency - albeit by demanding unprotected sex. However, women's rejection of condoms occurred in a knowledge vacuum about their own HIV risk because male partners had failed to disclose their HIV status prior to initiating condoms. Interventions need to encourage men to disclose their HIV status before they initiate condom use with their sexual partners. Furthermore men need to encourage their partners to be open about their sexual needs.
23023846	To describe the development, use, and evaluation of a patient self-assessment tool for screening patients at risk for drug therapy problems (DTPs) and potentially interested in receiving a personal consultation with a pharmacist.Quasi-experimental, nonrandomized, controlled study.	Area Agency on Aging-affiliated senior centers in Florida from April 2005 to December 2005.	175 clients of an Area Agency on Aging.	While attending a free seminar on obtaining the best value from their medications, participants completed a 12-item self-assessment tool. The tool was designed to (1) identify participants who were at risk for a DTP and (2) motivate those at risk to participate in a personal pharmacotherapy consultation with a pharmacist on a fee-for-service basis.	Relationship between total score on self-assessment tool and patient acceptance of offer of personal pharmacotherapy consultation.	Of 175 participants who attended a free seminar, 69 (39.4%) accepted the offer of a personal pharmacotherapy consultation. The median score on the self-assessment tool in these participants was significantly higher compared with participants who declined a consultation (3 vs. 1, P = 0.0489). The number of DTPs eventually identified during the personal pharmacotherapy consultation was significantly and positively correlated with the total score on the self-assessment tool (ρ = 0.3259, P = 0.0110).	The self-assessment tool appeared to be of use in predicting individuals who were likely to accept the offer of a personal consultation. Higher scores on the self-assessment tool may also predict patients who are likely to have a higher number of DTPs.	
23017036	It is a universal finding that there is huge heterogeneity in people's responses to all kinds of stress and adversity. Resilience is an interactive phenomenon that is inferred from findings indicating that some individuals have a relatively good outcome despite having experienced serious adversities.Resilience can only be inferred if there has been testing of environmental mediation of risks and quantification of the degree of risk. The use of 'natural experiments' to test environmental mediation is briefly discussed. The literature is then reviewed on features associated with resilience in terms of (a) those that are neutral or risky in the absence of the risk experience (such as adoption); (b) brief exposure to risks and inoculation effects; (c) mental features (such as planning, self-regulation or a sense of personal agency); (d) features that foster those mental features; (e) turning point effects; (f) gene-environment interactions; (g) social relationships and promotive effects; and (h) the biology of resilience.	Clinical implications are considered with respect to (a) conceptual implications; (b) prevention; and (c) treatment.	Resilience findings do not translate into a clear programme of prevention and treatment, but they do provide numerous leads that focus on the dynamic view of what may be involved in overcoming seriously adverse experiences.	
23015689	To assess current and intended future use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and characterise those attending sexual health clinics, the anticipated PrEP delivery setting.Cross-sectional study.	Self-administered survey of 842 HIV negative MSM recruited from social venues in London in 2011.	One in 10 (10.2%, 83/814, 95% CI 8.2% to 12.5%) and one in 50 (2.1%, 17/809, 95% CI 1.2% to 3.3%) reported having ever used post-exposure prophylaxis (PEP) and PrEP respectively. Half reported they would be likely to use PrEP if it became available as a daily pill (50.3%, 386/786, 95% CI 46.7% to 53.9%). MSM were more likely to consider future PrEP use if they were <35 years (adjusted OR (AOR) 1.57, 95% CI 1.16 to 2.14), had unprotected anal intercourse with casual partners (AOR 1.70, 95% CI 1.13 to 2.56), and had previously used PEP (AOR 1.94, 95% CI 1.17 to 3.24). Over half of MSM (54.8% 457/834 95% CI 51.3 to 58.2) attended a sexual health clinic the previous year. Independent factors associated with attendance were age <35 (AOR 2.29, 95% CI 1.68 to 3.13), and ≥ 10 anal sex partners in the last year (AOR 2.49, 95% CI 1.77 to 3.52).	The concept of PrEP for HIV prevention in the form of a daily pill is acceptable to half of sexually active MSM in London. MSM reporting higher risk behaviours attend sexual health clinics suggesting this is a suitable setting for PrEP delivery.	
23007209	Sexually transmitted infections (STIs) are increasing worldwide, mostly due to changing sexual behavior s (larger numbers of sexual partners, concurrent relationships, increasing proportion of adolescents engaging in sexual intercourse at young age, and inconsistent condom use with new partners). In Italy, few data are available about STI spread, since most infections are not subjected to mandatory notification.In this article, the occurrence of STIs in a random sample attending a STI Unit in Florence, Italy, is reported. Results were obtained through the administration of an anonymous questionnaire that patients could complete spontaneously in the waiting room while waiting for the visit. Self-reported questions allowed to collect information about socio-demographic and clinical data, sexual behavior and perception of risk.	Overall, 469 patients (321 males, 148 females) participated in the study. Age ranged from 16 to 70 years. Male patients who referred to engage sexual intercourse with men (MSM) were 133; females who had sex with women (FSF) were 5, while 24 patients declared to have sex with both males and females (bisexual); 59.7% (N.=280) of participants reported they had a stable relationship, but 20% of these reported they had had sex with more than five partners during the last 12 months. The use of condoms is declared to be very infrequent, especially in the two extreme age ranges. Fifty percent of patients had been diagnosed an STI in their life, particularly syphilis (39.3%), genital warts (64.6%) and chlamydial infections (42.9%). Among those subjects who had contracted an STI (including non-curable viral infections, i.e., HIV and herpes genitalis) 32.4% referred they never used condoms.	The authors discuss their results compared to the existing literature, and focus on identification of risk factors associated with self-reported STIs. Although conducted on a small population, this study provides a basis for targeting prevention and control strategies on our high-risk patients.	
22998844	This study examined the relationships between affect consciousness (AC) and symptom distress, interpersonal problems, low self-esteem, and the number of PD traits in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD).Within the setting of a treatment trial, 52 patients with APD or BPD were examined with structured interviews and self-report questionnaires before treatment and at 3-year follow-up. The evaluations included the Affect Consciousness Interview, the SCID-II interview, the Symptom Checklist 90-R, the Circumplex of Interpersonal Problems, and the Index of Self-esteem. A low global level of AC was expected to be associated with the severity of psychopathology; a low AC for interest, joy, and tenderness was expected to be associated with social detachment; and a low AC for anger, contempt, and disgust was expected to be associated with nonassertiveness.	A low AC was associated with interpersonal problems and low self-esteem, but not symptom distress or the number of fulfilled SCID-II criteria. Despite a significant reduction in the psychopathology based on most clinical variables, the associations measured at baseline were maintained after 3years. Examination of specific affect categories showed a pattern of convergent and discriminative relationships with different types of interpersonal problems. A low AC for pleasant affects was specifically related to communion problems, like cold, detached behavior, both at baseline and follow-up. In contrast, a low AC for self-boundary affects was specifically related to agency problems, like non-assertiveness, at follow-up.	Our results showed that a low AC was associated with central domains of psychopathology in patients with PDs. This suggested that AC would be an important focus for treatment and further research in PDs. Future studies are needed to examine how AC is related to various forms of personality pathology.	
22984949	The sense of self-agency is a pervasive experience that people infer from their actions and the outcomes they produce. Recent research suggests that self-agency inferences arise from an explicit goal-directed process as well as an implicit outcome-priming process. Three experiments examined potential differences between these 2 processes. Participants had the goal to produce an outcome or were primed with the outcome. Next, they performed an action in an agency-ambiguous situation, followed by an outcome that matched or mismatched the goal or prime, and indicated experienced self-agency over the action-outcome. Results showed that goals reduce self-agency over mismatching outcomes. However, outcome-primes did not affect self-agency over mismatching outcomes but even enhanced self-agency over mismatching proximate outcomes. Goals and outcome-primes equally enhanced self-agency for matches. Our findings provide novel evidence that self-agency experiences result from 2 distinct inferential routes and that goals and primes differentially affect the perception of our own behavior.
22981318	In normal observers, gazing at one's own face in the mirror for a few minutes, at a low illumination level, triggers the perception of strange faces, a new visual illusion that has been named 'strange-face in the mirror'. Individuals see huge distortions of their own faces, but they often see monstrous beings, archetypal faces, faces of relatives and deceased, and animals. In the experiment described here, strange-face illusions were perceived when two individuals, in a dimly lit room, gazed at each other in the face. Inter-subjective gazing compared to mirror-gazing produced a higher number of different strange-faces. Inter-subjective strange-face illusions were always dissociative of the subject's self and supported moderate feeling of their reality, indicating a temporary lost of self-agency. Unconscious synchronization of event-related responses to illusions was found between members in some pairs. Synchrony of illusions may indicate that unconscious response-coordination is caused by the illusion-conjunction of crossed dissociative strange-faces, which are perceived as projections into each other's visual face of reciprocal embodied representations within the pair. Inter-subjective strange-face illusions may be explained by the subject's embodied representations (somaesthetic, kinaesthetic and motor facial pattern) and the other's visual face binding. Unconscious facial mimicry may promote inter-subjective illusion-conjunction, then unconscious joint-action and response-coordination.
22968329	Health approaches to ecology have a strong basis in Aldo Leopold's thinking, and contemporary ecohealth in turn has a strong philosophical basis in Leopold. To commemorate the 125th anniversary of Leopold's birth (1887-1948), we revisit his ideas, specifically the notions of stewardship (land ethic), productive use of ecosystems (land), and ecosystem renewal. We focus on Leopold's perspective on the self-renewal capacity of the land, as understood in terms of integrity and land health, from the contemporary perspective of resilience theory and ecological theory more generally. Using a broad range of literature, we explore insights and implications of Leopold's work for today's human-environment relationships (integrated social-ecological systems), concerns for biodiversity, the development of agency with respect to stewardship, and key challenges of his time and of ours. Leopold's seminal concept of land health can be seen as a triangulation of productive use, self-renewal, and stewardship, and it can be reinterpreted through the resilience lens as the health of social-ecological systems. In contemporary language, this involves the maintenance of biodiversity and ecosystem services, and the ability to exercise agency both for conservation and for environmental justice.
22966453	Evidence is reviewed for the existence of a core system for moment-to-moment social communication that is based on the perception of dynamic gestures and other social perceptual processes in the temporal-parietal occipital junction (TPJ), including the posterior superior temporal sulcus (PSTS) and surrounding regions. Overactivation of these regions may produce the schizophrenic syndrome. The TPJ plays a key role in the perception and production of dynamic social, emotional, and attentional gestures for the self and others. These include dynamic gestures of the body, face, and eyes as well as audiovisual speech and prosody. Many negative symptoms are characterized by deficits in responding within these domains. Several properties of this system have been discovered through single neuron recording, brain stimulation, neuroimaging, and the study of neurological impairment. These properties map onto the schizophrenic syndrome. The representation of dynamic gestures is multimodal (auditory, visual, and tactile), matching the predominant hallucinatory categories in schizophrenia. Inherent in the perceptual signal of gesture representation is a computation of intention, agency, and anticipation or expectancy (for the self and others). The neurons are also tuned or biased to rapidly detect threat-related emotions. I review preliminary evidence that overactivation of this system can result in schizophrenia.
22965945	Despite commonsense appeal, the link between self-interest and happiness remains elusive. One reason why individuals may not feel satisfied with self-interest is that they feel uneasy about sacrificing the needs of others for their own gain. We propose that externally imposing self-interest allows individuals to enjoy self-benefiting outcomes that are untainted by self-reproach for failing to help others. Study 1 demonstrated that an imposed self-interested option (a reward) leads to greater happiness than does choosing between a self-interested option and a prosocial option (a charity donation). Study 2 demonstrated that this effect is not driven by choice in general; rather, it is the specific trade-off between benefiting the self and benefiting others that inhibits happiness gained from self-interest. We theorize that the agency inherent in choice reduces the hedonic value of self-interest. Results of Study 3 find support for this mechanism.
22927899	It has been proposed that self-awareness (SA), a multifaceted phenomenon central to human consciousness, depends critically on specific brain regions, namely the insular cortex, the anterior cingulate cortex (ACC), and the medial prefrontal cortex (mPFC). Such a proposal predicts that damage to these regions should disrupt or even abolish SA. We tested this prediction in a rare neurological patient with extensive bilateral brain damage encompassing the insula, ACC, mPFC, and the medial temporal lobes. In spite of severe amnesia, which partially affected his "autobiographical self", the patient's SA remained fundamentally intact. His Core SA, including basic self-recognition and sense of self-agency, was preserved. His Extended SA and Introspective SA were also largely intact, as he has a stable self-concept and intact higher-order metacognitive abilities. The results suggest that the insular cortex, ACC and mPFC are not required for most aspects of SA. Our findings are compatible with the hypothesis that SA is likely to emerge from more distributed interactions among brain networks including those in the brainstem, thalamus, and posteromedial cortices.
22915979	Patient-related outcomes measures could provide important information for the current state of the art in medical care and even have an impact on macrodecisions in the health care system. Patient-related outcomes were initially defined as subjective health indicators that allow disability and illness to be assessed, based on patient, caregiver, or physician self-reports. As illness involves psychological and behavioral complex processes of care, a multidisciplinary approach in measuring patient-reported outcomes should be recommended, such as quality of life questionnaires. Patient-related outcomes measures should correspond to specific clinical situations and bring opportunities to improve quality of care. Objective measurements enable quantitative data to be collected and analyzed. Depending on the aim of the research, investigators can use existing methods or develop new tools. This publication presents a methodology for developing patient-related outcomes measures, based on a multistage procedure. The proper definition of specific study objectives and the methodology of instrument development are crucial for successfully transferring the study concept. The model of instrument development is the process of starting from the preliminary phase and includes questionnaire design and scaling, pilot testing (cognitive debriefing), revision of the preliminary version, evaluation of the new tool, and implementation. Validation of the new instrument includes reliability, reproducibility, internal consistency, and responsiveness. The process of designing the new tool should involve a panel of experts, including clinicians, psychologists (preliminary phase), and statisticians (scale development and scoring), and patients (cognitive debriefing). Implementation of a new tool should be followed by evaluation study - assessment of the tool's usefulness in clinical practice. An instrument must show not only the expected methodological properties and performance but also a positive contribution to care. The necessity of implementation of direct patient-reporting methods has been highlighted by both the Food and Drug Administration and the European Medicines Agency.
22897521	One of the central tensions within the literature on body studies concerns the degree to which the physical body is constituted by or through language, knowledges, and practices and the degree to which the body has foundational, purely material, or essential attributes. Three theoretical approaches have been at the heart of this debate: social constructionism, phenomenology, and structuration theory. Recently, body studies theorists have challenged scholars to move beyond the widely recognised limitations of dominant theorising by taking into account all three perspectives and conceptualising the body as surface, vehicle, and circuit. Because they embrace agnosticism and relational materialism, science and technology studies scholars are in a distinctive position to answer this call. Proponents fully acknowledge the materiality of the body without espousing essentialist claims by effacing the analytic division between agency and structure. Starting from this perspective, I use the concept of corporeal transgression and the phenomenon of phantom limb to reveal how 'immaterial'--indeed, at times, fictive and fanciful--body parts became socially and materially substantive, engendering transformations within the bodies, minds, and brains of amputees, as well as within the field of neuroscience.
22889074	An agency-communion model of narcissism distinguishes between agentic narcissists (individuals satisfying self-motives of grandiosity, esteem, entitlement, and power in agentic domains) and communal narcissists (individuals satisfying the same self-motives in communal domains). Five studies supported the model. In Study 1, participants listed their grandiose self-thoughts. Two distinct types emerged: agentic ("I am the most intelligent person") and communal ("I am the most helpful person"). In Study 2, we relied on the listed communal grandiose self-thoughts to construct the Communal Narcissism Inventory. It was psychometrically sound, stable over time, and largely independent of the Narcissistic Personality Inventory-the standard measure of agentic narcissism. In Studies 3 and 4, agentic and communal narcissists shared the same self-motives, while crucially differing in their means for need satisfaction: Agentic narcissists capitalized on agentic means, communal narcissists on communal means. Study 5 revisited the puzzle of low self-other agreement regarding communal traits and behaviors. Attesting to the broader significance of our model, this low self-other agreement was partly due to communal narcissists: They saw themselves as high, but were seen by others as low, in communion.
22884752	Researchers and medical practitioners have argued that routine substance use histories are performed less frequently and less thoroughly than they should be. Previous research has identified a range of structural, attitudinal, and socio-cultural barriers that help to explain this pattern. Using conversation analytic (CA) methods, this paper complements previous work by exploring a potential interactional barrier to thorough substance use history taking in the USA. In response to routine substance use queries (e.g. "Do you drink alcohol?"), patients often do more than just providing information. They also convey normative stances toward their conduct, essentially making a case for how it should be understood by the physician. One stance that patients may take is that their conduct is normal and healthy. This paper describes three interactional practices that patients used to enact such a stance: 1) employing marked lexical, intonational, or interactional features when indicating no use of a substance; 2) volunteering normalizing details about the type, quantity, frequency, or circumstances of substance use; 3) providing minimizing characterizations of substance use. The paper explores some reasons why physicians treated these as appropriate and sufficient responses and did not seek additional details even when the information provided was quite superficial. Two social functions of patients' "normal/healthy" stances are discussed: 1) redirecting the physician's history taking to other topics and 2) presenting oneself as a health-conscious patient. "Normal/healthy" stances can represent an expression of patient agency, but can also present a dilemma for physicians, who must balance a concern for thoroughness with a concern for rapport. Recommendations for navigating this dilemma are discussed.
22880726	This study employed a social-cognitive theoretical perspective to assess the interactions of behavioral, cognitive, and situational factors to understand better how young male sex workers (MSWs) entered the sex trade industry. As part of a larger project examining male escorts working for a single agency, MSWs (n = 38) were interviewed about their work and personal lives. Interviews were transcribed and analyzed thematically. As predicted by a social-cognitive perspective, results supported reciprocal influences of behavior and environment, environment and cognition, and behavior and cognition. MSWs developed more self-efficacy around sex work behaviors and more positive outcome expectations with experience; moral conflict and lack of attraction to clients limited MSWs' self-efficacy. Key variables for sex work appeared to be cognitive in nature-mostly represented by a decreased commitment to normative social/sexual values, the specific nature of which may have varied by sexual orientation. Findings support the contention that social-cognitive theory can effectively model entry of young men into sex work. Social-cognitive theory provides a broad umbrella underneath which various explanations for male sex work can be gathered.
22873618	Numerous haematological diseases occur due to dysfunctions during homeostasis processes of blood cell production. Haematopoietic stem cell transplantation (HSCT) is a therapeutic option for the treatment of haematological malignancy and congenital immunodeficiency. Today, HSCT is widely applied as an alternative method to bone marrow transplantation; however, HSCT can be a risky procedure because of potential side effects and complications after transplantations. Although an optimal regimen to achieve successful HSCT while maintaining quality of life is to be developed, even theoretical considerations such as the evaluations of successful engraftments and proposals of clinical management strategies have not been fully discussed yet.   In this paper, we construct and investigate mathematical models that describe the kinetics of hematopoietic stem cell self-renewal and granulopoiesis under the influence of growth factors. Moreover, we derive theoretical conditions for successful HSCT, primarily on the basis of the idea that the basic reproduction number R (0) represents a threshold condition for a population to successfully grow in a given steady-state environment. Successful engraftment of transplanted haematopoietic stem cells (HSCs) is subsequently ensured by employing a concept of dynamical systems theory known as 'persistence'. On the basis of the implications from the modelling study, we discuss how the conditions derived for a successful HSCT are used to link to experimental studies.
22867502	While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes.
22846109	Attribution of agency involves the ability to distinguish our own actions and their sensory consequences which are self-generated from those generated by external agents. There are several pathological cases in which motor awareness is dramatically impaired. On the other hand, awareness-enhancement practices like tai-chi and yoga are shown to improve perceptual-motor awareness. Meditation is known to have positive impacts on perception, attention and consciousness itself, but it is still unclear how meditation changes sensorimotor integration processes and awareness of action. The aim of this study was to investigate how visuomotor performance and self-agency is modulated by mindfulness meditation. This was done by studying meditators' performance during a conflicting reaching task, where the congruency between actions and their consequences is gradually altered. This task was presented to novices in meditation before and after an intensive 8 weeks mindfulness meditation training (MBSR). The data of this sample was compared to a group of long-term meditators and a group of healthy non-meditators.Mindfulness resulted in a significant improvement in motor control during perceptual-motor conflict in both groups. Novices in mindfulness demonstrated a strongly increased sensitivity to detect external perturbation after the MBSR intervention. Both mindfulness groups demonstrated a speed/accuracy trade-off in comparison to their respective controls. This resulted in slower and more accurate movements.	Our results suggest that mindfulness meditation practice is associated with slower body movements which in turn may lead to an increase in monitoring of body states and optimized re-adjustment of movement trajectory, and consequently to better motor performance. This extended conscious monitoring of perceptual and motor cues may explain how, while dealing with perceptual-motor conflict, improvement in motor control goes beyond the mere increase of movement time. The reduction of detection threshold in the MBSR group is also likely due to the enhanced monitoring of these processes. Our findings confirmed our assumptions about the positive effect of mindfulness on perceptual-motor integration processes.	
22835808	In normal observers gazing at one's own face in the mirror for some minutes, at a low illumination level, triggers the perception of strange faces, a new perceptual illusion that has been named 'strange-face in the mirror'. Subjects see distortions of their own faces, but often they see monsters, archetypical faces, faces of dead relatives, and of animals.We designed this study to primarily compare strange-face apparitions in response to mirror gazing in patients with schizophrenia and healthy controls. The study included 16 patients with schizophrenia and 21 healthy controls. In this paper we administered a 7 minute mirror gazing test (MGT). Before the mirror gazing session, all subjects underwent assessment with the Cardiff Anomalous Perception Scale (CAPS). When the 7minute MGT ended, the experimenter assessed patients and controls with a specifically designed questionnaire and interviewed them, asking them to describe strange-face perceptions.	Apparitions of strange-faces in the mirror were significantly more intense in schizophrenic patients than in controls. All the following variables were higher in patients than in healthy controls: frequency (p<.005) and cumulative duration of apparitions (p<.009), number and types of strange-faces (p<.002), self-evaluation scores on Likert-type scales of apparition strength (p<.03) and of reality of apparitions (p<.001). In schizophrenic patients, these Likert-type scales showed correlations (p<.05) with CAPS total scores.	These results suggest that the increase of strange-face apparitions in schizophrenia can be produced by ego dysfunction, by body dysmorphic disorder and by misattribution of self-agency. MGT may help in completing the standard assessment of patients with schizophrenia, independently of hallucinatory psychopathology.	
22812669	Who has high self-esteem? Is it ambitious, competitive, outgoing people-agentic personalities? Or is it caring, honest, understanding people-communal personalities? The literature on agency-communion and self-esteem is sparse, indirect, and inconsistent. Based on William James's theorizing, we propose the "self-centrality breeds self-enhancement" principle. Accordingly, agency will be linked to self-esteem, if agency is self-central. Conversely, communion will be linked to self-esteem, if communion is self-central. But what determines the self-centrality of agency and communion? The literature suggests that agency is self-central in agentic cultures, as well as among nonreligious individuals, men, and younger adults. Communion is self-central in communal cultures, as well as among religious individuals, women, and older adults.This study examined 187,957 people (47% female; mean age = 37.49 years, SD = 12.22) from 11 cultures. The large sample size afforded us the opportunity to test simultaneously the effect of all four moderators in a single two-level model (participants nested in cultures).	Results supported the unique moderating effect of culture, religiosity, age, and sex on the relation between agency-communion and self-esteem.	Agentic and communal people can both have high self-esteem, depending on self-centrality of agency and communion.	
22812540	The experience of spatial presence (SP), i.e., the sense of being present in a virtual environment, emerges if an individual perceives himself as 1) if he were actually located (self-location) and 2) able to act in the virtual environment (possible actions). In this study, two main media factors (perspective and agency) were investigated while participants played a commercially available video game.The differences in SP experience and associated brain activation were compared between the conditions of game play in first person perspective (1PP) and third person perspective (3PP) as well as between agency, i.e., active navigation of the video game character (active), and non-agency, i.e., mere passive observation (passive). SP was assessed using standard questionnaires, and brain activation was measured using electroencephalography (EEG) and sLORETA source localisation (standard low-resolution brain electromagnetic tomography).	Higher SP ratings were obtained in the 1PP compared with the 3PP condition and in the active compared with the passive condition. On a neural level, we observed in the 1PP compared with the 3PP condition significantly less alpha band power in the parietal, the occipital and the limbic cortex. In the active compared with the passive condition, we uncovered significantly more theta band power in frontal brain regions.	We propose that manipulating the factors perspective and agency influences SP formation by either directly or indirectly modulating the ego-centric visual processing in a fronto-parietal network. The neuroscientific results are discussed in terms of the theoretical concepts of SP.	
22799584	In this article, the authors develop and test a differential effects model of university entry versus major selection using a set of common predictors, including background factors (gender and socioeconomic status), academic achievement, and academic self-concept. The research used data from 2 large longitudinal databases from Germany (N = 5,048) and England (N = 15,995) to explore the generalizability of the hypothesized model in 2 cultural contexts. For both countries, the results suggested that (a) socioeconomic status was a key predictor of university entry, whereas gender was a key predictor of major selection; (b) achievement and self-concept in both math and English were positive predictors of university entry; and (c) math achievement and self-concept predicted math-intensive major choice and lower likelihood of entering verbal-intensive majors (and vice versa). Implications for theory and practice are discussed.
22795864	The influence of movement skill on action representations and identification of agency was investigated. Point-light displays were created of highly skilled gestures of thirteen orchestral conductors in visual, auditory, and audiovisual versions and compared to two control conditions (static images and gait cycles of the same participants). In subsequent experimental sessions, participants indicated whether displays presented them or other conductors, whether the soundtrack contained their or others' musical interpretations, and rated the quality and emotional content of the gestures. Self-recognition was more accurate in conditions presenting highly skilled conducting movements as compared to other displays. Participants judged the quality of their own movements to be better than those of others, independently of whether or not they recognized movement agency. Emotional content was perceived accurately across conditions both for own and others' actions. These results point to the influence of dynamical characteristics of motor skill, rather than merely type of movement or emotional content, on action representations and self-other identification.
22781399	Power differentials are a ubiquitous feature of social interactions and power has been conceptualised as an interpersonal construct. Here we show that priming power changes the sense of agency, indexed by intentional binding. Specifically, participants wrote about episodes in which they had power over others, or in which others had power over them. After priming, participants completed an interval estimation task in which they judged the interval between a voluntary action and a visual effect. After low-power priming, participants judged intervals to be significantly longer than judgments after high-power or no priming. Thus, intentional binding was significantly changed by low-power, suggesting that power reduces the sense of agency for action outcomes. Our results demonstrate a clear intrapersonal effect of power. We suggest that intentional binding could be employed to assess agency in individuals suffering from anxiety and depression, both of which are characterised by reduced feelings of personal control.
22765020	The hospitals' outpatient clinics for people with multiple sclerosis (PwMS) are important in the health care. Research regarding physiotherapy in such clinics is limited. The purpose was to investigate how PwMS perceive movement during single sessions of physiotherapy in a hospital's outpatient clinic, and what do these experiences mean for the patient's insight into their movement disturbances? Qualitative research interviews were performed with a purposive sample of 12 PwMS and supplemented with seven videotaped sessions. Content analysis was performed. The results indicate that contextualized perceptions of movement appear to be an essential source for PwMS to gain expanded insight with regard to their individual movement disturbances regardless of their ambulatory status. The contextualization implies that perceptions of movement are integrated with the physiotherapist's explanations regarding optimizing gait and balance or other activities of daily life. Perceptions of improvement in body part movement and/or functional activities are vital to enhancing their understanding of their individual movement disorders, and they may provide expanded insight regarding future possibilities and limitations involving everyday tasks. The implementation of movements, which transforms the perceived improvement into self-assisted exercises, appeared to be meaningful. Contextualized perceptions of improvements in movement may strengthen the person's sense of ownership and sense of agency and thus promote autonomy and self-encouragement. The findings underpin the importance of contextualized perceptions of movement based on exploration of potential for change, as an integrated part of information and communication in the health care for PwMS. Further investigations are necessary to deepen our knowledge.
22737114	A framework is described for understanding the schizophrenic syndrome at the brain systems level. It is hypothesized that over-activation of dynamic gesture and social perceptual processes in the temporal-parietal occipital junction (TPJ), posterior superior temporal sulcus (PSTS) and surrounding regions produce the syndrome (including positive and negative symptoms, their prevalence, prodromal signs, and cognitive deficits). Hippocampal system hyper-activity and atrophy have been consistently found in schizophrenia. Hippocampal activity is highly correlated with activity in the TPJ and may be a source of over-excitation of the TPJ and surrounding regions. Strong evidence for this comes from in-vivo recordings in humans during psychotic episodes. Many positive symptoms of schizophrenia can be reframed as the erroneous sense of a presence or other who is observing, acting, speaking, or controlling; these qualia are similar to those evoked during abnormal activation of the TPJ. The TPJ and PSTS play a key role in the perception (and production) of dynamic social, emotional, and attentional gestures for the self and others (e.g., body/face/eye gestures, audiovisual speech and prosody, and social attentional gestures such as eye gaze). The single cell representation of dynamic gestures is multimodal (auditory, visual, tactile), matching the predominant hallucinatory categories in schizophrenia. Inherent in the single cell perceptual signal of dynamic gesture representations is a computation of intention, agency, and anticipation or expectancy (for the self and others). Stimulation of the TPJ resulting in activation of the self representation has been shown to result a feeling of a presence or multiple presences (due to heautoscopy) and also bizarre tactile experiences. Neurons in the TPJ are also tuned, or biased to detect threat related emotions. Abnormal over-activation in this system could produce the conscious hallucination of a voice (audiovisual speech), a person or a touch. Over-activation could interfere with attentional/emotional gesture perception and production (negative symptoms). It could produce the unconscious feeling of being watched, followed, or of a social situation unfolding along with accompanying abnormal perception of intent and agency (delusions). Abnormal activity in the TPJ would also be predicted to create several cognitive disturbances that are characteristic of schizophrenia, including abnormalities in attention, predictive social processing, working memory, and a bias to erroneously perceive threat.
22729358	Treating narcissistic personality disorder (NPD) successfully is possible but requires a thorough understanding of the pathology and appropriate clinical procedures. Perfectionism is one prominent feature often associated with narcissistic difficulties. Metacognitive Interpersonal Therapy (MIT) for NPD adopts manualized step-by-step procedures aimed at progressively dismantling narcissistic processes by first stimulating an autobiographical mode of thinking and then improving access to inner states and awareness of dysfunctional patterns. Finally, adaptive patterns of thinking, feeling, and acting are promoted, together with a sense of autonomy and agency and a reduction of perfectionistic regulatory strategies. Throughout, there needs to be constant attention to regulation of the therapy relationship to avoid ruptures and maximize cooperation. We describe here a successful case of MIT applied to a man in his early 20's with narcissism, perfectionism, and significant co-occurrence of Axis I and Axis II disorders.
22713168	Anecdotal evidence points to variations in individual students' evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study.A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students' accounts and reflections on what affected the evolution of their confidence during the internship.	At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students' levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and maturing as a student clinician.	This study provides insight into the factors perceived by students as affecting the development of professional confidence during internships. One particularly promising area for educational intervention may be the promotion of a pro-active approach to professional learning.	
22681593	Brain implants, such as Deep Brain Stimulation (DBS), which are designed to improve motor, mood and behavioural pathology, present unique challenges to our understanding of identity, agency and free will. This is because these devices can have visible effects on persons' physical and psychological properties yet are essentially undetectable when operating correctly. They can supplement and compensate for one's inherent abilities and faculties when they are compromised by neuropsychiatric disorders. Further, unlike talk therapy or pharmacological treatments, patients need not 'do' anything for the treatment to take effect. If one accepts, as we argue here, that brain implants are unique among implantable types of devices, then this can have significant implications for what it means to persist as the same person and be the source of one's thoughts and actions. By examining two of the most common indications for DBS in current use, namely in the motor (Parkinson's Disease) and psychiatric (Major Depression) domains, we further argue that although DBS, as it is currently applied, does not necessarily represent a unique threat to personal identity and agency per se, it introduces an unprecedented 'third party' into the debate on these concepts. In this way, DBS can be used as a tool to begin probing, both conceptually and empirically, some of philosophy's most perennial metaphysical questions. 
22666398	Goal-directed human behavior is enabled by hierarchically-organized neural systems that process executive commands associated with higher brain areas in response to sensory and motor signals from lower brain areas. Psychiatric diseases and psychotic conditions are postulated to involve disturbances in these hierarchical network interactions, but the mechanism for how aberrant disease signals are generated in networks, and a systems-level framework linking disease signals to specific psychiatric symptoms remains undetermined. In this study, we show that neural networks containing schizophrenia-like deficits can spontaneously generate uncompensated error signals with properties that explain psychiatric disease symptoms, including fictive perception, altered sense of self, and unpredictable behavior. To distinguish dysfunction at the behavioral versus network level, we monitored the interactive behavior of a humanoid robot driven by the network. Mild perturbations in network connectivity resulted in the spontaneous appearance of uncompensated prediction errors and altered interactions within the network without external changes in behavior, correlating to the fictive sensations and agency experienced by episodic disease patients. In contrast, more severe deficits resulted in unstable network dynamics resulting in overt changes in behavior similar to those observed in chronic disease patients. These findings demonstrate that prediction error disequilibrium may represent an intrinsic property of schizophrenic brain networks reporting the severity and variability of disease symptoms. Moreover, these results support a systems-level model for psychiatric disease that features the spontaneous generation of maladaptive signals in hierarchical neural networks.
22642548	Identity fusion is a relatively unexplored form of alignment with groups that entails a visceral feeling of oneness with the group. This feeling is associated with unusually porous, highly permeable borders between the personal and social self. These porous borders encourage people to channel their personal agency into group behavior, raising the possibility that the personal and social self will combine synergistically to motivate pro-group behavior. Furthermore, the strong personal as well as social identities possessed by highly fused persons cause them to recognize other group members not merely as members of the group but also as unique individuals, prompting the development of strong relational as well as collective ties within the group. In local fusion, people develop relational ties to members of relatively small groups (e.g., families or work teams) with whom they have personal relationships. In extended fusion, people project relational ties onto relatively large collectives composed of many individuals with whom they may have no personal relationships. The research literature indicates that measures of fusion are exceptionally strong predictors of extreme pro-group behavior. Moreover, fusion effects are amplified by augmenting individual agency, either directly (by increasing physiological arousal) or indirectly (by activating personal or social identities). The effects of fusion on pro-group actions are mediated by perceptions of arousal and invulnerability. Possible causes of identity fusion--ranging from relatively distal, evolutionary, and cultural influences to more proximal, contextual influences--are discussed. Finally, implications and future directions are considered.

22616370	The Canadian psychologist Albert Bandura (1925) author of the concept of self-efficacy is still not much known of nurses. This article offers an outline of his biography and his work. Theories of Albert Bandura provide a positive, dynamic relationship with the agentivity human control over events that affect their existence. The concept of vicarious learning, self-efficacy and agency can enrich nursing research.
22610831	The impact and meanings of homophobic violence on gay men's identities are explored with a particular focus on their identities as men and as gay men. Homosexuality can pose a challenge to conventional masculinities, and for some gay men, being victimized on account of sexual orientation reawakens conflicts about their masculinity that they thought they had resolved. Being victimized can reinvoke shame that is rooted in failure or unwillingness to uphold masculine norms. For some gay men, victimization therefore has connotations of nonmasculinity that make being a victim an undesirable status, yet that status must be claimed to obtain a response from criminal justice or victim services. Men who experience homophobic abuse are helped by accepting a victim identity, but only if they can quickly move on from it by reconstructing a masculine gay (nonvictim) identity. This process can be facilitated by agencies such as the police and victim services, provided they help men exercise agency in "fighting back," that is, resisting further victimization and recovering.
22593890	Despite the apparent unitary, global character of bodily self-consciousness, experimental manipulations have mainly focused on subglobal aspects, such as the sense of ownership and agency for one’s hand and its movements (Botvinick and Cohen 1998; Ehrsson et al. 2004; Jeannerod 2006, 2007; Knoblich 2002; Pavani et al. 2000; Tsakiris and Haggard 2005; Tsakiris et al. 2007). These latter studies on body-part representation are important (and will be discussed below in detail), yet we have argued (e.g., see Blanke and Metzinger 2009) that they fail to account for a key feature of bodily self-consciousness: its global character. This is because a fundamental aspect of bodily self-consciousness is its association with a single, whole body, not with multiple body parts (Blanke and Metzinger 2009; Carruthers 2008; Lenggenhager et al. 2007; Metzinger et al. 2007). A number of recent studies (Aspell et al. 2009; Ehrsson 2007; Lenggenhager et al. 2007, 2009; Mizumoto and Ishikawa 2005; Petkova and Ehrsson 2008) have demonstrated that more global aspects of body perception can also be experimentally manipulated using multisensory conflicts. These experimental studies on healthy subjects were inspired by an unusual and revealing set of neurological phenomena—autoscopic phenomena—in which the sense of the body as a whole is disrupted in different ways, and which are likely to be caused by an underlying abnormality in the multisensory integration of global bodily inputs (Blanke and Mohr 2005). In this chapter, we first examine how the scientific understanding of bodily self-consciousness and its multisensory mechanisms can be informed by the study of autoscopic phenomena. We then present a review of investigations of multisensory processing relating to body-part perception (“rubber hand” illusion studies: Botvinick and Cohen 1998; Ehrsson et al. 2004; Tsakiris and Haggard 2005) and go on to discuss more recent “full body” illusion studies that were inspired by autoscopic phenomena and have shown that it is also possible to dissociate certain components of bodily self-consciousness—namely, self-location, self-identification, and the first-person perspective—in healthy subjects by inducing multisensory conflicts.
22582043	Brain correlates of the sense of agency have recently received increased attention. However, the explorations remain largely restricted to the study of brains in isolation. The prototypical paradigm used so far consists of manipulating visual perception of own action while asking the subject to draw a distinction between self- versus externally caused action. However, the recent definition of agency as a multifactorial phenomenon combining bottom-up and top-down processes suggests the exploration of more complex situations. Notably there is a need of accounting for the dynamics of agency in a two-body context where we often experience the double faceted question of who is at the origin of what in an ongoing interaction. In a dyadic context of role switching indeed, each partner can feel body ownership, share a sense of agency and altogether alternate an ascription of the primacy of action to self and to other. To explore the brain correlates of these different aspects of agency, we recorded with dual EEG and video set-ups 22 subjects interacting via spontaneous versus induced imitation (II) of hand movements. The differences between the two conditions lie in the fact that the roles are either externally attributed (induced condition) or result from a negotiation between subjects (spontaneous condition). Results demonstrate dissociations between self- and other-ascription of action primacy in delta, alpha and beta frequency bands during the condition of II. By contrast a similar increase in the low gamma frequency band (38-47 Hz) was observed over the centro-parietal regions for the two roles in spontaneous imitation (SI). Taken together, the results highlight the different brain correlates of agency at play during live interactions.
22571383	Previous studies of source monitoring and auditory hallucinations (AH) have often conflated spatial source (internal-external) with source agency (self-other). Other studies have used suboptimal manipulations of auditory space (e.g., imagine saying vs. saying aloud). We avoided these problems by presenting experimenter-generated stimuli over headphones in the voice of another person so that the location of the voice sounded either internal or external to the participant's head.Participants (N=121) studied 96 words and indicated for each whether it was presented internally or externally (online spatial source monitoring). At test, studied words were presented visually, intermixed randomly with 96 unstudied words. Participants indicated whether each item was old or new (item memory) and whether it was presented internally or externally during study (spatial source memory). Independent measures of memory accuracy and response bias were derived for online source monitoring, item memory and source memory using signal detection theory. Performance on these measures was compared between two groups of 30 participants who scored low or high on a measure of AH proneness.	ANOVAs revealed no differences between the high- and low-AH groups in online spatial source monitoring, item memory, or spatial source memory.	We found no evidence that proneness to AH in a sample of healthy volunteers was related to any of the measures of spatial source monitoring performance. We recommend that the methods introduced be applied to future investigations of spatial source monitoring with patient groups and with individuals at-risk for psychosis.	
22529796	Gaze represents a major non-verbal communication channel in social interactions. In this respect, when facing another person, one's gaze should not be examined as a purely perceptive process but also as an action-perception online performance. However, little is known about processes involved in the real-time self-regulation of social gaze. The present study investigates the impact of a gaze-contingent viewing window on fixation patterns and the awareness of being the agent moving the window. In face-to-face scenarios played by a virtual human character, the task for the 18 adult participants was to interpret an equivocal sentence which could be disambiguated by examining the emotional expressions of the character speaking. The virtual character was embedded in naturalistic backgrounds to enhance realism. Eye-tracking data showed that the viewing window induced changes in gaze behavior, notably longer visual fixations. Notwithstanding, only half of the participants ascribed the window displacements to their eye movements. These participants also spent more time looking at the eyes and mouth regions of the virtual human character. The outcomes of the study highlight the dissociation between non-volitional gaze adaptation and the self-ascription of agency. Such dissociation provides support for a two-step account of the sense of agency composed of pre-noetic monitoring mechanisms and reflexive processes, linked by bottom-up and top-down processes. We comment upon these results, which illustrate the relevance of our method for studying online social cognition, in particular concerning autism spectrum disorders (ASD) where the poor pragmatic understanding of oral speech is considered linked to visual peculiarities that impede facial exploration.
22510529	"Sense of agency" refers to the feeling of controlling an external event through one's own action. On one influential view, sense of agency is inferred after an action, by "retrospectively" comparing actual effects of actions against their intended effects. In contrast, a "prospective" component of agency, generated during action selection, and in advance of knowing the actual effect, has received less attention. Here, we used functional magnetic resonance imaging to investigate prospective contributions of action selection processes to sense of agency. To do so, we dissociated action selection processes from action-outcome matching, by subliminally priming responses to a target. We found that participants experienced greater control over action effects when the action was compatibly versus incompatibly primed. Thus, compatible primes facilitated action selection processing, in turn boosting sense of agency over a subsequent effect. This prospective contribution of action selection processes to sense of agency was accounted for by exchange of signals across a prefrontal-parietal network. Specifically, we found that the angular gyrus (AG) monitors signals relating to action selection in dorsolateral prefrontal cortex, to prospectively inform subjective judgments of control over action outcomes. Online monitoring of these signals by AG might provide the subject with a subjective marker of volition, prior to action itself.
22503338	This exploratory qualitative study investigates the experiences of eight adults conceived following anonymous sperm donation who had discovered the identity both of their donor and of donor half-siblings and had established contact with each other. It focuses primarily on participants' reflections on genetic and social kinship relationships. Data were collected from this group as well as from the son of the donor and the donor-conceived half-sister of one participant by means of semistructured interviews utilizing asynchronous email and digitalized voice recording. Participants discussed their experience of genetic disconnection resulting from learning of their donor-conceived status and of revising their personal biographies and developing new kinship networks as a result of discovering the identity of their donor and the existence of donor half-siblings. The study highlights participants' agency expressed through their ability to draw on both genetic and non-genetic elements of their inheritance to redefine their self-identity and extend their familial/kinship networks in meaningful ways.
22493478	To assess the association between female sex workers' (FSWs) degree of community collectivisation and self-efficacy, utilisation of sexually transmitted infection (STI) services from government-run health centres in Andhra Pradesh, India.Cross-sectional analyses of 1986 FSWs recruited using a probability-based sampling from five districts of Andhra Pradesh during 2010-2011. Multiple logistic regression models were constructed to assess associations. The independent variables included-collective efficacy, collective agency and collective action-measured using a series of items that assessed the grouping of the community on issues that concern most sex workers. An additional independent variable included FSWs belonging to an area where there was a project partnership with government health centres to provide STI treatment services to FSWs. The outcome indicators included self-efficacy for service utilisation from government health facilities and the treatment for STIs from government health facilities at least once in the past year experience of STI symptoms.	Of the 1986 FSWs, nearly two-fifths (39.5%) reported a high level of overall collectivisation (collective efficacy: 89%, collective agency: 50.7%; collective action: 12.7%). Sex workers with a high degree compared with low degree of overall collectivisation were significantly more likely to report high self-efficacy to use government health facilities (75.0% vs 57.3%, adjusted OR 2.5, 95% CI 2.0 to 3.1) and to use government health centres for STI treatment in past 1 year (78.1% vs 63.2%, adjusted OR 2.1, 95% CI 1.6 to 2.8), irrespective of project partnership with government centres.	The current research findings reinforce the need for stronger community mobilisation for better utilisation of government health facilities for STI and HIV prevention interventions.	
22452562	Neuroscientists and philosophers, among others, have long questioned the contribution of bodily experience to the constitution of self-consciousness. Contemporary research answers this question by focusing on the notions of sense of agency and/or sense of ownership. Recently, however, it has been proposed that the bodily self might also be rooted in bodily motor experience, that is, in the experience of oneself as instantiating a bodily structure that enables a specific range of actions. In the current fMRI study, we tested this hypothesis by making participants undergo a hand laterality judgment task, which is known to be solved by simulating a motor rotation of one's own hand. The stimulus to be judged was either the participant's own hand or the hand of a stranger. We used this task to investigate whether mental rotation of pictures depicting one's own hands leads to a different activation of the sensorimotor areas as compared with the mental rotation of pictures depicting another's hand. We revealed a neural network for the general representation of the bodily self encompassing the SMA and pre-SMA, the anterior insula, and the occipital cortex, bilaterally. Crucially, the representation of one's own dominant hand turned out to be primarily confined to the left premotor cortex. Our data seem to support the existence of a sense of bodily self encased within the sensorimotor system. We propose that such a sensorimotor representation of the bodily self might help us to differentiate our own body from that of others.
22435056	During voluntary hand movement, we sense that we generate the movement and that the hand is a part of our body. These feelings of control over bodily actions, or the sense of agency, and the ownership of body parts are two fundamental aspects of the way we consciously experience our bodies. However, little is known about how these processes are functionally linked. Here, we introduce a version of the rubber hand illusion in which participants control the movements of the index finger of a model hand, which is in full view, by moving their own right index finger. We demonstrated that voluntary finger movements elicit a robust illusion of owning the rubber hand and that the senses of ownership and agency over the model hand can be dissociated. We systematically varied the relative timing of the finger movements (synchronous versus asynchronous), the mode of movement (active versus passive), and the position of the model hand (anatomically congruent versus incongruent positions). Importantly, asynchrony eliminated both ownership and agency, passive movements abolished the sense of agency but left ownership intact, and incongruent positioning of the model hand diminished ownership but did not eliminate agency. These findings provide evidence for a double dissociation of ownership and agency, suggesting that they represent distinct cognitive processes. Interestingly, we also noted that the sense of agency was stronger when the hand was perceived to be a part of the body, and only in this condition did we observe a significant correlation between the subjects' ratings of agency and ownership. We discuss this in the context of possible differences between agency over owned body parts and agency over actions that involve interactions with external objects. In summary, the results obtained in this study using a simple moving rubber hand illusion paradigm extend previous findings on the experience of ownership and agency and shed new light on their relationship.
22401645	This paper reports on a systematic review of qualitative research about vaginal practices in sub-Saharan Africa, which used meta-ethnographic methods to understand their origins, their meanings for the women who use them, and how they have evolved in time and place. We included published documents which were based on qualitative methods of data collection and analysis and contained information on vaginal practices. After screening, 16 texts were included which dated from 1951 to 2008. We found that practices evolve and adapt to present circumstances and that they remain an important source of power for women to negotiate challenges that they face. Recent evidence suggests that some practices may increase a woman's susceptibility to HIV and other sexually transmitted infections. The success of new female-controlled prevention technologies, such as microbicides, might be determined by whether they can and will be used by women in the course of their daily life.
22385814	Our 2007-2009 ethnography describes and analyses the practice of harm reduction in a heroin users' group in the midwestern United States. While dominant addiction interventions conceptualize the addict as powerless - either through moral or physical weakness - this group contested such "commonsense," treating illicit drug use as one of many ways that modern individuals attempt to "fill the void." Insisting on the destigmatization of addiction and the normalization of illicit drug use, the group helped its members work on incremental steps toward self-management. Although "Connection Points" had very limited resources to improve the lives of its members, our work suggests that the users' group did much to restore self-respect, rational subjectivity, and autonomy to a group historically represented as incapable of reason and self-control. As the users cohered as a community, they developed a critique of the oppressions suffered by "junkies," discussed their rights and entitlements, and even planned the occasional political action. Engaging with literature on the cultural construction of agency and responsibility, we consider, but ultimately complicate, the conceptualization of needle exchange as a "neoliberal" form of population management. Within the context of the United States' War on Drugs, the group's work on destigmatization, health education, and the practice of incremental control showed the potential for reassertions of social citizenship within highly marginal spaces.
22374553	Self-disturbances in schizophrenia have been explained and studied from the standpoint of an abnormal sense of agency. We devised an agency-attribution task that evaluated explicit experiences of the temporal causal relations between an intentional action and an external event, without any confounding from sense of ownership of body movement. In each trial, a square piece appeared on the bottom of a computer screen and moved upward. Subjects were instructed to press a key when they heard a beep. When the key was pressed, the piece jumped with various temporal biases. Subjects were instructed to make an agency judgment for each trial. We demonstrated that an excessive sense of agency was observed in patients with schizophrenia compared with normal controls. Moreover, patient groups had a greater tendency to feel a sense of agency even when external events were programmed to precede their action. Therefore, patients felt both forward and backward exaggerated causal efficacy in the temporal event sequence during the intentional action. Confusion in the experience of temporal causal relations between the self and the external world may underlie self-disturbances in schizophrenia.
25642017	This article confronts a persistent challenge in research on children's geographies and politics: the difficulty of recognizing forms of political agency and practice that by definition fall outside of existing political theory. Children are effectively "always already" positioned outside most of the structures and ideals of modernist democratic theory, such as the public sphere and abstracted notions of communicative action or "rational" speech. Recent emphases on embodied tactics of everyday life have offered important ways to recognize children's political agency and practice. However, we argue here that a focus on spatial practices and critical knowledge alone cannot capture the full range of children's politics, and show how representational and dialogic practices remain a critical element of their politics in everyday life. Drawing on de Certeau's notion of spatial stories, and Bakhtin's concept of dialogic relations, we argue that children's representations and dialogues comprise a significant space of their political agency and formation, in which they can make and negotiate social meanings, subjectivities, and relationships. We develop these arguments with evidence from an after-school activity programme we conducted with 10-13 year olds in Seattle, Washington, in which participants explored, mapped, wrote and spoke about the spaces and experiences of their everyday lives. Within these practices, children negotiate autonomy and self-determination, and forward ideas, representations, and expressions of agreement or disagreement that are critical to their formation as political actors.
22349924	Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to a disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. In this study, we investigated the presence of basic self-disturbance in an "ultra high risk" (UHR) for psychosis sample compared with a healthy control sample and whether it predicted transition to psychotic disorder.Forty-nine UHR patients and 52 matched healthy control participants were recruited to the study. Participants were assessed for basic self-disturbance using the Examination of Anomalous Self-Experience (EASE) instrument. UHR participants were followed for a mean of 569 days.	Levels of self-disturbance were significantly higher in the UHR sample compared with the healthy control sample (P < .001). Cox regression indicated that total EASE score significantly predicted time to transition (P < .05) when other significant predictors were controlled for. Exploratory analyses indicated that basic self-disturbance scores were higher in schizophrenia spectrum cases, irrespective of transition to psychosis, than nonschizophrenia spectrum cases.	The results indicate that identifying basic self-disturbance in the UHR population may provide a means of further "closing in" on individuals truly at high risk of psychotic disorder, particularly of schizophrenia spectrum disorders. This may be of practical value by reducing inclusion of "false positive" cases in UHR samples and of theoretical value by shedding light on core phenotypic features of schizophrenia spectrum pathology.	
22340899	The 'Age Well Feel Good' programme is a cohort study of older people in Wales. There is a gap in knowledge on how older people in Wales perceive health and social care services. Research is necessary to help address this gap and to provide an evidence base that informs  policy making and service delivery.A representative sample of 15 000 men and women aged 50 years and over, living in Cardiff, the Welsh capital, were invited to participate in a web-based study of successful ageing. A wide range of data were collected in the study. These  included psychological and cognitive assessments, self-reported health, financial status and deprivation measures.	Based on over 500 responses, information on health and social care service perceptions was analysed. Overall, the perception of service availability was rated  as good, yet there was widespread dissatisfaction. Furthermore, only 14% of older people were aware of a major health and social care programme in Wales, the National Service Framework for Older People.	The main observation is the difference between service availability  and satisfaction that views are sought. In the main, health service availability is good, yet there is widespread dissatisfaction. This raises some questions about the services provided. The evidence provided in this article is a further contribution to the policy-making process. Further work  is needed.	
22305109	Patients with obsessive-compulsive disorder (OCD) often lack the experience of action completion and have altered feelings of agency. This might depend on the integrity of predictions of action outcomes generated by forward models of the motor system. Such motor predictions are critical for inhibitory gating of actions and their consequences. Therefore, it was hypothesized that OCD patients show compromised forward model mechanisms.To test whether inhibitory gating based on motor predictions is altered in OCD, we used electroencephalography to measure suppression of the N1 component of the event-related potential during active generation and passive observation of visual feedback in 18 OCD patients and 18 healthy control subjects. Predictability of action feedback was manipulated on the basis of action and external cues, and simultaneous agency judgments were assessed.	OCD patients showed significantly reduced N1 suppression to actively generated feedback as compared with passively observed feedback. Moreover, in OCD patients, the N1 was not modulated by additional predictive motor cues as observed in control subjects. Patients also reported enhanced estimations of agency experience, which correlated with the strength of incompleteness feelings.	OCD patients fail to predict and suppress the sensory consequences of their own actions. The increased mismatch between expected and actual outcomes caused by this forward model dysfunction may explain persistent feelings of incompleteness even after properly executed actions and the augmented search for control in these patients.	
22224747	The purpose of this research is to (a) identify which of recent history's influential figures did and which did not personify moral excellence, and (b) to examine the motives that drove these individuals along such divergent paths. In Study 1, 102 social scientists evaluated the moral qualities of influential figures from Time Magazine's lists. In Study 2, we selected the 15 top ranking of these figures to comprise a moral exemplar group and the bottom 15 to comprise a comparison group of similarly influential people. We measured the motivational aspects of their personality (agency and communion) by content-analyzing extant speeches and interviews. Moral exemplars exhibited the hierarchical integration of agency and communion by treating agentic motives as a means to an end of communal motives. Comparison subjects, by contrast, personified unmitigated agency by treating motives of agency as both a means to an end and an end unto itself. These results imply that both the strength and structure of a person's motives account for moral behavior.
22212711	This study examines the neurocognitive mechanisms underlying the sense of agency, that is, the experience of causing and controlling events in our environment. Specifically, we tested the hypothesis that the sense of agency depends on an optimal integration of different anticipatory signals, generated by motor and nonmotor systems. An established marker of pre-reflective agency experience is the suppression of cortical responses to actively generated feedback as compared to passively observed feedback, which was measured here by event-related potentials (ERPs). Sensory expectations based on motor-related and unrelated signals were induced by varying the probabilistic contingency between action and feedback, and by priming the feedback prior to the action. Moreover, simultaneous conscious agency judgments were assessed. A reduction of visual N1 response was found to self- as compared to externally generated feedback. In addition, the N1 was modulated by accurate anticipations based on prime stimuli, independent of the precision of motor predictions. Conscious agency judgments, in contrast, were enhanced by prime stimuli only in situations where no precise motor predictions of the action feedback were available. These results indicate that anticipatory signals arising from motor and nonmotor systems are integrated differently depending on the level of agency processing. Our findings suggest that, at a pre-reflective level, the brain's agency system relies on both embodied signals and nonmotor sensory expectations. At higher cognitive levels, motor and nonmotor cues are weighted differently depending on their relative reliability in a given context, thereby providing a basis for robust agentive self-awareness.
22211748	The study investigates welfare recipients' perceptions of personal self-esteem in relationship with their participation in a welfare-to-wellness-to-work program.The cross-sectional, mixed-methods design examined a convenience sample of 33 participants who attended a welfare-to-wellness-to-work program called Work Wellness: The Basics that is based in an agency called Wellness Works!.	A demographic survey, Rosenberg's Self-Esteem scale, and qualitative interviews were used.	Even with normal self-esteem scores, the participants credited the program with decreasing negative thoughts and improving self-esteem. The themes identified include program, self-esteem, mental health, and domestic violence.	Information about the benefits of a holistic wellness program and its relationship with self-reported enhanced self-esteem can be used to assist with health promotion, policy, and the development of innovative programs that assist with transition from public assistance.	
23763232	A great deal of research in health care has examined a wide range of variables to better understand the degree to which patients follow the advice of medical professionals in managing their health, known as adherence. This paper explains the development of the linguistic systems to describe and evaluate two psychosocial constructs (i.e. control orientation and agency) that have been found to be related to adherence in previous research for subjects with diabetes (Trento et al. 2007; Wangberg 2007; O'Hea et al. 2009). The present data came from 43 semi-structured in-depth interviews of subjects with Type 2 diabetes. One-on-one interviews with open-ended questions elicited subjects' 'stories' about living with diabetes, and the transcribed interviews were analyzed to develop the linguistic systems of control orientation and agency. The resultant systems were applied to the 43 interviews by raters with high inter-rater reliability. The results showed demarcations of clearly identified codings of patient types. The paper presents the linguistic coding systems developed in the study, the results of their application to the patient interview data, and recommendations for improved communication with patients.
22200138	A range of implantable brain-interfacing devices (IBIDs) is currently in use and development for the treatment of movement disorders and disorders of mood, behaviour and thought. These include cochlear implants, deep brain stimulation (DBS), prosthetic limbs, and optogenetic interventions (the combined use of genetics and optics to control individual cells). While implantable non-brain devices, such as implantable cardioverter defibrillators, began receiving US Food and Drug Administration approval in 1980, the development of IBIDs is recent, with the approval of DBS for Parkinson's disease in 1997. The expansion in use of IBIDs from neurological to psychiatric conditions is even more recent, with current trials underway for a range of disorders including depression, OCD, addiction, Alzheimer's disease and Tourette's syndrome. Emerging applications of existing IBIDs and new devices in development differ from currently approved devices and applications in two potentially crucial ways: 1) They target conditions traditionally seen as psychiatric; and/or 2) They target and modify functions or traits tied closely to agency, personal identity and personhood. As such, understanding patients' and caregivers' conceptions of personal identity in the context of disease and treatment is important not only for the informed consent process, but also for questions of public policy.
22194878	Sense of agency refers to the feeling that "I" am responsible for those external events that are directly produced by one's own voluntary actions. Recent theories distinguish between a non-conceptual "feeling" of agency linked to changes in the processing of self-generated sensory events, and a higher-order judgement of agency, which attributes sensory events to the self. In the current study we explore the neural correlates of the judgement of agency by means of electrophysiology. We measured event-related potentials to tones that were either perceived or not perceived as triggered by participants' voluntary actions and related these potentials to later judgements of agency over the tones. Replicating earlier findings on predictive sensory attenuation, we found that the N1 component was attenuated for congruent tones that corresponded to the learned action-effect mapping as opposed to incongruent tones that did not correspond to the previously acquired associations between actions and tones. The P3a component, but not the N1, directly reflected the judgement of agency: deflections in this component were greater for tones judged as self-generated than for tones judged as externally produced. The fact that the outcome of the later agency judgement was predictable based on the P3a component demonstrates that agency judgements incorporate early information processing components and are not purely reconstructive, post-hoc evaluations generated at time of judgement.
22176265	Agency is the meta-concept associated with self-advancement in social hierarchies; communion is the partner concept associated with maintenance of positive relationships. Despite the wealth of data documenting the conceptual utility of agency and communion (A & C) as superordinate metaconcepts, no direct measures of global A & C value dimensions are currently available. The first part of this article presents structural analyses of data from 4 diverse data sets (3 archival and 1 new): Each included a broad inventory of values or life goals. All 4 data sets revealed higher order A & C dimensions that were either apparent or implicit. The second part details the development of the ACV, a 24-item questionnaire measuring global A and C values, and documents its psychometric properties. Four studies support their joint construct validity by positioning the value measures within a nomological network of interpersonal traits, self-favorability biases, ideology dimensions, gender, socio-sexuality, and religious attitudes. Potential applications of the new instrument are discussed.
22166129	The authors collaborated in refining a psychoeducational group on mentalizing--attending to mental states in self and others--that has been conducted for several years in the Professionals in Crisis program at The Menninger Clinic. The group is intended to promote active engagement with the treatment program as a whole. Toward this end, the group leaders also advocate patient initiative and responsibility, albeit from contrasting perspectives. Coming from the tradition of a similar institution, the Austen Riggs Center, the senior author imported the concept of "authority" to complement the junior author's emphasis on "agency" at The Menninger Clinic. The group leaders then converged on "authorship" as a means of highlighting narrative construction as central to mentalizing in this psychotherapeutically oriented inpatient treatment program. This article chronicles this continuing evolution of the psychoeducational group and presents the experiential exercises the authors have developed to enhance patients' mentalizing in the treatment program. The article concludes with a discussion of the wider applicability of this intervention.
22146673	The authors examined whether agentic and communal traits are associated with relationship and health outcomes among adolescents with and without diabetes. They interviewed 263 teens (average age 12; 132 Type 1 diabetes; 131 healthy) on an annual basis for 5 years. The authors measured agency, communion, unmitigated agency, and unmitigated communion as well as parent and peer relationship quality, psychological distress, and diabetes health. In concurrent and lagged multilevel models, unmitigated communion and unmitigated agency were associated with poor relationship outcomes and greater psychological distress for those with and without diabetes. In lagged analyses, unmitigated communion predicted deterioration in diabetes health. Communion and agency were associated with positive relationship and health outcomes, with the former being stronger than the latter. These results underscore the need to focus on unmitigated agency and unmitigated communion when studying the implications of personality for health during adolescence.
22145722	Through a poststructural lens, we examine how power may show itself in relationships between supervisees and supervisors, producing both helpful and harmful effects. Drawing from our own experiences, as well as conversations with other members of our supervisory group, we demonstrate how privileged discourses around professional status, gender, and race may bring about difficulties including a sense of doubt, worry, inadequacy, and a fear of speaking up. We also illustrate how these difficulties can be addressed in a manner that may lessen their influence, while increasing supervisees' sense of agency.
22145642	For adolescents with a diagnosis of lifelong chronic illness, mastery of self-management skills is a critical component of the transition to adult care. This study aims to examine self-reported medication adherence and self-care skills among adolescents with chronic rheumatic disease.Cross-sectional survey of 52 adolescent patients in the Pediatric Rheumatology Clinic at UCSF. Outcome measures were self-reported medication adherence, medication regimen knowledge and independence in health care tasks. Predictors of self-management included age, disease perception, self-care agency, demographics and self-reported health status. Bivariate associations were assessed using the Student's t-test, Wilcoxon rank sum test and Fisher exact test as appropriate. Independence in self-management tasks were compared between subjects age 13-16 and 17-20 using the chi-squared test.	Subjects were age 13-20 years (mean 15.9); 79% were female. Diagnoses included juvenile idiopathic arthritis (44%), lupus (35%), and other rheumatic conditions (21%). Mean disease duration was 5.3 years (SD 4.0). Fifty four percent reported perfect adherence to medications, 40% reported 1-2 missed doses per week, and 6% reported missing 3 or more doses. The most common reason for missing medications was forgetfulness. Among health care tasks, there was an age-related increase in ability to fill prescriptions, schedule appointments, arrange transportation, ask questions of doctors, manage insurance, and recognize symptoms of illness. Ability to take medications as directed, keep a calendar of appointments, and maintain a personal medical file did not improve with age.	This study suggests that adolescents with chronic rheumatic disease may need additional support to achieve independence in self-management.	
22143509	The world of Mad Men is one in which life lived on the surface and repression dominates the scene. A superficial reading seems to suggest that the classically gendered subject-object split characterizes Mad Men: women in the series appear devoid of desire, while men possess power, sexuality and agency. But despite its blatant sexism, Mad Men's rendering has turned traditional 1960s American culture on its head. There is no subject-object split in Mad Men because men do not have access to the subject position; they, as much as women, remain objects to themselves and their partners. In the absence of mutual recognition, serotics ultimately fails.
22115726	The conscious awareness of voluntary action is associated with systematic changes in time perception: The interval between actions and outcomes is experienced as compressed in time. Although this temporal binding is thought to result from voluntary movement and provides a window to the sense of agency, recent studies challenge this idea by demonstrating binding in involuntary movement. We offer a potential account for these findings by proposing that binding between involuntary actions and effects can occur when self-causation is implied. Participants made temporal judgements concerning a key press and a tone, while they learned to consider themselves as the cause of the effect or not. Results showed that implied self-causation (vs. no implied self-causation) increased temporal binding. Since intrinsic motor cues of movement were absent, these results suggest that sensory evidence about the key press caused binding in retrospect and in line with the participant's sense of being an agent.
22105086	In keeping with recent views of consciousness of self as represented in the body in action, empirical studies are reviewed that demonstrate a bottlenose dolphin's (Tursiops truncatus) conscious awareness of its own body and body parts, implying a representational "body image" system. Additional work reviewed demonstrates an advanced capability of dolphins for motor imitation of self-produced behaviors and of behaviors of others, including imitation of human actions, supporting hypotheses that dolphins have a sense of agency and ownership of their actions and may implicitly attribute those levels of self-awareness to others. Possibly, a mirror-neuron system, or its functional equivalent to that described in monkeys and humans, may mediate both self-awareness and awareness of others.
22103722	Railway controllers play a pivotal role in service recovery of normal rail system operations when incidents and accidents occur. Those in this position must have sufficient competence to overcome task difficulties caused by accident uncertainties. This study adopts Taiwan's railway system as a case study to diagnose railway-controller-perceived competence when facing diverse tasks during incidents and accidents that are derived from a proposed conceptual model. Railway-controller-perceived competence is measured using the Rasch model. Analytical results indicate that working with an external rescue agency handling a rescue operation, explanations to the public, and communication with an external rescue agency are considered the most troublesome tasks. Additionally, railway-controller-perceived competence differs based on the work experience. This information will prove useful for rail system operators and government regulators when designing and regulating railway controller competence management systems. STATEMENT OF RELEVANCE: This study presents a systematic approach for examining the gap between railway-controller-perceived competence and task difficulties associated with incidents and accidents. The relevance of findings encompasses the effects of transportation ergonomics and railway issues on the problem-solving competence and decision-making skills of railway controllers, and the competence management system.
22070375	Negotiable fate refers to the idea that one can negotiate with fate for control, and that people can exercise personal agency within the limits that fate has determined. Research on negotiable fate has found greater prevalence of related beliefs in Southeast Asia, East Asia, and Eastern Europe than in Western Europe and English-speaking countries. The present research extends previous findings by exploring the cognitive consequences of the belief in negotiable fate. It was hypothesized that this belief enables individuals to maintain faith in the potency of their personal actions and to remain optimistic in their goal pursuits despite the immutable constraints. The belief in negotiable fate was predicted to (a) facilitate sense-making of surprising outcomes; (b) increase persistence in goal pursuits despite early unfavorable outcomes; and (c) increase risky choices when individuals have confidence in their luck. Using multiple methods (e.g., crosscultural comparisons, culture priming, experimental induction of fate beliefs), we found supporting evidence for our hypotheses in three studies. Furthermore, as expected, the cognitive effects of negotiable fate are observed only in cultural contexts where the fate belief is relatively prevalent. Implications of these findings are discussed in relation to the intersubjective approach to understanding the influence of culture on cognitive processes (e.g., Chiu, Gelfand, Yamagishi, Shteynberg, & Wan, 2010), the sociocultural foundations that foster the development of a belief in negotiable fate, and an alternative perspective for understanding the nature of agency in contexts where constraints are severe. Future research avenues are also discussed.
22059848	According to models of objectification, viewing someone as a body induces de-mentalization, stripping away their psychological traits. Here evidence is presented for an alternative account, where a body focus does not diminish the attribution of all mental capacities but, instead, leads perceivers to infer a different kind of mind. Drawing on the distinction in mind perception between agency and experience, it is found that focusing on someone's body reduces perceptions of agency (self-control and action) but increases perceptions of experience (emotion and sensation). These effects were found when comparing targets represented by both revealing versus nonrevealing pictures (Experiments 1, 3, and 4) or by simply directing attention toward physical characteristics (Experiment 2). The effect of a body focus on mind perception also influenced moral intuitions, with those represented as a body seen to be less morally responsible (i.e., lesser moral agents) but more sensitive to harm (i.e., greater moral patients; Experiments 5 and 6). These effects suggest that a body focus does not cause objectification per se but, instead, leads to a redistribution of perceived mind.
22018516	Based on the data obtained through Child Protective Services (CPS) case records abstraction, this study aimed to explore patterns of overlapping types of child maltreatment in a sample of urban, ethnically diverse male and female youth (n= 303) identified as maltreated by a large public child welfare agency.A cluster analysis was conducted on data for 303 maltreated youth. The overall categorization of four types of abuse (i.e., physical, sexual, emotional abuse and neglect) was used to provide a starting point for clustering of the 303 cases and then the subtypes of emotional abuse were broken down in the clusters. The different clusters of child maltreatment were compared on the multiple outcomes such as mental health, behavior problems, self-perception, and cognitive development.	In this study, we identified four clusters of child maltreatment experiences. Three patterns involved emotional abuse. One cluster of children experienced all four types. Different clusters were differentially associated with multiple outcome measures. In general, multiply-maltreated youth fared worst, especially when the cluster involved sexual abuse. Also, sex differences were found in these associations. Boys who experienced multiple types of maltreatment showed more difficulties than girls.	These results reiterate the importance of creating more complex models of child maltreatment. Children who have experienced various types of maltreatment are especially in need of more attention from professionals and resources should be allocated accordingly.	
21998629	Agency plays an important role in self-recognition from motion. Here, we investigated whether our own movements benefit from preferential processing even when the task is unrelated to self-recognition, and does not involve agency judgments. Participants searched for a moving target defined by its known shape among moving distractors, while continuously moving the computer mouse with one hand. They thereby controlled the motion of one item, which was randomly either the target or any of the distractors, while the other items followed pre-recorded motion pathways. Performance was more accurate and less prone to degradation as set size increased when the target was the self-controlled item. An additional experiment confirmed that participant-controlled motion was not physically more salient than motion recorded offline. We found no evidence that self-controlled items captured attention. Taken together, these results suggest that visual events are perceived more accurately when they are the consequences of our actions, even when self-motion is task irrelevant.
21987514	HIV prevention efforts promote the use of condoms to prevent the spread of HIV and other STDs. Thus, a woman's agency to practice healthy sexual behaviors necessarily involves negotiation with another person. This poses unique challenges for women who have limited power in relationships. The current study explores how the experience of intimate partner violence (IPV) impacts a woman's confidence in her ability to negotiate condom use with a sexual partner (i.e., condom use self-efficacy), using data from incarcerated females in three states, who were interviewed just prior to release back into the community. The direct effect of experiencing IPV as an adult, controlling for other risk factors, on condom use self-efficacy has not previously been empirically tested. Results show that IPV experiences among women significantly decreases their confidence in negotiating condom use with a partner, putting them at a higher risk of HIV infection than women who do not report having recently experienced IPV.
21980137	Competent agency is a basic assumption of psychoanalytic change. Yet as an aspect of health, personal agency has in the main been only intuitively addressed and remains clinically unsystematized. Here experience-near and observer-centered criteria are developed that assess a person-as-agent's competence in particular domains. These ideas, clinically illustrated, stand as an operational framework that helps thinking and talking about agency in everyday clinical events and psychoanalytic outcomes. Three specific criteria are proposed: reversibility, self-observation, and appropriateness. The first is descriptively polar; together the three apply to each given context of action. They can also serve to ground future research. In this regard, several empirical psychoanalytic studies of adults and children that exemplify measurable aspects of agency are reviewed. Once clinical markers of personal agency are articulated, it will not be necessary to resolve the free will debate: pragmatically, we need only put such distinctions to work.
21978173	To open a discourse on the concept of autonomy as a precursor for participation in individuals with Spinal Cord Injury (SCI) by exploring the experiences about their perceived autonomy in their transition period from hospital to home.Based on the 'grounded theory' approach; in-depth, semi structured interviews were conducted with 11 SCI-patients. A theoretical sampling strategy was used and the data was analysed according to the constant comparative method.	To capture this complexity of autonomy, the results have been structured in themes with regard to the self of the patient and his independency. The analysis showed four different typologies of how autonomy is perceived; (1) the active agent, (2) the active follower, (3) the passive follower and (4) the passive victim.	Rehabilitation professionals can help individuals in disconnecting their internalised ideal of independency to avoid the illusion of being autonomous and can gain insight in the patients' typology and empower patients to avoid the paradox of being autonomous. If the ultimate goal of rehabilitation is participation; empowering the patient to achieve a 'sense of agency' instead of autonomy is the central goal for rehabilitation professionals. Empowerment and agency are key topics for the patient to gain mastery over his own life.	
21967087	The aims of this study were, first, to re-address the issue of empathy among people with autism conditions; second, to explore the relationships between empathy and values among autistic populations and controls; and third, to explore the capacity for moral agency among those affected by autism. We compared responses of an Asperger group (N = 41) and a control group (N = 139) to measures of self-reported empathy (Davis's IRI) and value priorities (Schwartz's PVQ). Control group results were largely in line with previous studies, such that empathy subscales of perspective taking and empathic concern showed their strongest positive and negative relations to the Schwartz self-transcendence/self-enhancement dimensions. Results for the Asperger group showed that although on the one hand there were self-reported difficulties in perspective taking and the cognitive recognition of affect, and that on the other hand there were less connections between the empathy and value measures, there was nevertheless a comparable prioritization of moral values. Conclusions suggest that different people may acquire moral values through different mechanisms.

21928912	Self-mastery refers to problem-focused coping facilitated through personal agency. Communal mastery describes problem solving through an interwoven social network. This study investigates an adaptation of self- and communal mastery measures for youth. Given the important distinction between family and peers in the lives of youth, these adaptation efforts produced Mastery-Family and Mastery-Friends subscales, along with a Mastery-Self subscale. We tested these measures for psychometric properties and internal structure with 284 predominately Yup'ik Eskimo Alaska Native adolescents (12- to 18-year-olds) from rural, remote communities-a non-Western culturally distinct group hypothesized to display higher levels of collectivism and communal mastery. Results demonstrate a subset of items adapted for youth function satisfactorily, a 3-response alternative format provided meaningful information, and the subscale's underlying structure is best described through 3 distinct first-order factors organized under 1 higher order mastery factor.
21928600	In the era of managed care, evidence-based practice, and short term, solution focused interventions, clinicians in agency based settings generally do not have the luxury of long-term contact with bereaved children. Although a substantial, yet controversial, literature argues that children cannot fully resolve early loss until adulthood, limited attention is given to how children's understandings of early loss shift as their cognitive capacities mature. This article argues the emotional experience of grief shifts: 1) as children grapple with both normative life changes and the tasks of mourning, and 2) as their cognitive and emotional development allow them to understand and question aspects of their deceased parent's life and death in new ways. This article will present an overview of longitudinal and cross-sectional research on the long-term impact of childhood grief. We then suggest the ways bereaved children and adolescents revisit and reintegrate the loss of a parent as their emotional, moral, and cognitive capacities mature and as normative ego-centrism and magical thinking decline. To demonstrate these ideas, we draw on the case of a parentally bereaved boy and his family presenting across agency-based and private-practice work over the course of 14 years. This case suggests the need for coordinated care for children who are moving beyond the initial trauma of parental loss into various stages of grief and reintegration. While the loss of a parent is permanent and unchanging, the process is not: it is part of the child's ongoing experience. (Worden, 1996, p. 16).
21920777	Sense of agency (SoA) is a compelling but fragile experience that is augmented or attenuated by internal signals and by external cues. A disruption in SoA may characterise individual symptoms of mental illness such as delusions of control. Indeed, it has been argued that generic SoA disturbances may lie at the heart of delusions and hallucinations that characterise schizophrenia. A clearer understanding of how sensorimotor, perceptual and environmental cues complement, or compete with, each other in engendering SoA may prove valuable in deepening our understanding the agency disruptions that characterise certain focal neurological disorders and mental illnesses. Here we examine the integration of SoA cues in health and illness, describing a simple framework of this integration based on Bayesian principles. We extend this to consider how alterations in cue integration may lead to aberrant experiences of agency.
21907160	The renal transplantation is nowadays the reference treatment of ESRD. Living donor kidney transplantation is less often performed in France than in other countries. Nevertheless, numerous French and international surveys have evidenced that it provides the recipients a longer life expectancy and a better quality of life. Donors themselves, what do they become? How are they? For the first time in France, a survey has been implemented to investigate the quality of life of living kidney donor to one of their close relations. This study has been undertaken by the Agency of the biomedecine and the service Clinical Epidemiology and Evaluation (EEC), of the University teaching hospital of Nancy. The main objective was to describe the quality of life of the living donors having given a kidney for more than a year and less than 5 years. The secondary objective was to contribute to the knowledge of the main factors associated to the living kidney donor quality of life, one year after the donation. Participants had to be living in France at the time of the donation which had taken place between June 30(th), 2005 and March 1(st), 2009. A folder gathering various self-administrated questionnaires was sent to the place of residence of the donor between March and April, 2010. These data were completed by medical data collected near the transplantation centres by the Agency of biomedecine within the framework of the register CRISTAL. They included the characteristics of the donation and of the donor at the very time of the donation, 3 months after the donation and at the last annual assessment. Three living donors in four, that is 501 persons, agreed to fully participate. They constituted a representative national sample of all the living donors of this period. The non participants were younger (4.5 years on average) and had a less adequate annual follow-up. The women were more represented (61 %) than men. The median age was 53 years. More of 2/3 were employed at the time of the survey. The three main categories of donors were ascendants (36 %), collateral (33 %) and spouses (26%). The donation decision was taken without hesitation (94 %) and at an early stage of the evolution of the recipient renal disease (64 %). The delivered information was considered globally satisfactory except for the painful consequences and for the scar. The living donors were, long after their donation, in an excellent physical health state according to the SF36 summarized physical score and this especially when they were old as compared to the same age and sex general population. This phenomenon highlights the drastic selection of the potential donors. The only factor influencing the level of long term physical health was the surgical technique: the 261 subjects having undergone a coelioscopy had less often presented post operative pain (OR=0.5; 0.3-0.8; P<0.002) and had more often recovered completely without any residual pain (OR=1.7; 1.2-2.5; P<0.004). The quality of life mental dimension according to the SF36 summarized mental score was very close to that of the same age and sex of the general population although a slightly lower. It is influenced by characteristics related to the way the donation had been lived, particularly the understanding of their donation by their circle of acquaintances (average score 74.2/100), the perception of a feeling of owing on behalf of the recipient (46.5 %) and the fact of having lived a competition to be retained as the donor (for 266 cases another potential donor did exist and 21 lived the donation as a strong competition). More than 84 % of the donors was still followed by a healthcare professional at the time of the survey. The main expressed complaints concern the quality of the medical follow-up (70 donors expressed themselves openly on this topic) and the pain and scar after effects of the intervention. In spite of the surgical complications, of the dissatisfactions regarding their medical follow-up, of dismissals or of necessary adjustments of their professional life (13 %), of their difficulties to carry heavy loads, of sometimes complex relations with the recipient (23 % positive, 10 % negative) or their circle of acquaintances, of expenses non reimbursement and of losses of salary (12 %), they would be 95 % to recommend the donation and if it was to be redone 98 % would do it again! Benefits brought to the recipient won largely over the encountered difficulties. This retrospective and cross-sectional study allows to state recommendations which have to be confirmed by the 2009-2012 longitudinal study: to favour the coelioscopy which offers an advantage in terms of less frequent pain and a better post operative recovery, to better understand the phenomena of competition between potential and donors recipients, to improve the information about the potential consequences of the donation on the pain and on the scar, to inform the donor about the importance to associate the proxies with the decisionmaking or at least with the discussion and finally to improve the society recognition of the donation.
21914211	Wind power has been harnessed as a source of power around the world. Debate is ongoing with respect to the relationship between reported health effects and wind turbines, specifically in terms of audible and inaudible noise. As a result, minimum setback distances have been established world-wide to reduce or avoid potential complaints from, or potential effects to, people living in proximity to wind turbines. People interested in this debate turn to two sources of information to make informed decisions: scientific peer-reviewed studies published in scientific journals and the popular literature and internet.The purpose of this paper is to review the peer-reviewed scientific literature, government agency reports, and the most prominent information found in the popular literature. Combinations of key words were entered into the Thomson Reuters Web of KnowledgeSM and the internet search engine Google. The review was conducted in the spirit of the evaluation process outlined in the Cochrane Handbook for Systematic Reviews of Interventions.	Conclusions of the peer reviewed literature differ in some ways from those in the popular literature. In peer reviewed studies, wind turbine annoyance has been statistically associated with wind turbine noise, but found to be more strongly related to visual impact, attitude to wind turbines and sensitivity to noise. To date, no peer reviewed articles demonstrate a direct causal link between people living in proximity to modern wind turbines, the noise they emit and resulting physiological health effects. If anything, reported health effects are likely attributed to a number of environmental stressors that result in an annoyed/stressed state in a segment of the population. In the popular literature, self-reported health outcomes are related to distance from turbines and the claim is made that infrasound is the causative factor for the reported effects, even though sound pressure levels are not measured.	What both types of studies have in common is the conclusion that wind turbines can be a source of annoyance for some people. The difference between both types is the reason for annoyance. While it is acknowledged that noise from wind turbines can be annoying to some and associated with some reported health effects (e.g., sleep disturbance), especially when found at sound pressure levels greater than 40 db(A), given that annoyance appears to be more strongly related to visual cues and attitude than to noise itself, self reported health effects of people living near wind turbines are more likely attributed to physical manifestation from an annoyed state than from wind turbines themselves. In other words, it appears that it is the change in the environment that is associated with reported health effects and not a turbine-specific variable like audible noise or infrasound. Regardless of its cause, a certain level of annoyance in a population can be expected (as with any number of projects that change the local environment) and the acceptable level is a policy decision to be made by elected officials and their government representatives where the benefits of wind power are weighted against their cons. Assessing the effects of wind turbines on human health is an emerging field and conducting further research into the effects of wind turbines (and environmental changes) on human health, emotional and physical, is warranted.	
21910554	Narrative identity is the internalized, evolving story of the self that each person crafts to provide his or her life with a sense of purpose and unity. A proliferation of empirical research studies focused on narrative identity have explored its relationship with psychological well-being. The present study is the first prospective, multiwave longitudinal investigation to examine short-term personality change via an emphasis on narrative identity as it relates to mental health. Forty-seven adults wrote rich personal narratives prior to beginning psychotherapy and after every session over 12 assessment points while concurrently completing a measure of mental health. Narratives were coded for the themes of agency and coherence, which capture the dual aims of narrative identity: purpose and unity. By applying in-depth thematic coding to the stories of participants, the present study produced 47 case studies of intraindividual personality development and mental health. By employing multilevel modeling with the entire set of nearly 600 narratives, the present study also identified robust trends of individual differences in narrative changes as they related to improvements in mental health. Results indicated that, across participants, the theme of agency, but not coherence, increased over the course of time. In addition, increases in agency were related to improvements in participants' mental health. Finally, lagged growth curve models revealed that changes in the theme of agency occurred prior to the associated improvements in mental health. This finding remained consistent across a variety of individual-difference variables including demographics, personality traits, and ego development.
21906232	This article presents a critique of an article previously featured in Nursing Philosophy (10: 26-33) by Ursula Naue and Thilo Kroll, who suggested that people living with dementia are assigned a negative status upon receipt of a diagnosis, holding the identity of the 'demented other'. Specifically, in this critique, we suggest that unwitting use of the adjective 'demented' to define a person living with the condition is ill-informed and runs a risk of defining people through negative (self-)attributes, which has a deleterious impact upon that person's social and relational personae. Moreover, use of the locution 'demented' reinforces a divide between the 'demented' (them) and the 'healthy others' (us). Social constructionist theory, malignant positioning and viewing people with dementia as semiotic subjects are the philosophical pillars through which we construct the main arguments of the critique. The article concludes with the voice of one of the authors, a younger person with dementia, asking for language in dementia care to be carefully reconsidered and reframed and for the recognition of the diagnosed person's agency in the conduct of their day-to-day lives.
21903372	Few studies have explored drug injectors' accounts of their initiation of others into injecting. There also lacks research on the social relations of initiating injecting drug use in transitional society. We draw upon analyses of 42 audio-recorded semi-structured interviews with current and recent injecting drug users, conducted in 2009 in the Republic of Moldova, a transitional society of south-eastern Europe. A thematic analysis informed by narrative theory was undertaken, focusing on accounts of self-initiation and the initiation of others. We also reflect upon the potential of peer efforts to dissuade would-be injectors from initiating. Findings emphasise initiation into injecting as a symbolic identity transition, enabled through everyday social relations. In turn, our analysis locates the drug transitions of the self inside an account of societal transition. We find that personal narratives of self transition are made sense of, and presented, in relation to broader narratives of social transition and change. Furthermore, we explore how narratives of self-initiation, and especially the initiation of others, serve to negotiate initiation as a moral boundary crossing. Self-initiation is located inside an account of transitioning social values. In looking back, initiation is depicted as a feature of a historically situated aberration in normative values experienced by the 'transition generation'. Accounts of the initiation of others (which a third of our sample describe) seek to qualify the act as acceptable given the circumstances. These accounts also connect the contingency of agency with broader narratives of social condition. Lastly, the power of peers to dissuade others from initiating injection was doubted, in part because most self-initiations were accomplished as a product of agency enabled by environment as well as in the face of peer attempts to dissuade.
21899522	Homelessness has been a perennial concern for sociologists. It is a confronting phenomenon that can challenge western notions of home, a discrete family unit and the ascetics and order of public space. To be without a home and to reside in public places illustrates both an intriguing way of living and some fundamental inadequacies in the functioning of society. Much homelessness research has had the consequence of isolating the 'homeless person' as distinct category or indeed type of individual. They are ascribed with homeless identities. The homeless identity is not simply presented as one dimensional and defining, but this imposed and ill-fitting identity is rarely informed by a close and long-term engagement with the individuals it is supposed to say something about. Drawing on a recent Australian ethnographic study with people literally without shelter, this article aims to contribute to understandings of people who are homeless by outlining some nuanced and diverse aspects of their identities. It argues that people can and do express agency in the way they enact elements of the self, and the experience of homelessness is simultaneously important and unimportant to understand this. Further, the article suggests that what is presumably known about the homeless identity is influenced by day-to-day lives that are on public display.
21897829	The aim of the study was to illuminate interpretative repertoires that jointly construct the interaction between adult women who self-harm and professional caregivers in psychiatric inpatient care. Participant observations and informal interviews were conducted among six women who self-harm and their professional caregivers in two psychiatric inpatient wards, and analysed using the concept of interpretative repertoires from the discipline of discursive psychology. The analysis revealed four interpretative repertoires that jointly constructed the interaction. The professional caregivers used a "fostering repertoire" and a "supportive repertoire" and the women who self-harmed used a "victim repertoire" and an "expert repertoire." The women and the caregivers were positioned and positioned themselves and people around them within and among these interpretative repertoires to make sense of their experiences of the interaction. It was necessary to consider each woman's own life chances and knowledge about herself and her needs. The participants made it clear that it was essential for them to be met with respect as individuals. Professional caregivers need to work in partnership with individuals who self-harm-experts by profession collaborating with experts by experience. Caregivers need to look beyond behavioural symptoms and recognise each individual's possibilities for agency.
21875454	To investigate the relationship between dietary patterns and self-perceived body shape silhouette and BMI in a sample of Mexican women.A cross-sectional analysis of dietary habits from baseline data of a large cohort study (EsMaestra) conducted in 2006-2008.	The state of Veracruz, Mexico.	Mexican teachers (n 20 330) provided information on body shape silhouette at baseline, changes in body shape silhouette and BMI, as well as information on sociodemographic variables and lifestyle.	The median BMI was 26·8 kg/m2; 43 % of women were overweight and 24 % were obese. The carbohydrates, sweet drinks and refined foods pattern was associated with a greater risk of having a large silhouette and a large BMI (BMI ≥ 30·0 kg/m2                   v. BMI < 25·0 kg/m2; ORT1-3 = 1·86, 95 % CI 1·56, 2·22 and 1·47, 95 % CI 1·28, 1·69, respectively) with a significant trend when comparing the first and third tertiles of intake. The fruit and vegetable pattern was associated with a lower risk of having a large silhouette and a large BMI (ORT1-3 = 0·68, 95 % CI 0·57, 0·82 and ORT1-3 = 0·77, 95 % CI 0·67, 0·88, respectively) with a significant decreasing trend. Similar results were observed when change in silhouette (from 18 years of age to current silhouette) was considered.	High intakes of carbohydrates, sweet drinks and refined foods are related to larger silhouettes. Public health intervention improving access to healthy dietary guidelines, healthy food choice in the work place, promotion of physical activity and regulation of beverages with a high sugar content and of refined foods should be considered.	
21875217	We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a person's environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p < .001 for each), and reasoning ability appeared most predictive (B = .117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t = -2.07; p = .039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space.
21849229	The recent debate in public health about the "inequality paradox" mirrors a long-standing dispute between proponents of structuralist approaches and advocates of action theory. Both views are genuine perspectives of health promotion, but so far they have not been adequately linked by health promotion theory. Using Anthony Giddens's concepts of structure and agency seems promising, but his theory has a number of shortcomings that need to be amended if it is to be applied successfully to health promotion. After briefly assessing Giddens's theory of structuration, this paper proposes to add to it both the concept of structural change as proposed by William Sewell and the policy dimension as described by Elinor Ostrom in her distinction between "operational" and "collective choice" level. On this basis, a multi-level model of the interaction of structure and agency in health promotion is proposed. This model is then connected to central claims of the Ottawa Charter, i.e. "build healthy public policy", "create supportive environments", "strengthen community actions", and "develop personal skills". A case study from a local-level health promotion project in Germany is used to illustrate the explanatory power of the model, showing how interaction between structure and agency on the operational and on the collective choice level led to the establishment of women-only hours at the municipal indoor swimming pool as well as to increased physical activity levels and improved general self-efficacy among members of the target group.
21825176	The received view in medical contexts is that informed consent is both necessary and sufficient for patient autonomy. This paper argues that informed consent is not sufficient for patient autonomy, at least when autonomy is understood as a "relational" concept. Relational conceptions of autonomy, which have become prominent in the contemporary literature, draw on themes in the thought of Charles Taylor. I first identify four themes in Taylor's work that together constitute a picture of human agency corresponding to the notion of agency implicit in relational accounts of autonomy. Drawing on these themes, I sketch two arguments against the position that informed consent secures autonomy. The first is that informed consent is an "opportunity" concept whereas autonomy is an "exercise" concept; the second is that informed consent requires merely weak evaluation and not strong evaluation. On Taylor's analysis of agency, strong evaluation is required for agency and for autonomy.
21818373	The experience of oneself as an agent not only results from interactions with the inanimate environment, but often takes place in a social context. Interactions with other people have been suggested to play a key role in the construal of self-agency. Here, we investigated the influence of social interactions on sensory attenuation of action effects as a marker of pre-reflective self-agency. To this end, we compared the attenuation of the perceived loudness intensity of auditory action effects generated either by oneself or another person in either an individual, non-interactive or interactive action context. In line with previous research, the perceived loudness of self-generated sounds was attenuated compared to sounds generated by another person. Most importantly, this effect was strongly modulated by social interactions between self and other. Sensory attenuation of self- and other-generated sounds was increased in interactive as compared to the respective individual action contexts. This is the first experimental evidence suggesting that pre-reflective self-agency can extend to and is shaped by interactions between individuals.
21807831	Hierarchically organized board-and-staff-run consumer-operated service programs (COSPs) are viewed as organizations that promote recovery while working in concert with community mental health agencies (CMHAs). This study's objective was to determine the effectiveness of such combined services for people with serious mental illness.A board-and-staff-run consumer-operated drop-in center and colocated CMHA provided the context for the randomized clinical trial. In a weighted sample, 139 new clients seeking help from the CMHA were randomly assigned to agency-only service or to a combination of COSP and CMHA services. Client-members were assessed at baseline and eight months on a measure of symptom severity and on four recovery-focused outcome measures: personal empowerment, self-efficacy, independent social integration, and hopelessness. All scales used have high reliability and well-established validity. Differences in outcome by service condition were evaluated with multivariate analysis of covariance via dummy variable regression. Change scores on the five outcomes were the dependent variables. The covariates for the multivariate analysis included baseline status on each outcome measure and service condition between-group demographic differences.	Results indicated that significant changes in three recovery-focused outcomes were associated with service condition across time: social integration (p<.001), personal empowerment (p<.006), and self-efficacy (p<.001). All changes favored the CMHA-only condition. Neither symptomology nor hopelessness differed by service condition across time.	Hierarchically organized board-and-staff-run COSPs combined with CMHA service may be less helpful than CMHA service alone.	
21787092	The Partner-Related Agency and Communion Test (PACT) was developed to measure implicit agentic and communal needs in the domain of couple relationships through content analyses of fantasy stories. Study 1 (N = 125) confirmed that the new thematic coding system captured experimentally induced differences in partner-related motivation and showed expected relations with D. G. Winter's (1994) motive scoring system. Study 2 confirmed the discriminant and incremental validity of the implicit partner-related needs compared with self-report measures of the Big Five traits and adult attachment in a sample of 499 couples. In addition, dyadic analyses revealed expected associations of the partner-related needs with relationship satisfaction as experienced by oneself and by one's partner. The studies lend initial support to the validity of the relationship-specific needs for agency and communion as assessed by the PACT and introduce dyadic data analyses to the study of implicit motives.
21784422	The immediate experience of self-agency, that is, the experience of generating and controlling our actions, is thought to be a key aspect of selfhood. It has been suggested that this experience is intimately linked to internal motor signals associated with the ongoing actions. These signals should lead to an attenuation of the sensory consequences of one's own actions and thereby allow classifying them as self-generated. The discovery of shared representations of actions between self and other, however, challenges this idea and suggests similar attenuation of one's own and other's sensory action effects. Here, we tested these assumptions by comparing sensory attenuation of self-generated and observed sensory effects. More specifically, we compared the loudness perception of sounds that were either self-generated, generated by another person or a computer. In two experiments, we found a reduced perception of loudness intensity specifically related to self-generation. Furthermore, the perception of sounds generated by another person and a computer did not differ from each other. These findings indicate that one's own agentive influence upon the outside world has a special perceptual quality which distinguishes it from any sort of external influence, including human and non-human sources. This suggests that a real sense of self-agency is not a socially shared but rather a unique and private experience.
21769038	: Since 2003, a new form of treatment for opioid dependence (OD), called buprenorphine medication-assisted treatment (B-MAT), has become increasingly available in the United States. The purpose of this study was to measure self-reported psychiatrists' practice patterns, personal and professional characteristics, and psychiatrists' barriers to treating OD patients with office-based opioid therapy.: Managed care network psychiatrists waivered to prescribe buprenorphine for treating OD were surveyed (N = 294) about specific skills and barriers to increasing the number of OD patients treated with B-MAT. Psychiatrists completed a self-administered survey about attitudes, beliefs, skills, experiences in general practice, and experience treating chronic disease, addiction, and OD.	: Of the 11 barriers measured on the survey, the 5 that were endorsed by the greatest number of psychiatrists as affecting their decision to use B-MAT or increase the number of B-MAT patients were as follows: urine testing requirements and logistical issues, possibility of patients selling their buprenorphine or taking more than prescribed, attracting more OD patients to their practice, concern about drug enforcement agency intrusion, and belief of greater time commitment for treating B-MAT patients.	: Barriers were perceived to exist, and the perception of the level of these barriers varied significantly between psychiatrists whose B-MAT practices were growing and those whose practices were not. The findings suggest that to increase the use of B-MAT by waivered psychiatrists, support services and medical education programs should focus on the barriers that are rated the most influential by psychiatrists whose patient sample was decreasing or remaining flat.	
21752362	Free will is classically attributed to the prefrontal cortex. In clinical neurology, prefrontal lesions have consistently been shown to cause impairment of internally driven action and increased reflex-like behaviour. Recently, parietal contributions to both free selection at early stages of sensorimotor transformations and perception of specifically self-intended movements were demonstrated in the healthy brain. Such findings generated the concept that 'free will' is not a function restricted to the prefrontal cortex but is more widely embedded in the brain, indeed including the parietal cortex. In this paper, a systematic re-interpretation of parietal symptoms, such as apraxia and reduced sense of agency, is given with reference to the consequences of reduced freedom of selection at early stages of sensorimotor transformation. Failed selection between possible movement options is argued to represent an intrinsic characteristic of apraxia. Paradoxical response facilitation supports this view. Perception of self-intended movement corresponds with a sense of agency. Impaired parietal distinction between predicted and perceived movement sensations may thus equal a restricted repertoire for selection between possible movement options of which intention is attributed to either oneself, others or an alien hand. Sense of agency, and thus perception of free will, logically fits a model of the parietal cortex as a neuronal interface between the internal drive to reach a goal and a body scheme required to select possible effectors for motor preparation.
21740216	Drawing on 40 in-depth interviews with sexually nonconforming Latinas, this work looks at how these women negotiate family and achieve empowerment both through visibility and invisibility. This work explores the experiences of Latinas who verbally articulated their sexual nonconformity to their families as well as those who chose to maintain their relationships tacit. I offer that study participants found empowerment and agency not only through verbal articulation but also through tacit relationships and that sexually nonconforming Latinas inhabited an "in-between space" with their families that gave them the flexibility to pursue or not pursue visibility as they desired.
21733868	Rhesus monkeys (Macaca mulatta) have shown the ability to monitor their own mental states, but fail the mirror self-recognition test. In humans, the sense of self-agency is closely related to self-awareness, and results from monitoring the relationship between intentional, sensorimotor and perceptual information. Humans and rhesus monkeys were trained to move a computer icon with a joystick while a distractor icon partially matched their movements. Both humans and monkeys were able to monitor and identify the icon they were controlling, suggesting they have some understanding of self-agency.
21733140	This article reports a study of self-care agency and perceived health in a group of people using advanced medical technology at home.An increasing number of people are using medical technology for self-care. Few studies describe daily life in this context at an overriding level, irrespective of the specific sort of technology. A connection between self-care, perceived health and sense of coherence has previously been implied.	A descriptive, comparative, cross-sectional quantitative design was used. Data were collected from a questionnaire during the winter of 2009/2010. The questionnaire addressed perceived health and daily life with medical technology. Swedish versions of the Appraisal of Self-care Agency scale and the 13-item version of Antonovsky's sense of coherence scale were included.	The questionnaire was answered by 180 adults performing self-care at home involving long-term oxygen, a ventilator, or peritoneal- or haemo-dialysis. Health-related and technology-related variables in daily life were mostly highly satisfactory. Perceived health was rated significantly lower among participants using long-term oxygen. Sufficient sense of coherence, knowledge of how to use technology, close contact with others and not feeling helpless contributed positively to self-care agency. Positive contributing factors for perceived health were being satisfied with life, having an active life and not feeling helpless, whereas age was a negative factor.	Daily life is manageable for people in this context. Long-term oxygen treatment and advanced age can be regarded as risk factors for perceiving ill health.	
21728426	Metacognitive methodologies are used to examine the integrity of self-referential processing in healthy adults and have been implemented to study disorders of the self-concept in neurologic and psychiatric populations. However, the extent to which metacognitive evaluations assess a uniquely self-evaluative capacity that cannot be explained fully by primary cognitive functions, demographics, or mood is not clear. The objective of the current study was to examine whether metamemory and a metacognitive test of agency shared a self-referential association that would not be explained by cognition, demographics, or mood.Thirty-eight nondemented older adults (Mini Mental State Examination [MMSE] ≥24 and mean age = 68.13) participated in metacognitive testing and completed cognitive testing and mood questionnaires. Bivariate correlations were used to evaluate the association between metamemory and agency, and to determine the cognitive (memory, attention, and executive functioning), demographic (age and education), and mood (anxiety and depression) correlates of each. Correlates of metamemory and agency were then entered into linear regression models to determine whether any association between metacognitive measures remained.	Metamemory was associated with agency judgments (n = 27), specifically those on self-controlled rather than computer-controlled trials (r = .41, p = .03). Regression results supported a role for agency in predicting metamemory, above and beyond memory and education (β = .39, p = .034). Metamemory was also an independent predictor of agency judgments (β = .36, p = .049).	The interrelation between metamemory and agency judgments suggests that metacognitive testing captures an important aspect of self-referential processing not otherwise assessed in a standard cognitive evaluation and may provide unique information about self-evaluative capacities in clinical populations.	
21722050	Adults and children have recently been shown to prefer guessing the outcome of a die roll after the die has been rolled (but remained out of sight) rather than before it has been rolled. This result is contrary to the predictions of the competence hypothesis (Heath & Tversky, 1991 ), which proposes that people are sensitive to the degree of their relative ignorance and therefore prefer to guess about an outcome it is impossible to know, rather than one that they could know, but do not. We investigated the potential role of agency in guessing preferences about a novel game of chance. When the experimenter controlled the outcome, we replicated the finding that adults and 5- to 6-year-old children preferred to make their guess after the outcome had been determined. For adults only, this preference reversed when they exerted control over the outcome about which they were guessing. The adult data appear best explained by a modified version of the competence hypothesis that highlights the notion of control or responsibility. It is proposed that potential attributions of blame are related to the guesser's role in determining the outcome. The child data were consistent with an imagination-based account of guessing preferences.
21707153	Our conscious experiences of self-agency tell us that we cause and change other people's emotions during social interactions, even without awareness of what we did. How do such experiences of being the cause of an outcome, such as the emotions of others, emerge? Previous authorship ascription research suggests that unconsciously primed knowledge about emotions produces a sense of self-agency upon seeing the primed emotions expressed in another agent. Taking into account the crucial role of valence and the nature of one's own actions in understanding others' behaviors, we predicted that preactivated knowledge linked to a particular emotion, in terms of action or valence, increases experienced self-agency upon seeing the emotion in another agent. In four experiments, participants interacted with another agent and observed this agent's neutral expressions change into emotional expressions. Results showed that various kinds of subliminal primes enhance experienced self-agency over the observed emotions. Our findings support the idea that the unconscious authorship ascription process is less rigid when outcomes are socially meaningful.

21671108	This paper responds to calls from social scientists in the area of globalization and women's empowerment to test a model that investigates both structural and individual components of women's empowerment in the context of globalization. The investigation uses a liberation psychology framework by taking into account the effects of globalization, human rights discourse, and women's activism within social movements to identify how structural inequities may be related to empowerment. Surveys conducted in rural Nicaragua revealed that land ownership and organizational participation among women were related to more progressive gender ideology, and in turn, women's power and control within the marital relationship, individual levels of agency, and subjective well-being. The study demonstrates that psychology can bridge the theoretical arguments surrounding human rights with the practical implementation of development interventions, and provide empirical support that has yet to be demonstrated elsewhere. The findings have important implications for strategies and interventions that can improve conditions for women and contribute to the aims of social justice articulated in the Beijing Platform for Action.
21641767	Although research on blood donor motivation abounds, most studies have typically focused on small sets of variables, used different terminology to label equivalent constructs, and have not attempted to generalize findings beyond their individual settings. The current study sought to synthesize past findings into a unified taxonomy of blood donation drivers and deterrents and to estimate the prevalence of each factor across the worldwide population of donors and eligible nondonors. Primary studies were collected, and cross-validated categories of donation motivators and deterrents were developed. Proportions of first-time, repeat, lapsed, apheresis, and eligible nondonors endorsing each category were calculated. In terms of motivators, first-time and repeat donors most frequently cited convenience, prosocial motivation, and personal values; apheresis donors similarly cited the latter 2 motivators and money. Conversely, lapsed donors more often cited collection agency reputation, perceived need for donation, and marketing communication as motivators. In terms of deterrents, both donors and nondonors most frequently referred to low self-efficacy to donate, low involvement, inconvenience, absence of marketing communication, ineffective incentives, lack of knowledge about donating, negative service experiences, and fear. The integration of past findings has yielded a comprehensive taxonomy of factors influencing blood donation and has provided insight into the prevalence of each factor across multiple stages of donors' careers. Implications for collection agencies are discussed.
21636211	Growing plants and flowers in greenhouses is a commercial activity that imposes a burden on the environment. Recently a system of registration, control, and licensing has been developed by the sector of greenhouse growers in the Netherlands, acknowledged by the state. The current study was executed to understand the achievements of the greenhouse growers within this system. We applied a social-cognitive model to understand intentions to reduce emissions and predict actual pesticide use. The social-cognitive concepts from the model were measured in a questionnaire that was completed by 743 greenhouse growers. Factual information on these growers' pesticide use in 2004 and 2005 was provided by the agency responsible for the program, and could be linked to the questionnaire data. Using structural equation modeling we found that intention to reduce emission was primarily predicted by the attitude, descriptive norm, and self-efficacy. Actual pesticide use was predicted by the interaction of intention and response efficacy. Results can be used to improve communication with growers, focusing on the influential determinants of intention and behavior.
21625532	When we speak, we provide ourselves with auditory speech input. Efficient monitoring of speech is often hypothesized to depend on matching the predicted sensory consequences from internal motor commands (forward model) with actual sensory feedback. In this paper we tested the forward model hypothesis using functional Magnetic Resonance Imaging. We administered an overt picture naming task in which we parametrically reduced the quality of verbal feedback by noise masking. Presentation of the same auditory input in the absence of overt speech served as listening control condition. Our results suggest that a match between predicted and actual sensory feedback results in inhibition of cancellation of auditory activity because speaking with normal unmasked feedback reduced activity in the auditory cortex compared to listening control conditions. Moreover, during self-generated speech, activation in auditory cortex increased as the feedback quality of the self-generated speech decreased. We conclude that during speaking early auditory cortex is involved in matching external signals with an internally generated model or prediction of sensory consequences, the locus of which may reside in auditory or higher order brain areas. Matching at early auditory cortex may provide a very sensitive monitoring mechanism that highlights speech production errors at very early levels of processing and may efficiently determine the self-agency of speech input.
21543355	The ability to distinguish actions and effects caused by oneself from events occurring in the external environment is a fundamental aspect of human cognition. Underlying such distinctions, self-monitoring processes are often assumed, in which predicted events accompanied by one's own volitional action are compared with actual events observed in the external environment. Although many studies have examined the absence or presence of a certain type of self-recognition (i.e. mirror self-recognition) in non-human animals, the underlying cognitive mechanisms remain unclear. Here, we provide, to our knowledge, the first behavioural evidence that chimpanzees can perform self/other distinction for external events on the basis of self-monitoring processes. Three chimpanzees were presented with two cursors on a computer display. One cursor was manipulated by a chimpanzee using a trackball, while the other displayed motion that had been produced previously by the same chimpanzee. Chimpanzees successfully identified which cursor they were able to control. A follow-up experiment revealed that their performance could not be explained by simple associative responses. A further experiment with one chimpanzee showed that the monitoring process occurred in both temporal and spatial dimensions. These findings indicate that chimpanzees and humans share the fundamental cognitive processes underlying the sense of being an independent agent.
21506043	Neuroscientists have recently begun to explore topics, such as the nature of the self, that were previously considered problems for philosophy rather than for science. This article aims to provide a starting point for interdisciplinary exchange by reviewing three philosophical debates about the nature of the self in light of contemporary work in cognitive neuroscience. Continental rationalist and British empiricist approaches to the unity of the self are discussed in relation to earlier work on split-brain patients, and to more recent work on "mental time travel" and the default mode network; the phenomenological movement, and the central concept of intentionality, are discussed in relation to interoceptive accounts of emotion and to the mirror neuron system; and ongoing philosophical debates about agency and autonomy are discussed in relation to recent work on action awareness and on insight in clinical populations such as addicts and patients with frontotemporal dementia.
21503647	Understanding the sense of agency is a key challenge for the psychological and brain sciences. When an individual makes an action that is followed by an effect such as an auditory tone, there is a perceived compression in time of the interval between the action and the effect. Since this only occurs for intentional actions, this compression is termed 'intentional binding' and has been suggested as an implicit measure of agency. Very little is known about how the sense of agency and indeed intentional binding may be altered in joint action contexts in which two individuals act and an effect occurs. Here, we assessed the subjective sense of agency via self-report and implicit agency via intentional binding in a joint action task in which one person initiated a movement which another person joined in with. We further manipulated whether both individuals knew who the initiator would be ahead of time (by assigning one person as the initiator at the start of a block of trials) or whether this became apparent in a dynamic fashion based on who acted first. In both settings, only the initiator reported reliable subjective feelings of agency, whereas both the initiator and the responder demonstrated significant and indistinguishable intentional binding. We suggest that, when two individuals are involved in a joint action context, there is an automatic formation of a new agentic identity (a 'we' identity). In such contexts, both partners register agency at the pre-reflective level, despite the fact that their subjective experience of agency differs, and indeed, their role in producing the outcome differs. Hence, the subjective sense of agency and intentional binding are dissociable, and it remains for future work to understand how pre-reflective agency 'registration' and the reflective 'experience' of agency are, if at all, related.
21500902	Appraisal theories of emotion propose that the emotions people experience correspond to their appraisals of their situation. In other words, individual differences in emotional experiences reflect differing interpretations of the situation. We hypothesized that in similar situations, people in individualist and collectivist cultures experience different emotions because of culturally divergent causal attributions for success and failure (i.e., agency appraisals). In a test of this hypothesis, American and Japanese participants recalled a personal experience (Study 1) or imagined themselves to be in a situation (Study 2) in which they succeeded or failed, and then reported their agency appraisals and emotions. Supporting our hypothesis, cultural differences in emotions corresponded to differences in attributions. For example, in success situations, Americans reported stronger self-agency emotions (e.g., proud) than did Japanese, whereas Japanese reported a stronger situation-agency emotion (lucky). Also, cultural differences in attribution and emotion were largely explained by differences in self-enhancing motivation. When Japanese and Americans were induced to make the same attribution (Study 2), cultural differences in emotions became either nonsignificant or were markedly reduced.
21494918	Correlational research investigating the relationship between scores on self-report imagery questionnaires and measures of social desirable responding has shown only a weak association. However, researchers have argued that this research may have underestimated the size of the relationship because it relied primarily on the Marlowe-Crowne scale (MC; Crowne & Marlowe, Journal of Consulting Psychology, 24, 349-354, 1960), which loads primarily on the least relevant form of social desirable responding for this particular context, the moralistic bias. Here we report the analysis of data correlating the Vividness of Visual Imagery Questionnaire (VVIQ; Marks, Journal of Mental Imagery, 19, 153-166, 1973) with the Balanced Inventory of Desirable Responding (BIDR; Paulhus, 2002) and the MC scale under anonymous testing conditions. The VVIQ correlated significantly with the Self-Deceptive Enhancement (SDE) and Agency Management (AM) BIDR subscales and with the MC. The largest correlation was with SDE. The ability of SDE to predict VVIQ scores was not significantly enhanced by adding either AM or MC. Correlations between the VVIQ and BIDR egoistic scales were larger when the BIDR was continuously rather than dichotomously scored. This analysis indicates that the relationship between self-reported imagery and social desirable responding is likely to be stronger than previously thought.
21471028	In this column the author presents an examination of Orem's conceptualization of environment as a metaparadigm concept, the role of environment in the theoretical structure of the self-care deficit nursing theory, and the creation of a developmental environment as one of the ways of helping another. Suggestions for further work related to the conceptualization of environment and the organization of existent knowledge are provided. Application of the concept of nursing agency and the environmental factor of healthcare system illustrate the utility of self-care deficit nursing theory in relation to the recommendations for changes in nursing education and for redesign of the healthcare system.
21463077	Naïve theories of behavior hold that actions are caused by an agent's intentions, and the subsequent success of an action is measured by the satisfaction of those intentions. However, when an action is not as successful as intended, the expected causal link between intention and action may distort perception of the action itself. Four studies found evidence of an intention bias in perceptions of action. Actors perceived actions to be more successful when given a prior choice (e.g., choose between 2 words to type) and also when they felt greater motivation for the action (e.g., hitting pictures of disliked people). When the intent was to fail (e.g., singing poorly), choice led to worse estimates of performance. A final experiment suggested that intention bias works independent from self-enhancement motives. In observing another actor hit pictures of Hillary Clinton and Barack Obama, shots were distorted to match the actor's intentions, even when it opposed personal wishes. Together these studies indicate that judgments of action may be automatically distorted and that these inferences arise from the expected consistency between intention and action in agency.
21458344	To analyse the perceived usefulness of continuous professional development (CPD) of the Professional Skills Accreditation Programme of the Andalusian Agency for Healthcare Quality, with 64 Skills Manuals available, one for each professional discipline.A quantitative and longitudinal study by questionnaire. Field of the study: every professional who has finished their professional skills accreditation process.	2006-2009. A validated questionnaire on the perceived quality of the professional skills accreditation process was distributed online to the targeted population. The questionnaire analysed the professionals' perception on the usefulness of the accreditation process in the "self-learning and reflection of their practice", the "maintenance and improvement of their skills" and the "maintenance and improvement of their results".	In 2009, 10,300 professionals were in some phase of the skills accreditation process, 1427 of whom have achieved some accreditation level. A total of 886 completed questionnaires were received (62.0%); the overall rating obtained by the Accreditation Programme was 7.7/10. The rating of the perceived usefulness in continuous professional development was: "self-learning and reflection of their practice": 7.8/10; "maintenance and improvement of their skills": 7.7/10; and "maintenance and improvement of their results": 7.5/10. The average length of their professional practice self-assessment was 168 days.	The Professional Skills Accreditation Programme of the Andalusian Agency for Healthcare Quality was perceived by the professionals as useful for their continuous professional development.	
21452945	The ability to recognize oneself in voluntary action is called the sense of agency and refers to the experience of causing one's own actions and their sensory consequences. This form of self-awareness is important not only for motor control but also for social interactions and the ascription of causal responsibility. Here, we examined the sense of agency at early and prereflective stages of action perception using ERPs. Subjects performed a visual forced-choice response task in which action effects were either caused by the subject or by the computer. In addition, to modulate the conscious experience of agency, action effects were subliminally primed by the presentation of congruent, incongruent, or neutral effect stimuli before the action. First, we observed sensorimotor attenuation in the visual ERP selectively for self-generated action effects. That is, the N1 component, a negative deflection around 100 msec after a visual stimulus, was smaller in amplitude for visual effects caused by the subject as compared with effects caused by the computer. Second, congruent effect priming enhanced the explicit judgment of agency and further reduced the N1 amplitude for self-generated effects, although effect primes were not consciously processed. Taken together, these results provide evidence of a top-down modulation of sensory processing of action effects by prior effect information and support the neurophysiological mechanism of sensorimotor attenuation as underlying self-registration in action. Our findings suggest that both efferent information and prior thoughts about the action consequence provide important cues for a prereflective form of the experience of being an agent.
21452749	Adolescence is a passage from dependence to adult responsibility. Alongside identity development, social-cognitive development, and the ability to construct a life story, adolescents become increasingly aware of both their potential responsibility in an expanded sphere of life and of complex, contextual influences on their lives. This was partially tested in a cross-sectional study, both in terms of linguistic means and content expressed in life narratives. Indicators were defined for narrative agency, grading of responsibility, serendipity, and turning points, and tested for age differences in relative frequencies in 102 life narratives from age groups of 8, 12, 16, and 20 years, balanced for gender. Narrative grading of responsibility, serendipity, and turning points increased throughout adolescence. The relative frequency of narrative agency, in contrast, remained constant across age groups. Results are interpreted in the context of adolescent development of narrative identity.
21446872	Interviews were conducted with 17 individuals who had intellectual disability to expand our understanding of the impact of self-determination in their life. Themes emerging from the interviews were grouped into three categories: meaning of self-determination, learning about self-determination, and dreams for the future. Participants described self-determination as being able to make choices and be in control of one's life and setting as well as being able to work toward goals and engage in advocacy. Participants discussed the importance of supports for expressing self-determination and identified environmental characteristics that promoted and inhibited self-determination. Overall, their perceptions confirm the importance of promoting personal development of skills and attitudes associated with self-determination and systems change to create environmental opportunities for self-determination and causal agency. Implications for future research and practice are discussed.
21396831	The sense of agency is the experience of being the origin of a sensory consequence. This study investigates whether contextual beliefs modulate low-level sensorimotor processes which contribute to the emergence of the sense of agency. We looked at the influence of causal beliefs on 'intentional binding', a phenomenon which accompanies self-agency. Participants judged the onset-time of either an action or a sound which followed the action. They were induced to believe that the tone was either triggered by themselves or by somebody else, although, in reality, the sound was always triggered by the participants. We found that intentional binding was stronger when participants believed that they triggered the tone, compared to when they believed that another person triggered the tone. These results suggest that high-level contextual information influences sensorimotor processes responsible for generating intentional binding.
21371052	Community services for carers of people with dementia can assist in relieving caregiver burden and delay the institutionalisation of the person with dementia. Under some conditions, however, engagement with dementia services may produce unintended negative consequences, resulting in increased confusion and a reduction of agency for carers. Drawing on an analysis of three salient aspects of caregiver identities, this paper examines specific instances and consequences of 'ambiguous gain', defined as 'a putative or demonstrated benefit that, as an unintended outcome, results in increased uncertainty and a consequent reduction of agency or wellbeing at the level of individual or collective identity'. The paper concludes with a discussion of implications for policy and practice.
21341958	In Ethiopia the level of illiteracy in rural areas is very high. In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play. In a pretest and posttest experimental study with an intervention group (n = 210) and control group (n = 210), we investigated the effects on HIV/AIDS knowledge and social cognitions. The intervention led to significant and relevant increases in HIV/AIDS knowledge, self-efficacy, perceived vulnerability to HIV/AIDS infection, response efficacy of condoms and condom use intention. In the intervention group, self-efficacy at posttest was the main determinant of condom use intention, with also a significant contribution of vulnerability. We conclude that audio HIV/AIDS prevention interventions can play an important role in empowering rural illiterate females in the prevention of HIV/AIDS.
21327721	In recent years limitations in the biomedical conceptualisation of health and illness have been well documented and a variety of alternative explanations produced to replace or supplement it. One such is Fredrik Svenaeus's philosophy of medical practice, which is a development of Hans-Georg Gadamer and Martin Heideggers' phenomenological and hermeneutical writings. This paper explores two texts, a short story by H. G. Wells, The Country of the Blind, and a poem by William Carlos Williams, Danse Russe to add further insight into the ideas proposed by Svenaeus. Both texts were written before either Gadamer or Heidegger published their work. Analysis of the texts reveal examples of Heidegger's understanding of 'da-sein', human-being, as the fundamental of human existence-how we relate to our 'life-world'-together with its conditions including the tools we use to engage with and the moods that interpret the world. Emerging from this core relationship of being are the phenomena of health and illness, which are conceptualised as home-like (Heimischkeit) and un-home-like (Unheimlichkeit) being-in-the-world. In the texts the sense of home-like (and un-home-like) being is an ontological 'web of significance', to use Heidegger's phrase, that creates, rather than results from a person's psychological state. One factor that is not fully explicated in the philosophical accounts is the role that behaviour (as the physical-relating of a person) plays as a pre-requisite for agency, the ability to act in taken-for-granted ways. A person's sense of authenticity, the extent to which someone makes their own choices rather than being led by what 'others' say, is linked with their ability to physically engage with and relate to their 'life-world'. Finally, similarities between the ontological wholeness of poetry-the meaning structure of poetry-and of Dasein are noted.
21317370	The concept of an ability to make choices and to determine one's own outcomes fits well with experiences that most people have, and these experiences form the basis for beliefs in free will. However, the existence of conscious free will is challenged by modern research findings highlighting the unconscious origins of goal-directed behavior that gives rise to free-will beliefs. This report expands on these insights by revealing that both conscious and unconscious processes play an important role in free-will beliefs. Specifically, Experiment 1 demonstrates that free-will beliefs are strengthened when conscious intentions to produce action outcomes bind the perception of action and outcome together in time. Experiment 2 shows that these beliefs are strengthened when unconscious priming of action outcomes creates illusory experiences of self-agency when the primed outcomes occur. Together, these findings suggest that beliefs in free will are associated with self-agency and are enhanced by both conscious and unconscious information processing of goal-directed behavior.
21307177	Current public discourse calls for America to act more interdependently in the world or act more like a conjoint agent. America and American selves, however, are typically associated acting independently or disjoint agency. Since nation is a significant sociocultural source of self, the authors examine what happens to American selves if America is instead associated with conjoint agency. Study 1 surveyed participants in America and nine nations (N=610) about America's role in the world and found that although people currently associate America with disjoint agency, they overwhelmingly prefer America to be a conjoint agent. Studies 2-4 demonstrated that framing America's role in the world with conjoint agency rather than disjoint agency led Americans to see themselves more positively (Studies 2 and 3) and be less individualistic in their self-descriptions and actions (Study 4). The results reveal how changes in the sociocultural context can catalyze a corresponding change in the selves that inhabit that context.
21291442	This research examines how youth in arts and leadership programs develop skills for organizing actions over time to achieve goals. Ethnically diverse youth (ages 13-21) in 11 high-quality urban and rural programs were interviewed as they carried out projects. Qualitative analyses of 712 interviews with 108 youth yielded preliminary grounded theory about youth's development of strategic thinking, defined as use of dynamic systems reasoning to anticipate real-word scenarios and plan work. Strategic thinking appeared to develop through youth's creative engagement with tactical challenges in the work and feedback from the work's outcomes. Program advisors supported this development by giving youth control and by providing nondirective assistance when needed.
21289646	Individuals with hypertension should lower and maintain their blood pressure levels through lifestyle modification and/or pharmacotherapy. To determine whether perception of blood pressure control is related to behaviours and intentions for improving blood pressure, data from 6142 Canadians age 20+ years with self-reported hypertension were analysed. Relationships between perception of control, current behaviours for blood pressure control and intentions to improve these behaviours were examined. Although individuals who reported uncontrolled blood pressure were equally likely to report engaging in lifestyle behaviours for blood pressure control, they were more likely to indicate an intention to improve their health, compared with those who reported well-controlled/low blood pressure. These individuals were also less likely to report having enough information to control their blood pressure. In addition, they were less likely to report having been advised to take antihypertensive medication, and to be taking and adhering to medications. Individuals who perceive their blood pressure as uncontrolled have intentions to make health-enhancing changes but may lack the information to do so. The study highlights the potential need for programmes/services to help those with uncontrolled blood pressure make lifestyle changes and/or take appropriate medication.
21220575	The relationship of nursing science and nursing practice has been the topic of numerous discussions over the past decades. According to Orem, nursing science is a practical science, meaning that knowledge is developed for the sake of nursing practice. Within Orem's self-care deficit nursing theory, the concept of nursing agency links nursing science and nursing practice. Nursing agency refers to the power or ability of the nurse to design and produce systems of care. The relationship of practical nursing science, nursing practice, and nursing agency is examined in this article. Suggestions for further work related to nursing agency are provided.
21207316	One of the defining characteristics of individuals with autism spectrum disorder (ASD) is difficulty with social interaction and communication with others, or interpersonal interaction. Accordingly, the majority of research efforts to date have focused on understanding the brain mechanisms underlying the deficits in social cognition and language associated with ASD. However, recent empirical and theoretical work has begun to reveal increasing evidence for altered self-representation, or intrapersonal cognition in ASD. Here we review recent studies of the self in ASD, focusing on paradigms examining 'physical' aspects of the self, including self-recognition, agency and perspective taking, and 'psychological' aspects of the self, including self-knowledge and autobiographical memory. A review of the existing literature suggests that psychological, but not physical, aspects of self-representation are altered in ASD. One key brain region that has emerged as a potential locus of self-related deficits in ASD is the medial prefrontal cortex, part of a larger 'default mode network'. Collectively, the findings from these studies provide a more comprehensive framework for understanding the complex social, cognitive, and affective symptomatology of ASD.
21198219	Evidence of the effects of negative affect (NA) and sexual craving on unprotected sexual activity remains scant. We hypothesized that NA and sexual craving modify the same day association between low self-efficacy to use condoms and unprotected anal or vaginal sex, and the same-day association between alcohol use during the 3 hours prior to sexual activity and unprotected sex. We used an electronic daily diary, drawing on a sample of 125 men and women recruited from an agency serving economically disadvantaged persons living with HIV/AIDS. Casual or steady partner type designation and perceived partner HIV serostatus were also examined. Findings support the hypothesized moderating effects of high NA and sexual craving on the association between low self-efficacy and unprotected sex, and the association between alcohol use and unprotected sex. Implications are discussed.
21184312	In this essay, I assess the narrative of obesity as articulated in representative contemporary mainstream media fare--namely, The Oprah Winfrey Show, The Biggest Loser, and Big Medicine. I contend that the emergent narrative of obesity across these programs signals a shift from the historically received narrative in light of its intersection with the concurrent culturally resonant narratives of addiction and self-actualization. In particular, the proposed "problem" and "solution" to obesity, both historically attributed to personal responsibility, appear to be shifting in favor of cultural explanations that describe obesity as symptomatic of and secondary to broader issues related to community, emotionality, and agency. This suggests novel cultural understandings, practices, and policies regarding the mounting "obesity epidemic."
21140173	We conducted a qualitative study to explore breast cancer survivors' perceptions and attitudes about their current healthcare utilization, screening, and information needs.We completed eight focus groups of breast cancer survivors. We included women, adult survivors, with an initial diagnosis of breast cancer in the year 2000, treated, and without a recurrence as per medical record. To analyze transcripts, we used grounded theory methods, wherein unexpected themes and direct answers emerged from consensus between co-coders.	Focus groups included 33 participants, the majority of whom were white (84.8%), college-educated (66.7%), and covered by private medical insurance (75.7%) or Medicare (27.3%). Participants' perceptions and attitudes about care were framed in terms of personal experiences (including facing barriers to screening, feeling in limbo in the healthcare system, having problems with communication with and between physicians, confusion about symptoms, and using self-prescribe remedies), personal attitudes (including strong opinions about what survivorship means, concerns about recurrence, and changes in self-perception and agency), and social influences (including modeling others' behaviors, changes in social life, and listening to family).	Survivorship attitudes, recurrence fears, memories, and self-perceptions were influential personal factors in addition to self-efficacy. Solutions such as providing a cancer treatment summary might resolve many of the problems by consolidating and making readily available the numerous medical history and recommendations that survivors accrue over time, switching from provider to provider. Clinicians must also implement communication changes in their interactions with patients to enhance positive attitudes and behaviors, and leverage social influences.	
21122832	The associative learning account of how infants identify human motion rests on the assumption that this knowledge is derived from statistical regularities seen in the world. Yet, no catalog exists of what visual input infants receive of human motion, and of causal and self-propelled motion in particular. In this manuscript, we demonstrate that the frequency with which causal agency and self-propelled motion appear in the visual environment predicts infants' understanding of these motions. In an observational study, an infant wearing a head-mounted camera saw people act as agents in causal events three times more often than he saw people engaged in self-propelled motion. Subsequent experiments with the habituation paradigm revealed that infants begin to generalize self-propulsion to agents in causal events between 10 and 14 months of age. However, infants cannot generalize causal agency to a self-propelled object at 14 or 18 months unless the object exhibits additional cues to animacy. The results are discussed within a domain-general framework of learning about human action.
21121699	The Australian Government encourages the regional settlement of refugees and it is expected that 45% of refugees to Australia be regionally located. Wagga Wagga, an inland regional city in New South Wales (NSW), a destination for both primary and secondary migration, offers settlement for refugees under the Australian Integrated Humanitarian Settlement Strategy (IHSS) and the Settlement Grants Program. Refugees currently represent 1% of Wagga Wagga's 60 000 population. For people previously living in cities or crowded camps with a background of disruption, torture and trauma, relocation to rural areas of Australia is confronting, and they require dedication and effort from those supporting resettlement. Currently, caseworkers working for settlement agencies do not have formal training. Volunteers are offered induction days and information sessions but have training needs beyond this.Two projects were undertaken during 2007 and 2008. Refugee services in regional and rural NSW and their efficacy were reviewed, exploring models of care in four NSW locations and clarifying needs via a literature search. Training and resources available to caseworkers and volunteers were also investigated. The objective was to design and construct a basic manual addressing the needs of this workforce informed by a literature search and consultation with key stakeholders in refugee resettlement. Literature searches of electronic databases, relevant websites and journals informed the questions for participants of focus groups and semi-structured interviews. Additional data were obtained via self-report questionnaires from caseworkers, volunteers and mainstream agencies. Information was also disseminated to refugees, inviting community to participate in focus groups.	Our study supported others noting difficulties associated with the settlement of refugees in regional Australia, and recommendations of improvements were developed using the social determinants of health. The supporting workforce encounters a multitude of issues when working with newly arrived refugees, including language barriers, client expectations and challenges in developing living skills. Workers reported that accessing refugees' information is time-consuming, and that available resources are fragmented. Refugees expressed frustration at being categorised but acknowledged the efforts of volunteers and caseworkers.	Findings and feedback from the literature review, focus groups, consultations with resettlement stakeholders and interviews supported the concept of developing a basic manual and conversation-starter flashcards. The limitations of the developed manual are acknowledged, as is a need for agency specific information on common topics for volunteers, caseworkers and clients, is suggested. Volunteer and caseworker training should be expanded.	
21117459	The recent construct of Self-leadership, which includes cognitive and behavioral strategies of managing oneself, has yet to be examined for associations with central personality dimensions such as the Big Five and their higher-order factors (Alpha, Beta). It was hypothesized that Self-leadership and its subfacets would be significantly correlated with all Big Five traits except Agreeableness, albeit higher with Extraversion and Openness to Experiences as it should pertain more strongly to agentic than communal traits. Analyses in university students (N=168) indicated that Self-leadership and its facets were more strongly related to Beta (Agency) than Alpha (Communion), and, although there were mostly positive correlations, Self-leadership should be distinguished from the Big Five traits. Findings are discussed regarding Self-leadership's associations with the Big Five traits and higher-order factors.
21111638	Research suggests that perceptual experience of our movements adapts together with movement control when we are the agents of our actions. Is this agency critical for perceptual and motor adaptation? We had participants view cursor feedback during elbow extension-flexion movements when they (1) actively moved their arm, or (2) had their arm passively moved. We probed adaptation of movement perception by having participants report the reversal point of their unseen movement. We probed adaptation of movement control by having them aim to a target. Perception and control of active movement were influenced by both types of exposure, although adaptation was stronger following active exposure. Furthermore, both types of exposure led to a change in the perception of passive movements. Our findings support the notion that perception and control adapt together, and they suggest that some adaptation is due to recalibrated proprioception that arises independently of active engagement with the environment.
21095611	The concept of informed decision making does not only comply with the ideals of the self-determining citizen. In politics and society it is more and more understood as an individual obligation. In order to be capable of making competent decisions regarding treatment options, citizens have to be provided with high quality information. With the aim of facilitating patients' and consumers' orientation in health care questions, the German Agency for Quality in Medicine (ÄZQ) has been committed to developing and promoting the use of reliable patient information for more than ten years. ÄZQ's activities are based on four main principles: development of patient versions of high quality clinical practice guidelines; provision of patient information which has been assessed according to its formal quality; provision of information on the German health care system (checklists); further development of quality standards and methods.
21087873	Depersonalization is characterised by a profound disruption of self-awareness mainly characterised by feelings of disembodiment and subjective emotional numbing. It has been proposed that depersonalization is caused by a fronto-limbic (particularly anterior insula) suppressive mechanism--presumably mediated via attention--which manifests subjectively as emotional numbing, and disables the process by which perception and cognition normally become emotionally coloured, giving rise to a subjective feeling of 'unreality'. Our functional neuroimaging and psychophysiological studies support the above model and indicate that, compared with normal and clinical controls, DPD patients show increased prefrontal activation as well as reduced activation in insula/limbic-related areas to aversive, arousing emotional stimuli. Although a putative inhibitory mechanism on emotional processing might account for the emotional numbing and characteristic perceptual detachment, it is likely, as suggested by some studies, that parietal mechanisms underpin feelings of disembodiment and lack of agency feelings.
21077003	Researchers have postulated that hope may be an important factor associated with burnout. Consistent with hope theory contentions, low-hope individuals may be susceptible to burnout because they are prone to experience goal blockage, frustration, and negative affect, all of which likely increase the risk of burnout. We examined the relationship between hope and athlete burnout among 178 competitive athletes (63 females and 115 males) aged 15-20 years. Hope was significantly and negatively correlated with all three burnout subscales: emotional/physical exhaustion, a reduced sense of accomplishment, and sport devaluation. Moreover, results of a multivariate analysis of variance showed that low-hope athletes scored significantly higher than medium- and high-hope athletes on all three burnout dimensions. Finally, results revealed that agency thinking was a significant predictor of all burnout dimensions. Frustration over unmet goals and a perceived lack of agency, a characteristic of low-hope athletes, might pose a risk factor in athlete burnout, whereas being able to maintain hope appears to be associated with health and well-being.
21039662	This study reviews the creation and testing of a model of Therapist Personal Agency during MFT training. A model including self-efficacy, trainee developmental level, supervisor working alliance, family of origin relationships, and psychological states was supported by data collected from a national sample of MFT students. The model supported by the data was consistent with much of the previous research regarding the correlates of therapist self-efficacy. Furthermore, the model accounted for 20% of the variance in therapist performance as measured by therapist reports of the working alliance. The results also highlighted the importance of attending to the relationships, interactions, and experiences that take place within the training environment and secondly, the added value that may accrue from focusing on the trainee's extended network of family relationships. A brief case example serves to illustrate the importance of tending to Therapist Personal Agency. In sum, this study provides preliminary support for holistic training methods that focus upon the whole person of the therapist.
20980233	While more research is emerging on women's capacity for successful resistance and the benefits of self-defense training for women, "resistance" to the idea of women's resistance remains high. In this note, I describe the importance of bringing true accounts of successful resistance to both academic and lay communities, and the benefits to women of recounting their own experiences of successful resistance to violence and harassment. Such accounts provide new scripts for women's options in responding to violence, mark attempted but thwarted rape as a visible event, and remind women of their own agency in the face of assault.
20976662	An association of professions, administrations and facilities as well as expert and self-help associations involved in rehabilitation, the German Association for Rehabilitation, DVfR has for several years been dealing intensively with the issue of technical aids provision in Germany. For many people with health problems, technical aids and assistive devices are an indispensable prerequisite for their equal participation in society. In light of the issue's considerable relevance for people with disabilities, the German Association had already in 2006 presented an expert opinion on the current status of technical aids provision, pointing out a number of quality problems in various fields. In the paper now presented, options are set out for overcoming these problems. Initially, fundamentals of technical aids provision are pointed out; apart from an overview of technical aids, this comprises conceptual and legal aspects of provision and, above all, issues involved in assessment of need and in quality including economical aspects. In the main section, suggestions are set out for optimizing the provision of technical aids, first in relation to the basic information processes of provision, followed by suggestions for improvements in the fields of professional education as well as further and continued education, including improvements in research. Another important section refers to suggestions for optimizing assessment of need, indication and prescription. Subsequently, the decision-making processes of the financially responsible agencies are dealt with as well as the process of clarifying which agency is in charge. The following sections deal with production and adaptation processes, outcome quality, as well as further development of the framework conditions at hand. Concluding annexes refer to legal issues in respect of the participation focus of technical aids provision and to considerations to be heeded in elaborating a provision concept.
20960357	Responsibility for the practise of (un)safe sex, for taking or not taking risks in relation to HIV transmission and for the negotiation of (safe) sex have been concerns in HIV-prevention research for a long time. This paper presents the findings of a discourse analysis of interview texts collected as part of the Three or More Study. We examine what, in the discourse examined, constrains and enables 'response-ability' - the capacity to respond to others and one's self in light of the complex contingencies that operate to enliven sexual contexts. We identify three key aspects of these sexual contexts that impact on response-ability: that there is an absence of 'explicit' (verbally communicated) negotiation and the presence of action-perception links, which are understood as forms of negotiation; that some sexual contexts appear to involve the passivity of participants to the sexual event, interaction or to other men, but that there is agency in and as part of this passivity; and that there exists a social obligation to being individually responsible for sexual decision making, including the taking of risks.
20950159	To examine the interactive effects of exercise identity (EI) and outcome expectations (OE) on constraints, constraint self-regulation, and leisure-time physical activity (LTPA).Surveyed a convenience sample of middle-aged and older adults (N = 271) at a metropolitan park agency in the Midwest.	The final reduced model predicted 24% of the variance in LTPA, including an indirect effect of EI x OE through intrapersonal constraints.	Results suggest that these social cognitive factors are useful in understanding low to high-intensity LTPA and have implications for LTPA programs for adults aged 50 and older.	
20937673	Evaluation of the Stepping Stones human immunodeficiency virus (HIV) prevention programme in South Africa showed sustained reduction in men and women's herpes simplex type 2 virus incidence and male violence, but no impact on HIV in women. Companion qualitative research was undertaken to explore how participants made meaning from the programme and how it influenced their lives. In-depth interviews were conducted with 10 men and 11 women before the intervention (one to three interviews per person). Then 9-12 months later, 18 follow-up interviews and 4 focus groups were held. Stepping Stones empowered participants and engendered self-reflection, in a process circumscribed by social and cultural context. Participants generally sought to be 'better', rather than 'different', men and women. Men shaped a more benign patriarchy, i.e. less violent and anti-social, and sought to avoid potential risks, ranging from imprisonment, witchcraft to HIV. While some women showed greater assertiveness and some agency in HIV risk reduction, most challenged neither their male partners nor the existing cultural norms of conservative femininities. This may explain the lack of impact of the intervention on HIV in women, since they lacked the power to embrace a greater feminist consciousness. Stepping Stones might be more effective for women when combined with other structural interventions.
20884681	Several UK resources, including the National Institute for Health and Clinical Excellence (NICE), Clinical Knowledge Summaries, the Infection Specialist Library, the HPA Management of Infection Guide, the Map of Medicine and the Royal College of General Practitioners (RCGP) web site, produce primary care antibiotic prescribing guidance. A BSAC 2009 workshop aimed to discuss how guidance could be best translated into practice using public and professional educational programmes. Workshop participants were asked to consider approaches within the context of a behaviour change model, in which readiness to change is recognized as a product of the individual's perception of the importance of change (the 'why' of change; 'Why should I change my antibiotic prescribing') and their confidence that they can achieve a change (the 'how' of change). Participants concluded that antibiotic education campaigns should be repeated during peak prescribing periods, should be located in pharmacies, clinical waiting areas and schools, and should be reinforced verbally during patient consultations for infections. Patients should receive clear information, ideally reinforced with leaflets, about the likely duration of symptoms, self-care and the likely benefits and harms of antibiotics. Education for clinicians needs to focus on increasing awareness of the importance of antibiotic resistance and providing tools to increase confidence in changing their prescribing. Videos are a useful tool for demonstrating good and poor communication skills and approaches to eliciting and addressing patient concerns and expectations. Well-designed patient information can facilitate consultations. Feedback and audit on antibiotic use to clinicians is essential; this can be facilitated by incentive schemes, especially if clinical records link diagnosis with prescriptions.
20879193	This essay seeks to contribute to work on moral agency of religious women through the creative naming of a dynamic that is emerging in recent scholarship. Drawing on fieldwork in Iran in 2004, I argue that prominent models of agency based on autonomy, heteronomy, and theonomy are unable take into account both religious influence on and individual creativity of women's actions. I propose the neologism, "dianomy," meaning dual-sources of the moral law, to account for moral agency that relies neither exclusively upon the self as a source of moral authority nor exclusively upon religious traditions. Dianomy also attempts to comprehend creative ruptures in obedience to tradition, even when these innovations are unintentional. Such a concept is particularly important in order to correct past tendencies to ignore or even negate feminist politics that do not resist or strategically reform religious norms. With dianomy, tactical moves, actions that are not "freely chosen," and even happy accidents can be studied as productive within traditional religious communities. I call these types of actions, which confound the actions theorized by autonomy, heteronomy, and theonomy, "creative conformity."
20875750	Over the past several years, the study of self-related cognition has garnered increasing interest amongst psychologists and cognitive neuroscientists. Concomitantly, lesion and neuroimaging studies have demonstrated the importance of intact cortico-cortical and cortico-subcortical connections for supporting high-level cognitive functions. Commissurotomy or "split-brain" patients provide unique insights into the role of the cerebral commissures in maintaining an individual's sense of self, as well as into the unique self-representation capabilities of each cerebral hemisphere. Here we review empirical work examining the integrity of self-related processes in patients with various disconnection syndromes, focusing on studies of self-recognition, ownership, and agency. Taken together, this body of work suggests that an intact corpus callosum enabling interhemispheric transfer is necessary for some, but not all types of self-representations.
20861912	Chronic myeloid leukemia (CML) has long served as a paradigm for generating new insights into the cellular origin, pathogenesis and improved approaches to treating many types of human cancer. Early studies of the cellular phenotypes and genotypes represented in leukemic populations obtained from CML patients established the concept of an evolving clonal disorder originating in and initially sustained by a rare, multipotent, self-maintaining hematopoietic stem cell (HSC). More recent investigations continue to support this model, while also revealing new insights into the cellular and molecular mechanisms that explain how knowledge of CML stem cells and their early differentiating progeny can predict the differing and variable features of chronic phase and blast crisis. In particular, these emphasize the need for new agents that effectively and specifically target CML stem cells to produce non-toxic, but curative therapies that do not require lifelong treatments.
20849240	The psychoanalytic view of adolescence as a phase of turbulence and reorganization occupied a central position in child and adolescent psychiatry until about 1980. The view of adolescence as a silent-transition phase then prevailed and diverged from the psychoanalytic perspective. This article reviews infant and adolescent development using an interdisciplinary, neuro-psychoanalytic model in which psychoanalytic, neurobiological, and developmental perspectives converge and complement each other. Recent empirical research focuses attention on adolescence as a phase in which a far-reaching neurobiological and psychological reorganization takes place. According to the ontogenetic principle of psychoanalysis, the development and organization of the basic psychic functions occur in the first five years of life, while a reorganization takes place in adolescence. Neurobiological research confirms that the basic growth and maturation of the brain occurs in the first five years of life, and that a substantial reorganization in brain development transpires in adolescence. Research also verifies the clinical psychoanalytic concept that neurobiological and psychological maturation in adolescence remain unfinished till approximately age 23. The long-term and late biopsychosocial maturation in adolescence implies that adequate monitoring by parents and school remains necessary. The view that adolescents need to separate, and discover their individuality and independence alone, is unsupported by recent findings. The adolescent must acquire his independence, personal identity, and self-agency ("scaffolding") step by step. It is important that the adolescent knows that his parents are in the background monitoring and intervening as necessary; that he is not entirely alone, adrift and at risk for potential fragmentation. The long-term plasticity of the brain in adolescence implies greater vulnerability for the development of psychopathology, but offers opportunity for psychotherapeutic interventions to have greater impact.
20841343	This study aimed to extend Lee and Hobson's (1998) findings regarding self-conceptualisation in autism by using a more verbally able sample. The study also investigated the ability to conceptualise self through other. Sixteen typically developing and sixteen adolescents with ASD matched for chronological and verbal mental age were administered a modified version of Damon and Hart's (1988) self-as-subject interview, which also required participants to conceptualise themselves from another's perspective. Self-conceptualisation ability was similar between groups across the categories of distinctiveness and continuity, but reduced in the ASD group under the category of agency. Participants with ASD were, however, less able to conceptualise themselves from another's perspective. These results are discussed in relation to second-person processes and narrative abilities.
20833565	I compare Frith and colleagues' influential comparator account of how the sense of agency is elicited to the multifactorial weighting model advocated by Synofzik and colleagues. I defend the comparator model from the common objection that the actual sensory consequences of action are not needed to elicit the sense of agency. I examine the comparator model's ability to explain the performance of healthy subjects and those suffering from delusions of alien control on various self-attribution tasks. It transpires that the comparator model needs case-by-case adjustment to deal with problematic data. In response to this, the multifactorial weighting model of Synofzik and colleagues is introduced. Although this model is incomplete, it is more naturally constrained by the cases that are problematic for the comparator model. However, this model may be untestable. I conclude that currently the comparator model approach has stronger support than the multifactorial weighting model approach.
20830644	A primary aspect of the self is the sense of agency – the sense that one is causing an action. In the spirit of recent reductionistic approaches to other complex, multifaceted phenomena (e.g., working memory; cf. Johnson &Johnson, 2009), we attempt to unravel the sense of agency by investigating its most basic components, without invoking high-level conceptual or 'central executive' processes. After considering the high-level components of agency, we examine the cognitive and neural underpinnings of its low-level components, which include basic consciousness and subjective urges (e.g., the urge to breathe when holding one's breath). Regarding urges, a quantitative review revealed that certain inter-representational dynamics (conflicts between action plans, as when holding one's breath) reliably engender fundamental aspects both of the phenomenology of agency and of 'something countering the will of the self'. The neural correlates of such dynamics, for both primordial urges (e.g., air hunger) and urges elicited in laboratory interference tasks, are entertained. In addition, we discuss the implications of this unique perspective for the study of disorders involving agency.


20680857	In the context of rolling out antiretroviral treatment programmes in resource-constrained settings, "expert patients" are hailed as an important step towards greater involvement of people living with HIV (PLHIV) in HIV care, and in addressing the human resources crisis. The rise of the "expert patient" in HIV care partly echoes the move towards greater patient agency and self-management that informs health services delivery in industrialised countries. However, the "expert patient" also represents a particular moment in the trajectory of PLHIVs' quest for greater access to treatment and health care. In this paper, we examine the unique evolution and 'instrumentalisation' of PLHIV in public health in relation to shifts in the epidemiology, interventions and socio-political response related to HIV since the 1980s. Synthesised broadly as "risk-based", "empowerment", "structural" and "activist" approaches, four key paradigms are identified that attribute different levels of citizenship for PLHIV, that is the motivation, agency and responsibility to act not only on their own interests, but also on behalf of collective interests in HIV prevention and care. We problematise the concept of the patient-citizen by drawing attention to the context-specificity of such notions as patient identity, capacity and rights as well as the structural realities of access to treatment, and broader engagement with the health system. We conclude by offering some thoughts on the applicability of 'expert patient' approaches across a broad range of settings.
20683331	This review covers recent books and articles on the perennial problem of how mind and brain work together to produce psychiatric symptoms.Discussed in this article are research on predictors of anxiety disorders, evidence relating to agency and sense of self-ownership, the extended mind hypothesis, and brain differences in genders of moral sensitivity.	Advances in brain sciences continue, but psychiatry would do well to work with philosophers in the field of philosophy of mind.	
20671301	The purpose of this qualitative research study was to describe how students in an accelerated master's degree entry program experientially learned the practice of nursing. One research question examined in this study was: What formative experiences did students identify as helping them develop and differentiate their clinical practice? Data from clinical observations and a combination of small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Students identified formative skills learned through the independent care of a patient as pivotal in their identity and agency development. By experiencing the responsibility and action from within the body and from within concrete situations, students developed a new understanding that changed their embodied ways of perceiving and orienting to the situation, as well as their skills and sense of agency.

20635249	To date, studies on psychosocial determinants of condom use among adolescents in Africa have mainly focused on more literate urban youth. In this study, we investigated the psychosocial determinants of condom use among low-literate females in rural Ethiopia. Moreover, some controversy exists on the role of perceived vulnerability to HIV infection to promote HIV preventive behavior in Africa, which we also tried to clarify in this study. In this study, 200 rural females participated, aged 13-24, from the Amhara Highland in Ethiopia. Using data collectors who interviewed the low-literate females with a structured questionnaire, we assessed perceived vulnerability to HIV infection, response efficacy of condom use, self-efficacy, attitude to condom use, and subjective norm to condom use. Moreover, we assessed intended and actual condom use. Compared to non-users of condoms, users of condoms scored significantly higher on all psychosocial determinants. Regression analysis indicated that vulnerability, condom attitude, and self-efficacy were significantly related to intended condom use. Attitude, vulnerability, and response-efficacy were significantly related to actual condom use. Among low-literate females in rural Ethiopia, psychosocial determinants were strongly related to intended and actual condom use, which indicates the usability of psychosocial models of condom use among low-literate females.
20626539	Self-care agency is a fundamental concept in nursing and health care research. Having self-care agency enhances an individual's health-promoting behaviours and/or specific capabilities for chronic disease self-management. The purpose of this study was to continue the development and psychometric testing of the Appraisal of Self-Care Agency - Revised (ASAS-R).A cross-sectional methodological design was used to examine the reliability, validity and factor structure of the ASAS-R among individuals from the general population. The sample consisted of 629 adults who were randomly selected to conduct an exploratory factor analysis (EFA; n=240) and a confirmatory factor analysis (CFA; n=389) of the scale. A demographic questionnaire, the ASAS-R and the Health-Promoting Lifestyle Profile (HPLP-II) were the measures used to collect the data.	The final 15-item three-factor ASAS-R had an overall Cronbach's alpha (α) of 0.89. The three factors extracted, rotated and scored in this study were labelled: having power for self-care, developing power for self-care and lacking power for self-care. All inter-items and item-to-total correlations met recommended criteria of r=0.30 to r=0.70, except for one of the items that had an item-to-total correlation of 0.71, slightly exceeding the maximum recommended item-to-total correlation. The three factors had Cronbach's alphas of 0.86, 0.83 and 0.79, respectively. The three factors together explained 61.7% of the scale items variance. Each item of the scale had a strong factor loading ranging from 0.52 to 0.81. All measures of model fit exceeded the recommended criteria, indicating that the 15-item ASAS-R had a very good fit (χ(2) /d.f.=1.97, GFI=0.94, AGFI=0.92, CFI=0.96, TLI=0.95, RMSEA=0.05, RMR=0.05 and the PCLOSE=0.48).	The 15-item three-factor ASAS-R is a short, reliable and valid instrument to measure self-care agency among individuals from the general population, but further psychometric evaluation is needed among individuals with chronic diseases, especially those with diabetes mellitus.	
20615175	Antibody formation is an intended physiological reaction to a "non-self" protein intentionally triggered in the case of vaccines. However, an unwanted immune response to a therapeutic protein may lead to a loss of efficacy and/or to severe side effects. The Committee for Medicinal Products for Human Use (CHMP) at the European Medicines Agency (EMA) issued a multidisciplinary guideline providing general recommendations from a marketing authorisation perspective on how to systematically assess an unwanted immune response following the administration of a biological drug. In this article, we discuss key aspects of this guideline and its concept, with a particular focus on the impact of immunogenicity on benefit/risk estimation of a therapeutic protein.
26162188	The study of culture and self casts psychology's understanding of the self, identity, or agency as central to the analysis and interpretation of behavior and demonstrates that cultures and selves define and build upon each other in an ongoing cycle of mutual constitution. In a selective review of theoretical and empirical work, we define self and what the self does, define culture and how it constitutes the self (and vice versa), define independence and interdependence and determine how they shape psychological functioning, and examine the continuing challenges and controversies in the study of culture and self. We propose that a self is the "me" at the center of experience-a continually developing sense of awareness and agency that guides actions and takes shape as the individual, both brain and body, becomes attuned to various environments. Selves incorporate the patterning of their various environments and thus confer particular and culture-specific form and function to the psychological processes they organize (e.g., attention, perception, cognition, emotion, motivation, interpersonal relationship, group). In turn, as selves engage with their sociocultural contexts, they reinforce and sometimes change the ideas, practices, and institutions of these environments. 
20574827	Intervention effectiveness research requires that investigators include "real world" variables in the design of studies to develop an understanding of how interventions perform in the "real world." Two areas that have been neglected in effectiveness research on mental health case management are mental illness self-stigma and the effects of different case managers. Self-stigma is a reality for many consumers that negatively impacts their lives. Case managers, themselves, are a potential source of autocorrelation and likely provide services differently. This study explores the relationship between self-stigma and quality of life for consumers receiving services from different case managers. Cross-sectional data were collected from 160 consumers of an urban case management agency. Self-stigma was negatively associated with quality of life. Case managers did not account for a significant amount of variance in quality of life scores. However, the interaction between case manager and self-stigma was significant. Some case managers were able to mitigate the negative effects of self-stigma on quality of life. Future effectiveness research in community mental health case management needs to account for the effects of self-stigma, case managers, and the interaction between the two in the research design.
20515228	Previous cross-cultural comparisons of correlations between positive and negative emotions found that East Asians are more likely than Americans to feel dialectical emotions. However, not much is known about the co-occurrence of positive and negative emotions in a given situation. When asked to describe situations in which they felt mixed emotions, Japanese and American respondents listed mostly similar situations. By presenting these situations to another group of respondents, we found that Japanese reported more mixed emotions than Americans in the predominantly pleasant situations, whereas there were no cultural differences in mixed emotions in the predominantly unpleasant situations or the mixed situations. The appraisal of self-agency mediated cultural differences in mixed emotions in the predominantly pleasant situations. Study 2 replicated the findings by asking participants to recall how they felt in their past pleasant, unpleasant, and mixed situations. The findings suggest that both Americans and Japanese feel mixed emotions, but the kinds of situation in which they typically do so depends on culture.
20512380	Normally, we are aware that our arms and legs belong to us and not to someone else. However, some stroke patients with hemiparesis/-plegia after right-sided stroke show a disturbed sensation of limb ownership and a disturbed self-awareness of actions and such patients with anosognosia for hemiparesis/plegia typically deny their paresis/-plegia and are convinced that their limbs function normally. They may experience their limb(s) as not belonging to them and may even attribute them to other persons. Modern lesion analyses techniques in such patients and recent neuroimaging results in healthy subjects suggest a prominent role of the right insula for our sense of limb ownership as well as for our feeling of being involved in a movement-our sense of agency. We thus hypothesize that the right insular cortex constitutes a central node of a network involved in human body scheme representation.
20510255	The exact relation between the sense that one's body is one's own (body-ownership) and the sense that one controls one's own bodily actions (agency) has been the focus of much speculation, but remains unclear. On an 'additive' model, agency and body-ownership are strongly related; the ability to control actions is a powerful cue to body-ownership. This view implies a component common to the senses of body-ownership and agency, plus possible additional components unique to agency. An alternative 'independence' model holds that agency and body-ownership are qualitatively different experiences, triggered by different inputs, and recruiting distinct brain networks. We tested these two specific models by investigating the sensory and motor aspects of body-representation in the brain using fMRI. Activations in midline cortical structures were associated with a sensory-driven sense of body-ownership, and were absent in agency conditions. Activity in the pre-SMA was linked to the sense of agency, but distinct from the sense of body-ownership. No shared activations that would support the additive model were found. The results support the independence model. Body-ownership involves a psychophysiological baseline, linked to activation of the brain's default mode network. Agency is linked to premotor and parietal areas involved in generating motor intentions and subsequent action monitoring.
20455078	It has become axiomatic that assessment impacts powerfully on student learning, but there is a surprising dearth of research on how. This study explored the mechanism of impact of summative assessment on the process of learning of theory in higher education. Individual, in-depth interviews were conducted with medical students and analyzed qualitatively. The impact of assessment on learning was mediated through various determinants of action. Respondents' learning behaviour was influenced by: appraising the impact of assessment; appraising their learning response; their perceptions of agency; and contextual factors. This study adds to scant extant evidence and proposes a mechanism to explain this impact. It should help enhance the use of assessment as a tool to augment learning.
20428979	How can human agency be reconciled with bio-physical determinism? Starting with a discussion of the long standing debate between determinism and agency, we argue that the seeds of a reconciliation can be found in George Herbert Mead's ideas concerning social acts, perspectives, differentiation, self-other interactivity, and conscious understanding. Drawing on more recent reformulations of Mead's ideas, we present an integrated account of the ontogenesis of human agency. Human agency, we argue, should be conceptualized in terms of distanciation from immediate experience, and we show how social interactions, institutions and symbolic resources foster the development of agency in increasingly complex ways. We conclude by situating our work in relation to other developmental accounts and the larger project of theorizing and empirically supporting a compatibilist rendering of human agency as the "determined" self-determination of persons.
20415964	This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale - a 'Good Samaritan' story - which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times.
20404623	This investigation was a secondary analysis of focus group transcripts to address the question of how women with low vision or blindness have experienced healthcare.Secondary analysis of qualitative data was performed on transcripts from 2 focus groups.	These focus groups were conducted at an agency serving visually impaired people in Philadelphia.	The 2 focus groups included 7 and 11 women, respectively, having low-vision or who are blind who had been part of an original study of reaching hard-to-reach women with disabilities.	Content analysis for the identification of thematic clusters was performed on transcriptions of the focus group data.	Findings are consistent with existing research on the health needs of women with disabilities but add specific understanding related to visual impairment. Six thematic categories were identified: health professionals' awareness, information access, healthcare access, isolation, the need for self-advocacy, and perception by others.	Secondary analysis of qualitative data affords in-depth understanding of a particular subset of participants within a larger study. Clinical nurse specialists and other health professionals need to increase their sensitivity to the challenges faced by women with visual impairment, and plan and provide care accordingly. Health professions students need to be prepared to interact with people who are visually impaired and healthcare settings need to respond to their needs.	
20378581	Self-agency (SA) is the individual's perception that an action is the consequence of his/her own intention. The neural networks underlying SA are not well understood. We carried out a novel, ecologically valid, virtual-reality experiment using blood oxygen level-dependent functional magnetic resonance imaging (fMRI) where SA could be modulated in real-time while subjects performed voluntary finger movements. Behavioral testing was also performed to assess the explicit judgment of SA. Twenty healthy volunteers completed the experiment. Results of the behavioral testing demonstrated paradigm validity along with the identification of a bias that led subjects to over- or underestimate the amount of control they had. The fMRI experiment identified 2 discrete networks. These leading and lagging networks likely represent a spatial and temporal flow of information, with the leading network serving the role of mismatch detection and the lagging network receiving this information and mediating its elevation to conscious awareness, giving rise to SA.
20372083	An intradermal trivalent inactivated influenza vaccine administered using a microinjection system has received European marketing authorization from the European Medicine Agency. We assessed clinical trial subjects' perception of injection site reactions (ISRs) and whether ISRs affected overall acceptability of vaccination and willingness to be vaccinated in the future. A validated, self-administered, patient reported outcome questionnaire was completed 21 days after intradermal or intramuscular vaccination by elderly and non-elderly adult participants in two European randomized, controlled, open-label phase 3 trials. The questionnaire addressed: the acceptability of ISRs, effect of ISRs on arm movement or sleep, satisfaction with the injection system, and willingness to be revaccinated. Questions were answered using a 5-point Likert verbal rating scale (1 = most favourable, 5 = most unfavourable response). Mean scores were calculated per group. 5,305 questionnaires were completed and analysed (95% return rate). Mean scores were close to 1 in all cases (maximum 1.68), indicating an overall favourable opinion of the vaccination and ISRs. More than 96% of participants rated ISRs after intradermal or intramuscular vaccination as either 'totally acceptable' or 'very acceptable'. Willingness to get vaccinated the following year and satisfaction with the intradermal microinjection system or the conventional intramuscular syringe were high and were not adversely affected by ISRs. ISRs after intradermal influenza vaccine administered using a microinjection system are well accepted by the vaccinees and are generally not a cause for concern.
20356626	This study aims to evaluate the effectiveness of a parent training program in improving parenting practices, parents' feeling of self-efficacy and parents' perception of their child's behavior, implemented in a child protection service, with trained professionals from the agency acting as facilitators.Thirty-five parents monitored in a child protection service for child neglecting behaviors participated either in the intervention group (n=26) or were on the waiting list (n=9). The program implemented (Incredible Years) lasted 16 weeks, was in a group format, and aimed: (1) to develop a harmonious parent-child relationship; (2) to support parents in learning and consistently applying effective practices; (3) to improve problem solving and communication skills within families and with teachers. A repeated measures design was used to test the program's effects on parenting practices, parents' feeling of self-efficacy, parents' perception of their child's behavior, and parents' satisfaction. Parents were tested twice, during a 19-week interval, before and after the parent training program.	Analyses of variance comparing Intervention and Control groups with repeated measures (pre- and post-test measures) revealed that the program has a positive impact on parenting practices (harsh discipline, physical punishment, praise/incentive, appropriate discipline and positive verbal discipline) and parents' perception of their child's behavior (frequency of behavioral problems and number of problematic behaviors). No change on clear expectations from parents, or on parents' self-efficacy was observed.	Though the implementation of an evidence-based parent training program by professionals in a child protection service presents specific challenges, results suggest that it can contribute to improvements in parenting practices and in parents' perception of their child's behavior.	
20347269	It has been recently argued that recovery from schizophrenia may involve the recapturing or developing one's personal narrative. Unknown is whether the fullness of the narrative accounts of persons with schizophrenia form about their lives is indeed uniquely linked to wellness in daily life, that is, independent of other factors including symptoms, hope, self-esteem and general intellectual functioning. To explore this issue the current study correlated assessments of personal narratives using the Scale to Assess Narrative Development with the Quality of Life Scale for 103 adults with schizophrenia spectrum disorders. General assessments of personal narrative were associated with the quality and quantity of social relationships, even after controlling for positive and negative symptoms, self report of hope and self-esteem and a test of general intellectual function. The domains of social connectedness within narratives were most closely linked with frequency of social relationships and the domains of Agency and Social Worth were mostly closely linked with quality of social relationships after the effects of symptoms, hope, self-esteem and general intellectual function were accounted for statistically.
20346183	Within the working population there is a vulnerable group: workers without an employment contract and workers with a flexible labour market arrangement, e.g. temporary agency workers. In most cases, when sick-listed, these workers have no workplace/employer to return to. Also, for these workers access to occupational health care is limited or even absent in many countries. For this vulnerable working population there is a need for tailor-made occupational health care, including the presence of an actual return-to-work perspective. Therefore, a participatory return-to-work program has been developed based on a successful return-to-work intervention for workers, sick-listed due to low back pain.The objective of this paper is to describe the design of a randomised controlled trial to study the (cost-)effectiveness of this newly developed participatory return-to-work program adapted for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders, compared to usual care.The design of this study is a randomised controlled trial with one year of follow-up. The study population consists of temporary agency workers and unemployed workers sick-listed between 2 and 8 weeks due to musculoskeletal disorders. The new return-to-work program is a stepwise program aimed at making a consensus-based return-to-work implementation plan with the possibility of a (therapeutic) workplace to return-to-work. Outcomes are measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure is duration of the sickness benefit period after the first day of reporting sick. Secondary outcome measures are: time until first return-to-work, total number of days of sickness benefit during follow-up; functional status; intensity of musculoskeletal pain; pain coping; and attitude, social influence and self-efficacy determinants. Cost-benefit is evaluated from an insurer's perspective. A process evaluation is part of this study.	For sick-listed workers without an employment contract there can be gained a lot by improving occupational health care, including return-to-work guidance, and by minimising the 'labour market handicap' by creating a return-to-work perspective. In addition, reduction of sickness absence and work disability, i.e. a reduction of disability claims, may result in substantial benefits for the Dutch Social Security System.		NTR1047.	
20336569	Research on body image and older women has grown in the past decade. However, there is a gap in the literature regarding body image, older women, and countertransference. This article provides 7 case examples of racially and ethnically diverse women over 60, drawn from MSW student and agency staff supervision, and participant feedback from a national conference on aging workshop. Themes related to loss and grief, adult daughter and aging mother issues, incest, anger, disability, personality disorders, phobic reactions, and shame are discussed. Recommendations and implications for social work practice, education and research are provided.
20232253	In this article, I focus on possibly impaired self-determination in addiction. After some methodological reflections, I introduce a phenomenological description of the experience of being self-determined. I argue that being self-determined implies effectivity of agency regarding three different behavioural domains. Such self-referential agency shall be called 'self-effectivity' in this article. In a second step, I will use this phenomenological description to understand the impairments of self-determination in addiction. While addiction does not necessarily imply a basic lack of control over one's life, this can well be the case during certain periods of time or in special situations. Addiction is herein described as an embodied custom-highly effective with respect to changing one's lived experience-which is learned and developed while becoming addicted. Such a repeatedly performed custom, called a 'psychotropic technique', implies deep changes in one's personal identity and alters an agent's 'self-effectivity'. In the closing section, I discuss the possible implications of a phenomenological approach to personal responsibility.
20181501	Research on self-agency emphasizes the importance of a comparing mechanism, which scans for a match between anticipated and actual outcomes, in the subjective experience of doing. This study explored the "feeling of doing" in individuals with checking symptoms by examining the mechanism involved in the experienced agency for outcomes that matched expectations. This mechanism was explored using a task in which the subliminal priming of potential action-effects (emulating outcome anticipation) generally enhances people's feeling of causing these effects when they occur, due to the unconscious perception of a match between primed and observed outcomes. The main result revealed a negative relationship between checking and self-agency for observed outcomes that were primed prior to actions. This suggests that checking individuals fail to grasp the correspondence between actual outcomes of their actions and expected ones. We discuss the possible role of undermined self-agency in checking phenomena and its relationship with cognitive dysfunction.
20154295	In this article we examine the discourse of four focus groups we conducted at a pediatric research hospital in which we queried teenage patients, parents, nurses, and physicians about their perceptions of the informed consent process in research. Autonomy, as the goal of informed consent, is a murky concept, with some ethicists questioning the possibility that it can ever be attained. We argue that it might be more productive to consider agency, which we define as language and action that are constructed, negotiated, and maintained through effective communication. Our goal was to understand how individuals rhetorically constructed agency in discussions of informed consent experiences. After transcribing and coding the focus group interviews, we identified six aspects of agency in participants' discourse: (a) defining roles, (b) seeking information, (c) providing information, (d) supporting others, (e) making decisions, and (f) claiming agency for self. Examining these aspects of agency indicated that efforts to improve the informed consent process must address: (a) status differentials, (b) role definitions, (c) information flow, and (d) relationships.
20144893	An important principle of human ethics is that individuals are not responsible for actions performed when unconscious. Recent research found that the generation of an action and the building of a conscious experience of that action (agency) are distinct processes and crucial mechanisms for self-consciousness. Yet, previous agency studies have focussed on actions of a finger or hand. Here, we investigate how agents consciously monitor actions of the entire body in space during locomotion. This was motivated by previous work revealing that (1) a fundamental aspect of self-consciousness concerns a single and coherent representation of the entire spatially situated body and (2) clinical instances of human behaviour without consciousness occur in rare neurological conditions such as sleepwalking or epileptic nocturnal wandering. Merging techniques from virtual reality, full-body tracking, and cognitive science of conscious action monitoring, we report experimental data about consciousness during locomotion in healthy participants. We find that agents consciously monitor the location of their entire body and its locomotion only with low precision and report that while precision remains low it can be systematically modulated in several experimental conditions. This shows that conscious action monitoring in locomoting agents can be studied in a fine-grained manner. We argue that the study of the mechanisms of agency for a person's full body may help to refine our scientific criteria of self-hood and discuss sleepwalking and related conditions as alterations in neural systems encoding motor awareness in walking humans.
20139291	Ageing of the population will result in unprecedented numbers of older adults living with age-related vision loss (ARVL). Self-management models improve health outcomes and reduce healthcare costs; however, the principles have rarely been applied in low vision services.A two-armed randomised controlled trial of older adults (n=77) with ARVL compared 'usual care' provided by a not-for-profit community agency with an extended model of care (usual care+self-management group intervention). The primary outcome variable (participation in life situations) was measured using the Activity Card Sort. Secondary outcome measures examined general health and vision-specific domains.	The intention-to-treat analysis demonstrated that the extended model produced significantly better participation in life situations at post-test when compared with the usual care only group. Gains were made regardless of whether participants were, or were not, depressed at baseline. The addition of the self-management group was also successful in significantly reducing depression, increasing physical and mental health, generalised and domain-specific self-efficacy, and adjustment to ARVL. With the exception of adjustment and mental health, differences were still apparent at 12 weeks' follow-up.	Addition of self-management significantly improved general health and vision-specific rehabilitation outcomes for older adults with ARVL.	
20122852	Voluntary actions and their distal effects are intimately related in conscious awareness. When an expected effect follows a voluntary action, the experience of the interval between these events is compressed in time, a phenomenon known as 'intentional binding' (IB). Current accounts of IB suggest that it serves to reinforce associations between our goals and our intention to attain these goals via action, and that IB only occurs for self-generated (i.e., intentional) actions. We used a novel approach to study IB in the context of shared intentions and actions. Pairs of participants judged the time of occurrence of actions and events attributed either to oneself or to another agent. We found that IB and subjective agency are not mutually predictive when an action can be attributed to only one of two 'co-intending' agents. Our results pose a complication for the prevailing view that IB and subjective agency reflect a common mechanism.
20122851	We studied how people attribute action outcomes to their own actions under conditions of uncertainty. Participants chose between left and right keypresses to produce an action effect (a corresponding left or right light), while a computer player made a simultaneous keypress decision. In each trial, a random generator determined which of the players controlled the action effect at varying probabilities, and participants then judged which player had produced it. Participants' effect control ranged from 20% to 80%, varied blockwise, and they could use trial-by-trial feedback to optimize the accuracy of their agency judgments. Participants tended to attribute action effects to themselves (agency bias), probably reflecting a rational guessing strategy of always naming the more likely player. However, participants systematically neglected information favoring the computer player as the agent, even under conditions where this bias could only harm judgment accuracy. We conclude that agency biases have both rational and irrational components.
20112209	Parental competencies have influence on the professional health care needs of a child and its caregivers. One reason for this is the influence of parental competencies on the healthy development of the child. This applies especially to infants and young children. In order to develop their inborn abilities to regulate themselves and their behaviour, infants and young children are dependent on the perception of and appropriate response to their behaviour by the persons they are most closely attached to. The differentiation of self-regulating abilities is a precondition for a healthy development. The current rise of sleeping and feeding disorders, as well as interaction problems among infants and young children, indicates that parents are increasingly dependent on support in the perception and development of their parental competencies. Paediatric nurses can make an important contribution to this, where a concept of parental competencies, defined by nursing professionals, is available. The Theory of Dependent-Care and especially the concept of Dependent-Care Agency will be presented in this paper. It will be examined how they can provide a theoretical framework for the systematic assessment, support, and promotion of parental competencies by paediatric nurses. To conclude, issues for further investigation of parental Dependent-Care Agency and the necessity for a more detailed conceptualisation of the Theory of Dependent-Care will be demonstrated.
20109186	The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings.Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309). Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ). Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high.	Most of the scores related to dimensions, and the overall patient safety score (44%) were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%), and the lowest score belonged to the "frequency of events reported" (15%). The study revealed that more than three quarters of the physicians and nurses were not reporting errors.	The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey.	
20100895	This study gathered data by interviewing women who had left abusive relationships. Analysis of the discursive resources used by participants indicated that their constructions of the abusive situation were influenced by wider social and cultural discourses. Some of these maintained participants in their abusive relationships and gave rise to dilemmas that reduced their ability to deal with the situation. Other discourses promoted self-reliant ways of behaving. These helped participants to leave the abusive situation and encouraged a self-construction of personal strength and agency. The role of social discourses in how women deal with abuse and the implications of this are discussed.
20095444	A "sense of agency" involves a contemporaneous experience that the "self" causes the actions performed by the "self" (i.e., "I am the one who causes my actions"). This may comprise the main component of self-consciousness. The present research focuses on the development of a questionnaire to investigate the subjective aspects of a sense of agency. We selected items from the extant relevant measures and from previous empirical studies, and conducted four longitudinal surveys with additional scales. Statistical computations confirmed the validity and reliability of the Sense of Agency Scale (SOAS), consisting of seventeen items involving three factors. Furthermore, the results indicated that these three factors might be organized hierarchically, with each factor showing a unique relationship with emotional or social traits. This novel finding, emerging from the Sense of Agency Scale, would have been difficult to obtain via traditional empirical studies.
20083798	What makes a movement feel voluntary, and what might make it feel involuntary? Motor conversion disorders are characterized by movement symptoms without a neurologic cause. Conversion movements use normal voluntary motor pathways, but the symptoms are paradoxically experienced as involuntary, or lacking in self-agency. Self-agency is the experience that one is the cause of one's own actions. The matched comparison between the prediction of the action consequences (feed-forward signal) and actual sensory feedback is believed to give rise to self-agency and has been in part associated with the right inferior parietal cortex. Using fMRI, we assessed the correlates of self-agency during conversion tremor.We used a within-subject fMRI block design to compare brain activity during conversion tremor and during voluntary mimicked tremor in 8 patients.	The random effects group analysis showed that conversion tremor compared with voluntary tremor had right temporoparietal junction (TPJ) hypoactivity (p < 0.05 family-wise error whole brain corrected) and lower functional connectivity between the right TPJ, sensorimotor regions (sensorimotor cortices and cerebellar vermis), and limbic regions (ventral anterior cingulate and right ventral striatum).	The right TPJ has been implicated as a general comparator of internal predictions with actual events. We propose that the right TPJ hypoactivity and lower TPJ and sensorimotor cortex interactions may reflect the lack of an appropriate sensory prediction signal. The lack of a match for the proprioceptive feedback would lead to the perception that the conversion movement is not self-generated.	
20071196	Recent research suggests that one can have the feeling of being the cause of an action's outcome, even in the absence of a prior intention to act. That is, experienced self-agency over behavior increases when outcome representations are primed outside of awareness, prior to executing the action and observing the resulting outcome. Based on the notion that behavior can be represented at different levels, we propose that priming outcome representations is more likely to augment self-agency experiences when the primed representation corresponds with a person's behavior representation level. Three experiments, using different priming and self-agency tasks, both measuring and manipulating the level of behavior representation, confirmed this idea. Priming high level outcome representations enhanced experienced self-agency over behavior more strongly when behavior was represented at a higher level, rather than a lower level. Thus, priming effects on self-agency experiences critically depend on behavior representation level.
20068380	A considerable number of schizophrenic patients develop delusions of technical alien control. In such cases, patients experience their thoughts, movements and feelings to be controlled by mysterious machines and contemporary technologies such as computers, the internet, X-rays and lasers.In this paper, we describe 3 cases of patients with disorders of self-experience and schizophrenic delusions involving a controlling technical device. We also analyse case reports from historical and modern psychiatric literature which describe 'influencing machines' and similar phenomena.	Of the 3 patients analysed, all complained of being controlled and impaired by some form of contemporary technology. Moreover, the presented cases illustrate psychopathological phenomena such as self-centrality, loss of ego boundaries, subjectification of perception, 'paradoxes of delusions', morbid objectification and loss of the sense of agency.	Delusions of technical alien control and influencing machines constitute a characteristic form of delusional ideation in schizophrenic patients. They may be preceded by prodromal schizophrenic alterations such as disembodiment, alienation and reification of self-experience, depersonalization, derealization and bodily hallucinations. We propose that these prior experiences, especially if technically reifying in nature, may give rise to the phenomenon of technical delusions, thus expressing a particular affinity of basic self-experience in schizophrenia to modern technology. This is also consistent with the pathoplasticity hypothesis.	
20060103	Schizophrenia has been conceptualized as a disorder of integration of neural activity across distributed networks. However, the relationship between specific symptom dimensions and patterns of functional connectivity remains unclear. The current study aimed to investigate the relationship between auditory-verbal hallucinations (AVH), a particularly prevalent and clinically relevant symptom in schizophrenia, and functional connectivity of the temporo-parietal junction (TPJ).Resting state functional magnetic resonance imaging scans were obtained from 27 schizophrenia patients with AVH and 27 matched control subjects. We calculated correlations reflecting functional connectivity between a priori defined regions-of-interest and the bilateral TPJ seed regions, comprising the neural network involved in inner speech processes and AVH.	Compared with healthy control subjects, schizophrenia patients showed reduced functional connectivity between left TPJ and the right homotope of Broca. Within the patient group, more severe AVH were associated with reduced neural coupling between left TPJ and bilateral anterior cingulate as well as the bilateral amygdala.	In schizophrenia patients with chronic hallucinations, the left TPJ-a critical node in the speech perception/AVH network-shows reduced functional connectivity with brain areas involved in the attribution of agency, self-referent processing, and attentional control.	
20026225	Agency, a feeling that the self is the cause of action, has a strong relationship to the processing of discrepancies between the predicted multi-sensory feedback from one's intended action and its actual outcome (hereafter, agency error). Although previous studies have explored the neural basis of agency by assessing the brain's response to agency error, the effects found are confounded by two types of error irrelevant to agency: a mismatch between different sensory inputs in general (sensory mismatch, SM error) and a basic response to any type of prediction error (oddball error). In this functional magnetic resonance imaging study, we identified the neural response specific to agency error by dissociating it from responses to SM and oddball errors. Subjects played a game in which they controlled an on-screen character. Neural responses to rare events of violated control and congruency between types of audio-visual feedback were compared to dissociate agency from SM error. In a separate session, subjects viewed repetitive motions of the character, and neural responses to rare events of unpredictable change in movement were identified as related to oddball error. Agency-error-specific activation was observed in the supplementary motor area (SMA), left cerebellum, right posterior parietal cortex (PPC), and right extrastriate body area (EBA). Oddball errors also activated areas near the PPC and EBA peaks. SM errors activated the pre-SMA and the right posterior superior temporal sulcus. Our results suggest that the SMA, cerebellum, and some parts of the PPC and EBA serve as the neural bases of agency.
20012472	During anthropological fieldwork, the author had a serious accident on the outskirts of a Hmong village in the highland of Laos. However, this dramatic incident turned out to be the occasion of his ritual initiation into the local village community. An analysis of narratives of the incident reveals Hmong conceptions of the anthropologist's physical, mental and moral affliction, its causative concomitants and his ritual healing. Hmong mental health and identity are situated in a moral space of exchange relationships to significant others, challenging basic assumptions of concepts of the person widely held in psychiatry and beyond. The healing ritual transformed the author's being from indeterminate "other," in a life-threatening state of identity crisis, to a wholesome Hmong "self," in a state of health and moral agency. This exemplary rite de passage highlights the affinity of ritual healing and constitution of self in a moral space. The underlying relational concept of the person is in sharp contrast to psychiatry's concepts of the person, which are deeply shaped by values of individualism. Psychiatric services must accommodate substantial differences in the concepts of the person when treating Hmong migrants from Laos.
19963309	In an attempt to promote patient agency and foster more egalitarian relationships between patients and doctors, discourse concerning health and wellbeing in the UK has increasingly centred around the notion of informed and 'expert' patients who are able to effectively input into the direction and management of their own health care and treatment. While the relationship between a patient and their doctor can play a vital role in influencing the treatment decisions and health-related outcomes of people living with long term illness, little is known about the ways in which people living with HIV actually perceive their relationship with their doctors, nor the implications this may have for the types of treatment they may seek to use and the related information that they share. Drawing on 11 focus group discussions and 20 repeat interviews undertaken in 2008-2009 with HIV-positive adult migrants from Zambia, Zimbabwe and South Africa living in the UK, this paper argues that patient-doctor relationships can be heavily influenced by the perceived legitimacy of different forms of medical knowledge and treatments and by culturally influenced ideas regarding health, wellbeing and agency. Despite a desire amongst some migrants to use 'traditional' medicines from southern Africa as well as other non-biomedical treatments and therapies, the research found that the perceived lack of legitimacy associated with these treatments in the UK rendered their use a largely clandestine activity. At the same time, many patients made clear distinctions concerning issues affecting their immediate health and factors influencing their more general wellbeing, which in turn, impacted upon the information that they chose to share with, or conceal from, their doctors. Such findings challenge assumptions underpinning policy promoting patient agency and have significant and, in cases, potentially adverse implications for the safety and effective administration and management of HIV treatments in African migrant populations and possibly more generally.
19963291	The implementation of disease control programs on farms requires an act of behavioral change. This study presents a theoretical framework from behavioral science, combined with basic epidemiological principles to investigate and explain the control of zoonotic agents on cattle farms. A pathway to disease control model was adapted from existing models in behavioral science and human medicine. Field data was used to demonstrate the validity of the model to identify and explain motivational factors for implementation of disease control programs among English and Welsh cattle farmers. The field data consisted of interviews conducted with 43 farmers, which were analyzed to investigate the farmers' perception of responsibility for safe cattle produce as well as the intrinsic and extrinsic barriers that inhibited the implementation of a zoonotic control program on their farms. The model was used to illustrate barriers affecting the implementation process and to classify farmers according to their current level of zoonotic control at each stage within the model. Ordinal multivariable logistic regression was used to identify the motivators associated with different levels of implementation. Younger farmers and/or larger herds were more likely to place financial responsibility upon the industry rather than government and all but two farmers accepted a social responsibility for food safety within cattle production. In general, attitudes towards zoonotic control were positive, but approximately half the farmers showed no intent to control and were inhibited by non-supportive social norms and/or a lack of belief in self-efficacy. The remaining farmers showed intent to control, but had not implemented any structured control program due to external barriers including lack of knowledge and both cultural and economic pressure from society and industry. The farmers with no intent to adopt control measures identified their private veterinarian as the preferred motivator, whereas consumer-demand and financial rewards or penalties were significantly associated with farmers who intended to control.
19950867	The theoretical concept of self-socialization suggests that an individual is able to reflect on the self, formulate a vision of a future self, set goals, and take actions that create or alter the developmental trajectory. This case study of a parachute child illustrates how a person constructs her life from a very young age, drawing on a profound capacity for personal agency to overcome obstacles, identify resources, and internalize values to build a life structure. A model of the psychosocial process of self-socialization emerges from this case. Following the disruption of a well-defined trajectory, self-socialization is observed as a sequence of actions, reflection, correction, and new actions. Self-socialization is possible when a strong sense of self-efficacy is applied to attaining internalized values and goals.
19950483	Hand action can bias the perceived direction of ambiguously moving objects (Wohlschlager, 2000 Vision Research 40 925-930). A common coding framework has been proposed to account for action-perception interaction, assuming goal-based feature matching between action and perception [Prinz, 2003, in Agency and Self-Awareness (New York: Oxford University Press)]. I investigated whether and how movement representation and a distal action goal are implicated in biased motion perception using a stream-bounce display as stimulus. By moving a mouse, participants controlled the progression of disks, which were initially separated and then moved toward each other. Mouse movement was found to bias perception toward the stream when the directional motion of the mouse and disk were consistent; however, this biased perception was not observed when the directions were orthogonal. Subsequent experiments revealed that this induced stream percept could not be attributed to the processes of attention, and the action goal of disk control was critical to the occurrence of biased motion perception. These results suggest that feature matching occurs at the level of movement representation, and the action goal is important in linking movement representation to perceptual representation.
19943832	To test the hypothesis that, in older persons, sense of personal mastery, defined as the extent to which one regards one's life chance as being under one's own control, predicts change in lower extremity performance during a 6-year follow-up.Prospective cohort study.	Community based.	Six hundred twenty-six participants aged 65 and older.	Personal mastery was assessed at baseline using Pearlin's mastery scale. Lower extremity performance was measured at baseline and at 6-year follow-up using the Short Physical Performance Battery (SPPB) of lower extremity function.	Higher sense of mastery was associated with a significantly less-steep decline in lower extremity performance. Participants in the two lowest quartiles of personal mastery had, respectively, a 2.6 (95% confidence interval (CI)=1.4-5.1, P=.01) and 3.2 (95% CI=1.6-6.6, P=.002) higher risk of experiencing a substantial decline (> or =3 points) in SPPB scores after 6 years as those in the highest quartile.	Older individuals with poor sense of personal mastery are at high risk of accelerated lower extremity physical function decline. Whether interventions aimed at improving personal mastery may prevent disability remains unknown.	
19915270	Investigations have suggested that poor compliance could be an indicator of poor relationship with family and could be related to the person's personality traits.The aim of this study was to determine the effect of parents attitude, the anxiety during treatment and self-confidence/self-care of the patient on cooperation during orthodontic treatment.	The study material consisted of questionnaires completed by 82 adolescent patients and their parents. The patients were divided into two groups of 42 compliant and 40 non-compliant patients. The above-mentioned questionnaires were State-Trait Anxiety Inventory-STAI, Piers-Harris Children's Self Concept Scale and The Exercise of Self-Care Agency for the patients and Mc Master Family Assessment Device and Parental Attitude Research Instrument-PARI for the parents.	The problem solving and caring attitude of the father and his determinative role in the family had a positive influence on the compliance of the child. The patients who showed better compliance also had a lower state of anxiety, which could also be explained by the positive effect of the attitude of the father in the family.	It would be useful to overcome the increased state of anxiety of the child in the orthodontic clinic by using educational and relaxation techniques. Besides, it would be wise to ask the father to be present at the first appointment during part of the education of the child.	
19904667	Quitting smoking is a major life stressor that results in numerous aversive consequences, including persistently increased level of post-cessation negative affect and relapse. The identification of factors that may enhance behavioral and emotional regulation after quitting may be useful in enhancing quit rates and preventing relapse. One factor broadly linked with behavioral and emotional regulation is mindfulness. This study examined baseline associations of mindfulness with demographic variables, smoking history, dependence, withdrawal severity, and agency among 158 smokers enrolled in a cessation trial. Results indicated that mindfulness was negatively associated with level of nicotine dependence and withdrawal severity, and positively associated with a sense of agency regarding cessation. Moreover, mindfulness remained significantly associated with these measures even after controlling for key demographic variables. Results suggest that low level of mindfulness may be an important predictor of vulnerability to relapse among adult smokers preparing to quit; thus, mindfulness-based interventions may enhance cessation.
19897234	Stattin and Kerr's (2000; Kerr & Stattin, 2000) seminal work challenged our understanding of parental monitoring, shifted attention to adolescents' agency as information managers, and pushed researchers to focus more on their measures and to think more about the interactional and relational processes that keep, or fail to keep, parents informed. Spurred by this reinterpretation of "parental monitoring", research has shifted in the last decade from a nearly exclusive focus on parents' role in socializing adolescents through monitoring their whereabouts, friendships, and activities, to a broader recognition of, and appreciation for, adolescents' active role in strategically managing their parents' access to information. This special issue showcases this new perspective by gathering a set of studies focusing collectively on a wide variety of information management strategies and exploring bidirectional links with indicators of youths' psychosocial adjustment and parent-child relationship qualities.
19896020	Although adults with developmental disabilities are at high risk for obesity and its sequelae, few community-based lifestyle interventions targeting those with developmental disabilities exist.The study was a single group, community-based demonstration project with pre-post test evaluation conducted from December 2005 to June 2006.	Eligible participants were 431 community-dwelling adults with developmental disabilities, aged 18-65 years, who were overweight/obese (BMI > or =25) with another risk factor for diabetes or metabolic syndrome or who had a diagnosis of diabetes, and received services from a community agency. Eighty-five signed up (20% of those eligible), 68 participated in an initial class, and 44 completed the program (35% attrition rate).	The Healthy Lifestyle Change Program (HLCP) is a community-based health intervention developed and implemented using community-based participatory research methods by members of the developmental disabilities community, in collaboration with academic researchers. The HLCP was a 7-month, twice-weekly education and exercise program to increase knowledge, skills, and self-efficacy regarding health, nutrition, and fitness among adults with developmental disabilities. Peer mentors served as participant leaders and primary motivators.	Changes in weight, BMI, abdominal girth, access to care, and self-reported nutrition, physical activity, and life satisfaction were each measured.	Two thirds of participants maintained or lost weight, with a mean weight loss of 2.6 pounds and a median weight loss of 7 lbs (range: 2-24 lbs). Average BMI decreased by 0.5 kg/m(2) (p=0.04). Abdominal girth decreased in 74% of participants (mean= -1.9 inches). Sixty-one percent of participants reported increased physical activity. Mean exercise frequency increased from 3.2 times to 3.9 times per week (p=0.01). Mean exercise duration increased from 133 minutes to 206.4 minutes per week (p=0.02). Significant improvements in nutritional habits and self-efficacy were reported. Over half (59%) of participants showed improvements in life satisfaction. Participants received 206 referrals for needed medical care. The HLCP and its dissemination increased participants' and peer mentors' ability to act as community advocates and partners in research.	The HLCP resulted in improved lifestyles, weight loss success, and increased community capacity, indicating that a community-based program with significant participation of those with developmental disabilities is feasible. This program should be expanded and evaluated with larger populations with developmental disabilities.	
19891296	The impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) on the participation of women in paid/unpaid work is a little understood phenomenon.A research study exploring the lived experiences of Canadian women's engagement in paid/unpaid work and the barriers and facilitators mediating this phenomenon.	Study design employed a phenomenological approach using data subanalysis of transcripts, double coded for agreement and to ensure saturation of themes.	Analysis of the data revealed an overarching theme of engagement mediated by interacting forces with eight subthemes: active management, agency constrained by structure, the nature of supports, HIV/AIDS sequelae, work as a galvanizing force, the presence of children, the element of fear, and negotiation of self.	Insights gained indicate a need for further education, resources, supports, and policy changes at the systems level. Occupational therapy is positioned to broaden the role of rehabilitation in the context of HIV/AIDS, episodic disability, and work participation.	
19880330	The goal of this study is to characterize observers' abilities to discriminate between endogenous (i.e., self-produced) and exogenous changes. To do so, we developed a new experimental paradigm. On each trial, participants were shown a dot pattern on the screen. Next, the pattern disappeared and participants were to reproduce it. Changes were surreptuously introduced in the stimulus, either by presenting participants anew with the dot pattern they had themselves produced on the previous trial (endogenous change) or by presenting participants with a slightly different dot pattern (exogenous changes). We analyzed awareness of the changes and behavioral adaptation to them in a dynamical manner. We observe (1) signal attenuation in the presence of endogenous change, (2) dissociation between self-attribution reports and behavioral effect of agency. We discuss the source of this sensitive attenuation as well as the relation between a minimal or core self and an extended, narrative or autobiographical self.
19874435	The purpose of this study is to assess patients' self-care ability and self-efficacy, to examine the relationship between them and to determine the factors affecting self-care ability and self-efficacy in people undergoing hemodialysis (HD).This research was conducted as a descriptive survey study by 138 people with ESRD who were patients of HD units service in Sivas. The data were collected with a Personal Information Form, Exercise of Self-Care Agency (ESCA) Scale and Self-Efficacy Assessment Form. Data collected from the study were analysed using percent, mean, Tukey test, significance test of two means, one-way variant analysis and Kruskal-Wallis test.	The study results demonstrate that while there is a correlation between self-care ability and education level, work status, income level and frequency of HD application, factors such as age, gender, education level, work status, income level and frequency of HD application determine self-efficacy. Furthermore, a positive correlation was found between patients' self-care ability and self-efficacy. It was determined that as the level of self-care ability increases self-efficacy level also increases.	Hemodialysis application affects patients' self-care ability and self-efficacy levels. There is a positive correlation between self-care ability and self-efficacy. In view of this study's results, it is recommended to organize education programmes to increase self-care ability and self-efficacy levels of HD patients and prepare comprehensive plans including patients' families.	
19836900	This study aimed to investigate factors related to initiation of cannabis consumption among adolescents. A questionnaire was administered to 2043 14-15-year-olds from Barcelona who were followed-up and re-interviewed after 15 months. A bivariate analysis was performed to identify the factors associated with consumption, and multivariate logistic regression was carried out to model cannabis initiation. Among matched students, 23.7% of non-users at baseline had started to consume 15 months later (23.0% boys and 24.2% girls). Among those who had reported occasional cannabis use, 30.3% reported consumption during the previous month at the follow-up survey. Factors associated with cannabis initiation among boys and girls were smoking, risky alcohol use and intention to consume cannabis. Among boys, other associated factors were frequenting bars or discotheques and not having organized activities in leisure time. Among girls, another risk factor for initiation was having cannabis-using friends. Cannabis initiation was facilitated by legal drug use, favorable attitudes and context-related variables. These results highlight the role of behavioral and contextual variables and support the importance of reinforcing social skills in preventive programs.
19835895	The aim of our paper is to show that there is a sense of body that is enactive in nature and that enables to capture the most primitive sense of self. We will argue that the body is primarily given to us as source or power for action, i.e., as the variety of motor potentialities that define the horizon of the world in which we live, by populating it with things at hand to which we can be directed and with other bodies we can interact with. We will show that this sense of body as bodily self is, on the one hand, antecedent the distinction between sense of agency and sense of ownership, and, on the other, it enables and refines such distinction, providing a conceptual framework for the coherent interpretation of a variety of behavioral and neuropsychological data. We will conclude by positing that the basic experiences we entertain of our selves as bodily selves are from the very beginning driven by our interactions with other bodies as they are underpinned by the mirror mechanism.
19828223	Since Gesler first introduced the concept in 1992, the language of 'therapeutic landscapes' has attained a core position in the toolkit of health/place studies. Whilst many authors using the term acknowledge that therapeutic landscapes are often also spaces of contestation, few if any have extended this to incorporate a serious critique of therapy itself. In this article, I use the case study of an 'alternative' psychiatric survivor (self-help) group in the north of England to attempt just this. Based on a ten month period of ethnography, I engage with the spaces - meeting places and venues - occupied by the group, focusing on the dilapidated and reputedly dangerous city park where the group hosts its most regular meetings. Three qualities of these spaces were found to be particularly embraced by the group: spaces of agency and appropriation; a space in the world; and a non-technical relation with space. The article uses these three themes to explore how the unconventional spaces of the group are not mere products of marginality but a serious aspect of mobilising the dissident and 'anti-psychiatric' recovery sought by its members. Through attending to what the survivors' found helpful in the park, a more sensitive rendition of 'anti-psychiatry' as it relates to the group is developed. The therapeutic landscapes framework as put forward by Gesler retains currency in highlighting the importance of place to the processes and identity of the group. However, it is also suggested that the 'dissident topophilias' of the survivors express a critique of current therapeutic landscapes thinking, challenging the supposition that it is the planned, the pleasant and the professional that provide the best backdrops for recovery.
19809534	We will review converging evidence that language related symptoms of the schizophrenic syndrome such as auditory verbal hallucinations arise at least in part from processing abnormalities in posterior language regions. These language regions are either adjacent to or overlapping with regions in the (posterior) temporal cortex and temporo-parietal occipital junction that are part of a system for processing social cognition, emotion, and self representation or agency. The inferior parietal and posterior superior temporal regions contain multi-modal representational systems that may also provide rapid feedback and feed-forward activation to unimodal regions such as auditory cortex. We propose that the over-activation of these regions could not only result in erroneous activation of semantic and speech (auditory word) representations, resulting in thought disorder and voice hallucinations, but could also result in many of the other symptoms of schizophrenia. These regions are also part of the so-called "default network", a network of regions that are normally active; and their activity is also correlated with activity within the hippocampal system.
19768541	Clinical trials demonstrate that Supported Employment is effective in assisting persons with severe mental illness in obtaining competitive employment. However, little is known about the factors related to consumers' decisions to pursue employment, especially for consumers with co-occurring substance and mental disorders. This study examines the demographic, socioeconomic and illness characteristics of consumers referred for Supported Employment services. Consumers were drawn from Integrated Dual Diagnosis Treatment programs in four community mental health agencies. Study participants included 113 consumers referred for Supported Employment services and 78 randomly selected non-referred consumers as the comparison group. Results suggest that consumers who have past work experience are more likely to be referred to Supported Employment, while consumers who perceive themselves as disabled or who are diagnosed as substance dependent are less likely to be referred to Supported Employment. Implications for agency practice and future research are discussed.
19752675	For health organizations (private and public) to advance their care-management programs, to use resources effectively and efficiently, and to improve patient outcomes, it is germane to isolate and quantify care-management activities and to identify overarching domains.The aims of this study were to identify and report on an application of mixed methods of qualitative statistical techniques, based on a theoretical framework, and to construct variables for factor analysis and exploratory factor analytic steps for identifying domains of dementia care management.	Care-management activity data were extracted from the care plans of 181 pairs of individuals (with dementia and their informal caregivers) who had participated in the intervention arm of a randomized controlled trial of a dementia care-management program. Activities were organized into types, using card-sorting methods, influenced by published theoretical constructs on self-efficacy and general strain theory. These activity types were mapped in the initial data set to construct variables for exploratory factor analysis. Principal components extraction with varimax and promax rotations was used to estimate the number of factors. Cronbach's alpha was calculated for the items in each factor to assess internal consistency reliability.	The two-phase card-sorting technique yielded 45 activity types out of 450 unique activities. Exploratory factor analysis produced four care-management domains (factors): behavior management, clinical strategies and caregiver support, community agency, and safety. Internal consistency reliability (Cronbach's alpha) of items for each factor ranged from.63 for the factor "safety" to.89 for the factor "behavior management" (Factor 1).	Applying a systematic method to a large set of care-management activities can identify a parsimonious number of higher order categories of variables and factors to guide the understanding of dementia care-management processes. Further application of this methodology in outcome analyses and to other data sets is necessary to test its practicality.	
19686886	As with the first of two companion manuscripts, this investigation employed a grounded theory approach to identify patterns of coping responses by adults responding to the stress resulting from the threat of stuttering. The companion paper described emotion-based avoidant coping responses that were used to protect both the speaker and the listener from experiencing discomfort associated with stuttering. This paper describes two cognitive-based approach patterns that emphasize self-focused and problem-focused forms of coping. The first of the cognitive-based coping patterns involved speakers approaching stuttering with a broader perspective about themselves and the experience of stuttering, resulting in an improved self-concept and increased self-confidence. The second coping pattern involved speakers focusing on their own goals which results in increased agency and self-confidence. Participants described the development of more functional coping responses. They moved from emotion-based avoidant patterns of coping that focused on protecting the self and the listener from experiencing discomfort associated with stuttering to cognitive-based approach patterns that focused on the needs of the speaker. As the participants chose to approach rather than avoid or escape stuttering, they experienced many positive social, physical, cognitive, and affective results.The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with the process of coping with stuttering, (2) describe the basic rationale for the procedures associated with grounded theory methods, (3) describe the factors that influence coping choices, and (4) explain the factors that contribute the use of approach-oriented and agentic coping strategies.	
19683460	Recent work has demonstrated that the sense of agency is not only determined by efference-copy-based internal predictions and internal comparator mechanisms, but by a large variety of different internal and external cues. The study by Moore and colleagues [Moore, J. W., Wegner, D. M., & Haggard, P. (2009). Modulating the sense of agency with external cues. Conscious and Cognition] aimed to provide further evidence for this view by demonstrating that external agency cues might outweigh or even substitute efferent signals to install a basic registration of self-agency. Although the study contains some critical points that, so we argue, are central to a proper interpretation of the data, it hints at a new perspective on agency: optimal cue integration seems to be the key to a robust sense of agency. We here argue that this framework could allow integrating the findings of Moore and colleagues and other recent agency studies into a comprehensive picture of the sense of agency and its pathological disruptions.
19667399	Although the cancer stem cell (CSC) concept implies that CSCs are rare, recent reports suggest that CSCs may be frequent in some cancers. We hypothesized that the proportion of leukemia stem cells would vary as a function of the number of dysregulated pathways. Constitutive expression of MN1 served as a 1-oncogene model, and coexpression of MN1 and a HOX gene served as a 2-oncogene model. Leukemia-initiating cell (LIC) number and in vitro expansion potential of LICs were functionally assessed by limiting dilution analyses. LIC expansion potential was 132-fold increased in the 2- compared with the 1-oncogene model, although phenotypically, both leukemias were similar. The 2-oncogene model was characterized by granulocyte-macrophage colony-stimulating factor (GM-CSF) hypersensitivity and activated STAT/ERK signaling. GM-CSF hypersensitivity of the 2-oncogene model (MN1/HOXA9) was lost in Stat5b(-/-) cells, and the LIC expansion potential was reduced by 86- and 28-fold in Stat5b(-/-) and Stat1(-/-) cells, respectively. Interestingly, in 201 acute myeloid leukemia (AML) patients, coexpression of MN1 and HOXA9 was restricted to patients with the poorest prognosis and was associated with highly active STAT signaling. Our data demonstrate the functional heterogeneity of LICs and show that STAT signaling is critical for leukemia stem cell self-renewal in MN1- and HOXA9-expressing leukemias.
19657934	In this study, the author uses ethnographic and interview data from Pussy Palace, a lesbian/queer bathhouse in Toronto, Canada, to examine the ways in which the bathhouse space impacted participants' sexuality, behaviors, and notions of self. The Toronto Women's Bathhouse Committee (TWBC), an explicitly feminist and queer organization, is responsible for putting on Pussy Palace events and in creating an atmosphere that is simultaneously sexual and safe. Findings indicate elements of both spatial praxis and sexual agency, wherein individuals expressed being able to "take risks," "find their sexuality," and "discover who they are" in a safe space, where nonnormative bodies and sexualities are to be celebrated. Although participants expressed feeling "liberated," many also described feeling anxious, awkward, and insecure. Within a sexual space where bodies are exposed and highly salient, these anxieties worked to inhibit and curtail bodily expression. The author concludes by discussing the significance of spaces like Pussy Palace for lesbian/queer individuals when it comes to sexual expression and the need for further research when it comes to examining lesbian/queer sexualities and public sexual cultures.
19637065	Male sexuality in Africa is often associated with harmful sexual practices, which, in the context of HIV and AIDS, often positions men as central to the spread of the epidemic. Despite this focus on men's practices, there is a lack of research exploring the subject positions of men living with HIV. This study explores how masculinity is constructed by a group of black South African men who self-identify as heterosexual and are living with HIV. Using discourse analysis, a construction of a normative masculinity is identified as being both idealised and perceived as a burden, in that men continually need to engage in actions that affirm their position as 'real' men. By depicting men as invulnerable and unemotional, this construction limits men from acknowledging health risks or accessing support. A second discourse constructs HIV and AIDS as disrupting normative masculinity, in that it restricts men's agency through illness and the need for care. A final discourse relates to a transformed masculinity, where men living with HIV reconstruct their masculinity, as conforming to normative constructions of male identity is perceived as restrictive and harmful.
19620178	Distortion of the sense of reality, actualized in delusions and hallucinations, is the key feature of psychosis but the underlying neuronal correlates remain largely unknown. We studied 11 highly functioning subjects with schizophrenia or schizoaffective disorder while they rated the reality of auditory verbal hallucinations (AVH) during functional magnetic resonance imaging (fMRI). The subjective reality of AVH correlated strongly and specifically with the hallucination-related activation strength of the inferior frontal gyri (IFG), including the Broca's language region. Furthermore, how real the hallucination that subjects experienced was depended on the hallucination-related coupling between the IFG, the ventral striatum, the auditory cortex, the right posterior temporal lobe, and the cingulate cortex. Our findings suggest that the subjective reality of AVH is related to motor mechanisms of speech comprehension, with contributions from sensory and salience-detection-related brain regions as well as circuitries related to self-monitoring and the experience of agency.
19581436	Leaders frequently form stronger relationships with certain subordinates moreso than others, creating an inner circle of close friendships and an outer circle of more distant relationships. Three studies examine the effects of inner-circle membership on group dynamics and interpersonal influence in hierarchical teams. Study 1 finds that, compared to outer-circle members, inner-circle members feel safer and participate in the group discussion more, and leaders recognize them as making a greater contribution and allocate a larger bonus to them. Consequently, inner-circle members influence the groups' decisions more, and team decision quality improves when inner-circle members possess expert knowledge. Study 2 finds that leaders attended to and recalled suggestions from their inner circle more regardless of argument strength, suggesting heuristic information processing. Study 3 replicates these findings using intact teams in a large governmental agency. Implications for leadership and group decision making are discussed.
19558754	Conceptualizations of teachers' agency beliefs converge around domains of support and instruction.We investigated changes in student teachers' agency beliefs during a 1 year teacher education course, and related these to observed classroom quality and day-to-day experiences in partnership schools during the practicum.	Out of a sample of 66 student teachers who had responded to at least two out of four times to a questionnaire (18 men 48 women; mean age 26.4 years), 30 were observed during teaching, and 20 completed a 4-day short form diary.	Confirmatory factor analysis validated two agency belief constructs. Multi-level models for change investigated individual differences in change over time. Multi-level path models related observation and diary responses to agency beliefs.	Supportive agency belief was high and stable across time. Instructional agency belief increased over time, suggesting a beneficial effect of teacher education. This increase was predicted by observed classroom quality (emotional support and student engagement) and daily positive affect and agency beliefs.	Teacher education is successful in creating a context in which student teachers' supportive agency beliefs can be maintained and instructional agency beliefs can increase during the course.	
19531122	In this paper I explore the role of mirror neurons and motor intentionality in the development of self-agency. I suggest that this will also give us a firmer basis for an emergent view of archetypes, as key components in the development trajectory of self-agency, from its foundation in bodily action to its mature expression in mentalization and a conscious awareness of intentionality. I offer some ideas about the implications of these issues of self-agency for our clinical work with patients whose developmental trajectory of self-agency has been partially inhibited, so that their communications have a coercive effect. I discuss the possibility that this kind of clinical phenomenon may relate to Gallese and Lakoff's hypothesis that abstract thought and imagination are forms of simulated action, and that the same sensory-motor circuits that control action also control imagination, concept formation and understanding, but with a crucial development, that of an inhibition of the connections between secondary pre-motor cortical areas and the primary motor cortex. I shall speculate that in the earlier developmental stages of self-agency, the separation of secondary from primary motor areas is not complete, so that imagination and thought are not entirely independent of physical action.
19527156	The high rates of suicide among older men are cause for concern, and have prompted the investigation of factors that might explain these elevated rates. The current research examined whether the gender role construct agency was associated with depression and suicidal ideation among older adults. The results, based on self-report data from a sample of older Australian men (n = 69) and women (n = 90), indicated that depression mediated the relation between agency and suicidal ideation. In addition, for older men only, agency moderated the depression-suicidal ideation relation. The results suggest that older adults, and particularly men, with low levels of agency should be the targets for interventions aimed at increasing levels of agency and improving mental health.
19517530	Action observation leads to the automatic activation of the corresponding motor representation in the observer through "mirror-matching." This constitutes a "shared representational system," which is thought to subserve social understanding by motor simulation. However, it is unclear how these shared representations can be controlled and distinguished. Brain imaging suggests that controlling shared representations, indexed by the ability to control automatic imitative responses, activates anterior fronto-median cortex (aFMC), and temporo-parietal junction (TPJ). Crucially, these regions are also consistently implicated in mental state attribution and have provided an alternative account for higher-level social cognition. Here, we directly tested whether social-cognitive processes involve similar key computational mechanisms as the control of shared representations by using functional brain imaging to reveal overlapping brain circuits. We show in a within-subject design that commonly activated regions occurred selectively in aFMC and TPJ. Mentalizing and self-referential thoughts recruited a region in aFMC, which was also activated when controlling imitation. In the TPJ, an area overlapped between mentalizing, agency processing, and imitative control. Behavioral and neural correlates of mentalizing were further related to the individual ability for controlling imitation. Our findings support the assumption of shared key processes and suggest a novel link between embodied and social cognition.
19477796	This study uses a mixed-method approach to examine the relationship between body image and sexual health among adolescent boys. In Study 1, eight 12th-grade boys participated in semistructured interviews focusing on dating and sexuality. Qualitative analyses revealed several differences between boys who were satisfied with their bodies and boys who were not. Specifically, boys who were satisfied with their bodies indicated that they were clear about what they wanted sexually and were comfortable communicating those wants with partners. In contrast, boys with low body satisfaction were often unclear about their sexual choices and resisted talking about sexuality with partners. Study 2 examined these same themes using quantitative data from 149 boys from the 12th grade who completed surveys assessing body image, sexual experiences, and sexual attitudes. Body satisfaction was significantly associated with sexual agency and with clarity of personal sexual values. Implications for promoting adolescent sexual health are discussed.
19469614	The current study aimed to develop a reliable and valid appraisal scale (The Appraisals of DisAbility: Primary and Secondary Scale; ADAPSS) for adult spinal cord injury (SCI) populations.Items for the ADAPSS were generated using themes and quotes from a qualitative study exploring appraisals made by individuals with SCI. The ADAPSS was administered with 2 additional appraisal measures, a measure of anxiety and depression, a measure of social desirability and demographic information. The study used a cross-sectional questionnaire design with a test-retest component, sampling community-based individuals with SCI. Data analysis was undertaken on 237 completed questionnaires.	Factor analysis revealed the ADAPSS to have a 6-factor structure and the following subscales identified: (a) Fearful Despondency, (b) Overwhelming Disbelief, (c) Determined Resolve, (d) Growth and Resilience, (e) Negative Perceptions of Disability, and (f) Personal Agency.	Preliminary analyses suggest the ADAPSS demonstrates reasonable reliability and validity and has potential as a therapeutic outcome measure. Future research should focus on the relationship between appraisals identified on the ADAPSS and their relationship to the coping strategies that individuals employ and adjustment to SCI. (PsycINFO Database Record (c) 2009 APA, all rights reserved).	
19457378	One fundamental property of voluntary action is the feeling of control and causation, also referred to as self agency. Recent research suggests that the sense of agency is based on low-level, sensory-motor control processes, which compare predicted and actual action-effects. Brain imaging research revealed that the temporo-parietal junction (TPJ) plays a crucial role for signalling whether a sensory action-consequence matches the prediction or not. However, while it was assumed that sensory outcome predictions are based on ideomotor (action-effect) learning, it has rarely been investigated whether such learning can lead to a sense of agency. In this functional MRI experiment we tested whether a sense of agency develops from learning action-effect associations. In the first part of the experiment, participants learned new action-effect associations. During the following scanning session participants were exposed to matching and non-matching action-effects. In accordance with previous behavioural research, participants reported a decreased sense of agency for non-matching events. As predicted, activity in the TPJ increased with greater incongruence between predicted and actual sensory effects. Furthermore, attributing the causation of sensory events to another person was correlated with activity in fronto-median cortex, a region involved in the representation of intentional agents. This relationship was modulated by the external attribution disposition of the participants. Complementing our view on agentive processes, our findings indicate that ideomotor learning provides an essential basis for the distinction of agents' behaviour and also point to a possible high-level contribution of prefrontal cortex and personality traits to the sense of agency.

19415681	A qualitative metasynthesis was conducted to identify the essence of healing from sexual violence, as described by adults who experienced it as children or as adults. Based on the findings of 51 reports, four domains of healing were identified: (a) managing memories, (b) relating to important others, (c) seeking safety, and (c) reevaluating self. The ways of healing within each domain reflected opposing responses. The dialectical process identified for each of the four domains include, respectively: (a) calling forth memories, (b) regulating relationships with others, (c) constructing an "as-safe-as-possible" lifeworld, and (d) restoring a sense of self. These complex processes resulted in a new reality for the participants that was based on a greater sense of agency and provided a more satisfying life course.
19413558	To develop and refine three new scales that measure diabetes self-care agency, diabetes self-efficacy and diabetes self-management to reflect the American Diabetes Association current standards of diabetes care and the American Association of Diabetes Educators self-care behaviours. And, to establish the clarity, consistency and content validity of the scales.There is a need to have valid and reliable instruments or scales to assess an individual's diabetes self-care agency, self-efficacy and self-management to plan appropriate interventions that can be effective in improving glycaemic control and delaying or preventing diabetes-related complications.	A methodological design was used to conduct this study.	Ten clinicians and 10 insulin-treated individuals with type 2 diabetes (T2DM) from a diabetes care center in the southern USA participated in this study. Analysis consisted of inter-rater agreement to determine clarity and consistency with standards of diabetes care and content validity of individual items on the scales (I-CVI) and the overall scales (S-CVI/Ave) to determine relevance for current diabetes care practice.	All I-CVI and S-CVI/Ave of the DSES exceeded the minimum acceptable criteria. All I-CVI and the S-CVI of the DSMS also exceeded the minimum accepted criteria, except for one item that had I-CVI = 0.70. Evaluation of the items and the directions of the scales by the sample of insulin-treated individuals with T2DM exceeded the minimum criteria of 80% inter-rater agreement. RELEVANCE TO RESEARCH AND CLINICAL PRACTICE: Further psychometric testing of the scales with samples of insulin-treated individuals with diabetes is warranted and will lay the groundwork for further research and clinical practice to enhance the capability, confidence and actual performance of diabetes self-management activities among insulin-treated individuals with T2DM.	The scales can be used by diabetes care providers to assess and follow-up individuals with diabetes who need intense case management. They also can be the measures of choice to conduct future research to test the effects of interventions among insulin-treated individuals with T2DM.	
19384998	Self-assembly of artificially designed proteins is extremely desirable for nanomaterials. Here we show a novel strategy for the creation of self-assembling proteins, named "Nanolego." Nanolego consists of "structural elements" of a structurally stable symmetrical homo-oligomeric protein and "binding elements," which are multiple heterointeraction proteins with relatively weak affinity. We have established two key technologies for Nanolego, a stabilization method and a method for terminating the self-assembly process. The stabilization method is mediated by disulfide bonds between Cysteine-residues incorporated into the binding elements, and the termination method uses "capping Nanolegos," in which some of the binding elements in the Nanolego are absent for the self-assembled ends. With these technologies, we successfully constructed timing-controlled and size-regulated filament-shape complexes via Nanolego self-assembly. The Nanolego concept and these technologies should pave the way for regulated nanoarchitecture using designed proteins.
19379030	The conscious experience of self-agency (i.e., the feeling that one causes one's own actions and their outcomes) is fundamental to human self-perception. Four experiments explored how experienced self-agency arises from a match between nonconsciously activated outcome representations and the subsequent production of the outcome and explored specifically how implicit motivation to produce the outcome may impinge on this process. Participants stopped a rapidly presented sequence of colors on a computer screen. Subsequently, they were presented with what could be the color on which they had stopped the sequence or a color that was randomly chosen by the computer. Agency ratings after each trial revealed that priming outcomes (a specific color) just before the outcome was produced enhanced experienced self-agency. Importantly, priming outcomes relatively far in advance also augmented self-agency, but only if the outcome was attached to positive affect and thus operating as a nonconscious goal maintaining the outcome representation active over time. As such, these studies show how the mechanisms underlying nonconscious goal pursuit promote experiences of self-agency, thus integrating 2 lines of research that so far have led separate lives.
27269638	Impaired 'traumatic' memory of disaster-affected populations has come to the forefront of humanitarian work. In this article, the application of the notion of 'mental trauma' by psychosocial intervention programmes, relating to the tsunami disaster, will be critically examined. It will be shown in which type of theoretical structure the guidelines' notion of 'mental trauma' is rooted, presenting 'traumatic' experience as a division of the self, which is defined through agency and coherence. It will be argued that this entails a certain subjectivity of representation, which may not have transcultural validity. It is concluded that rehabilitation and development programmes after disasters have to integrate and address multiple levels, including community-level interventions, drawing on local coping strategies and resources. 
22029454	From a proactive agentic perspective, social support is not just seen as a protective cushion against environmental demands. Rather, support may facilitate an individual's self-regulation by enhancing perceived self-efficacy (i.e., enabling hypothesis). In the present study, patient-reported indicators of mobilized and received spousal support as predictors of their own and their spouses' self-efficacy beliefs were investigated within 1 year following radical prostatectomy. During this time frame, postoperative sequelae such as urinary incontinence and erectile dysfunctions are still likely to interfere with couples' everyday activities. Seventy-two patients receiving radical prostatectomy and their spouses participated. Patients' and spouses' self-efficacy beliefs and patients' received and mobilized spousal support were assessed prior to and 12 months following surgery. Additional patient-reported covariates at 1 year post-surgery were degree of bother by urinary incontinence, overall sexual satisfaction, and relationship satisfaction. Results indicated that patients' received spousal support was associated with higher levels of patients' self-efficacy only cross-sectionally, but not longitudinally. Support mobilized by the patient prior to and 1 year after surgery, however, positively predicted spouses' levels and changes in self-efficacy. Results, thus, did not fully confirm predictions by the enabling hypothesis of social support; rather, associated aspects, such as the degree of being mobilized as a provider of support or being needed, seem to enhance agency beliefs in spouses.
19325023	Perspectives on the concept of personhood and its relationship to health care delivery are considered in the context of the life of an adolescent with multiple disabilities. One phenomenological interview lasting 3 hours illuminated life-long experiences of suffering, healing, and the quest to be treated as human, as perceived by a 16-year-old girl disfigured by multiple cancer treatments. Age-appropriate development is the ground of her existence, whereas the quality of relationships with care providers and the extent to which they demonstrate regard for her value as a person are figural. Health care providers have often failed to interact with her in ways supporting dignity and growth, treating her with "care" that is antithetical to the aims of their professions. The case has relevance for health care education and practice, challenging professionals to examine their views on personhood and self-care agency, and the ways in which those views impact the care they provide.
19306996	In three experiments we investigated how people determine whether or not they are in control of sounds they hear. The sounds were either triggered by participants' taps or controlled by a computer. The task was to distinguish between self-control and external control during active tapping, and during passive listening to a playback of the sounds recorded during the active condition. Experiment 1 required detection of a change in control mode within trials. Experiments 2 and 3 introduced a simple rhythm reproduction task that requires discrimination of control modes between trials. The results demonstrate that both sensorimotor cues and perceptual cues are used to infer agency. In addition, there may be further influences of cognitive expectation and/or multimodal integration. In accordance with hierarchical models of intention [e.g., Pacherie, E. (2008). The phenomenology of action: A conceptual framework. Cognition, 107, 179-217] this suggests that the sense of agency is not situated on one specific level of action control but subject to multiple influences.
19306797	To prospectively examine whether personal agency beliefs and direct coping mediate the association between spirituality and depressive symptoms in a school-based sample of adolescents, and whether gender, race, or grade level moderate this model.Students (N = 1096) from sixth through ninth grades in a northeastern public school system were administered self-report instruments in group format at baseline, 6-month follow-up, and 1-year follow-up. Demographic variables and constructs of spirituality, personal agency, direct coping, and depressive symptoms were assessed.	Structural equation modeling was used to examine the longitudinal associations among the constructs while controlling for socioeconomic status and baseline depressive symptoms. For the total sample, the model predicted 21% of the variance in depressive symptoms over 1 year. The model was moderated by gender but not by race or grade level. The model explained 28% of the variance in depressive symptoms for girls and 16% of the variance in depressive symptoms for boys. Moreover, there was an indirect effect of spirituality on depressive symptoms for girls but not for boys.	These results suggest mechanisms by which spirituality may maintain lower levels of depressive symptoms among adolescent girls during periods of transition to middle and high school.	
19298250	This study explored associations between self-esteem and interpersonal functioning in a one-year clinic cohort of psychiatric outpatients (n= 338). At intake, patients completed questionnaires measuring self-esteem, interpersonal problems, interpersonal style, and general symptomatic distress. They were also diagnosed according to the ICD-10. Interpersonal behaviour was measured along the agency and communion dimensions of the Inventory of Interpersonal Problems-Circumplex [IIP-C]. The results show that lower self-esteem was associated with higher levels of interpersonal problems in general. Further, lower self-esteem was first and foremost linked to frustrated agentic motives, as measured by the IIP-C. Hence, the study concludes that fostering patient agency should be considered as an important goal in psychotherapy. Furthermore, the analyses revealed an interaction effect of agency and communion on self-esteem, indicating a need for balancing the two motive dimensions. Finally, some questions are raised concerning the interpretation of the IIP-C subscales in general.
19271843	Preschoolers' causal learning from intentional actions--causal interventions--is subject to a self-agency bias. The authors propose that this bias is evidence-based, in other words, that it is responsive to causal uncertainty. In the current studies, two causes (one child controlled, one experimenter controlled) were associated with one or two effects, first independently, then simultaneously. When initial independent effects were probabilistic, and thus subsequent simultaneous actions were causally ambiguous, children showed a self-agency bias. Children showed no bias when initial effects were deterministic. Further controls established that children's self-agency bias is not a wholesale preference but rather is influenced by uncertainty in causal evidence. These results demonstrate that children's own experience of action influences their causal learning, and the findings suggest possible benefits in uncertain and ambiguous everyday learning contexts.
19251569	The sense of personal identity is an element of the Jasperian definition of self-conscience. Each of us is convinced of being a unique and stable individual, different from other individuals. These properties - stability ad coherence - belong to an image of ourselves that was proposed to us by the Other's look during the mirror phase. Brain focal lesions may threaten this certitude in two ways: 1) brain lesions result in deficiency, disability or handicap, which are experienced as a narcissistic injury. The patient questions himself about the image he offers to the Other's look, and, as a result, his sense of personal identity is unsettled; 2) a variety of focal brain lesions or dysfunctions may alter the activity of areas which are necessary for maintaining a stable image of the patients' body or self. This may lead patients to experience depersonalisation, autoscopy, somatoparaphrenic "delusions" or disturbed agency. The sense of personal identity may be disturbed during brief paroxystic or psychologically traumatic phenomena. However, this is not observed in chronic sequelae of brain lesions (e.g. right hemisphere syndrome or amnesic syndrome), even though the patients may present a broken up image of themselves.
19250993	First-rank symptoms of schizophrenia have been related to an impaired sense of agency (the sense of causing and controlling an action). The sense of agency is considered as one of the two components of self-recognition, the other component being the sense of body (awareness of one's body). The present study aimed at evaluating whether first-rank symptoms can be considered as a general impairment in self-recognition that will also concern the sense of body. A group of schizophrenic patients with first-rank symptoms, a group of schizophrenic patients without first-rank symptoms and a group of normal subjects were compared in a self-recognition task where they first had to execute hand movements simultaneously with the experimenter and subsequently to indicate the position either of their own or the experimenter's hand. The visualized locations of the hands could rotate by 0 degrees , 90 degrees , -90 degrees or 180 degrees from their real locations. This rotation allowed us to induce a distorted sense of body since there was a visual discontinuity between the patient's hand and the rest of his/her body. If patients present a perturbed sense of body we would expect a greater impairment in discriminating between their own hand and the experimenter's hand as the rotation values increased. This preliminary study shows that patients with first-rank symptoms are more impaired than normal subjects in distinguishing between their own hands and the experimenter's hands when the visualization of the locations of their hands were rotated respective to their real locations. However, both group of patients performed equally, thus showing that sense of body impairment is not specific to first-rank symptoms. These symptoms, compared to other symptoms of schizophrenia do not reflect general self-recognition impairment but rather a specific impairment of the sense of agency.

19232579	The present research examined whether 5- to 6.5-month-old infants would hold different expectations about various physical events involving a box after receiving evidence that it was either inert or self-propelled. Infants were surprised if the inert but not the self-propelled box: reversed direction spontaneously (Experiment 1); remained stationary when hit or pulled (Experiments 3 and 3A); remained stable when released in midair or with inadequate support from a platform (Experiment 4); or disappeared when briefly hidden by one of two adjacent screens (the second screen provided the self-propelled box with an alternative hiding place; Experiment 5). On the other hand, infants were surprised if the inert or the self-propelled box appeared to pass through an obstacle (Experiment 2) or disappeared when briefly hidden by a single screen (Experiment 5). The present results indicate that infants as young as 5 months of age distinguish between inert and self-propelled objects and hold different expectations for physical events involving these objects, even when incidental differences between the objects are controlled. These findings are consistent with the proposal by Gelman, R. (1990). First principles organize attention to and learning about relevant data: Number and the animate-inanimate distinction as examples. Cognitive Science, 14, 79-106, Leslie, A. M. (1994). ToMM, ToBY, and Agency: Core architecture and domain specificity. In L. A. Hirschfeld & S. A. Gelman (Eds.), Mapping the mind: Domain specificity in cognition and culture (pp. 119-148). New York: Cambridge University Press, and others that infants endow self-propelled objects with an internal source of energy. Possible links between infants' concepts of self-propelled object, agent, and animal are also discussed.
19212809	Legalized gambling in Canada is governed by Provincial legislation. In Ontario, the Ontario Lottery and Gaming Corporation is responsible for all aspects of gambling in the Province. There have been a number of recent lawsuits against this Crown agency of the Government of Ontario by gamblers, most of which have been settled or otherwise resolved. A recent class-action lawsuit on behalf of thousands of Ontario gamblers against this agency raises a number of interesting questions regarding the issue of responsibility and liability. The questions surround the issue of self-exclusionary practices of gamblers who deem themselves in need of external intervention in order interesting questions regarding the issue of responsibility and liability. The questions surround the issue to abstain from further gambling. A contract is voluntarily signed by the self-excluding gamblers whereby their further attendance at gaming venues is prevented and could be punishable by law. Where the gaming venues have failed to enforce the terms of this contract, gamblers have continued to gamble at these establishments. The class-action lawsuit stems from the grievances of these self-excluded gamblers who were not turned away. Relevant psychological theories and recent findings pertaining to gambling are reviewed and questions relevant to these grievances are discussed in favor of government responsibility and liability toward gamblers.
19161514	This paper explores the relationship between language and the development of self-agency. I suggest that a child discovers that he or she actually exists as a person with a mind and desires through the mirroring response he or she creates in the parent. This developmental stage of 'teleological' level of self-agency is related to Terrence Deacon's concept of indexical communication. The coercive effect this has on others is explored and the way language may become subverted from its symbolic function and used in the service of indexical communication is discussed, illustrated by examples from the plays of Harold Pinter.
19149865	The identification of various individual, social and physical environmental factors affecting physical activity (PA) behavior in Canada can help in the development of more tailored intervention strategies for promoting higher PA levels in Canada. This study examined the influences of various individual, social and physical environmental factors on PA participation by gender, age and socioeconomic status, using data from the 2002 nationwide survey of the Physical Activity Monitor.In 2002, 5,167 Canadians aged 15-79 years, selected by random-digit dialling from household-based telephone exchanges, completed a telephone survey. The short version of the International Physical Activity Questionnaire was used to collect information on total physical activity. The effects of socio-economical status, self-rated health, self-efficacy, intention, perceived barriers to PA, health benefits of PA, social support, and facility availability on PA level were examined by multiple logistic regression analyses.	Self-efficacy and intention were the strongest correlates and had the greatest effect on PA. Family income, self-rated health and perceived barriers were also consistently associated with PA. The effects of the perceived health benefits, education and family income were more salient to older people, whereas the influence of education was more important to women and the influence of perceived barriers was more salient to women and younger people. Facility availability was more strongly associated with PA among people with a university degree than among people with a lower education level. However, social support was not significantly related to PA in any subgroup.	This study suggests that PA promotion strategies should be tailored to enhance people's confidence to engage in PA, motivate people to be more active, educate people on PA's health benefits and reduce barriers, as well as target different factors for men and women and for differing socio-economic and demographic groups.	
19132913	The objective of this work is to evaluate the impact of agency deficiency on presence. We hypothesize that a deficit in agency, such as occurs in schizophrenia, has repercussions on the sense of presence as well as on performance in a sensorimotor test involving the body. Nineteen healthy controls and 19 stable patients with schizophrenia, matched by age and gender, participated in the study. We used new interactive technologies that enable the users to physically interact with a virtual environment and simultaneously sees themselves performing the actions. Two conditions were balanced: the control condition in which the participant see himself or herself doing the test, and the mask condition, in which the central part of the participant's body is hidden. At the end of the test, all participants completed a questionnaire on presence. The results show that control participants performed better than those with schizophrenia in the control condition. On the contrary, in the mask condition, their performance was significantly lower, whereas participants with schizophrenia obtained the same score as in the control condition. Controls also rated higher in the scale of presence than did participants with schizophrenia. Those results seem to corroborate a relationship between agency and presence. The body awareness and the self in schizophrenia are discussed in the light of agency.
20192130	Bodily illusions differently affect body representations underlying perception and action. We investigated whether this task dependence reflects two distinct dimensions of embodiment: the sense of agency and the sense of the body as a coherent whole. In experiment 1 the sense of agency was manipulated by comparing active versus passive movements during the induction phase in a video rubber hand illusion (vRHI) setup. After induction, proprioceptive biases were measured both by perceptual judgments of hand position, as well as by measuring end-point accuracy of subjects' active pointing movements to an external object with the affected hand. The results showed, first, that the vRHI is largely perceptual: passive perceptual localisation judgments were altered, but end-point accuracy of active pointing responses with the affected hand to an external object was unaffected. Second, within the perceptual judgments, there was a novel congruence effect, such that perceptual biases were larger following passive induction of vRHI than following active induction. There was a trend for the converse effect for pointing responses, with larger pointing bias following active induction. In experiment 2, we used the traditional RHI to investigate the coherence of body representation by synchronous stimulation of either matching or mismatching fingers on the rubber hand and the participant's own hand. Stimulation of matching fingers induced a local proprioceptive bias for only the stimulated finger, but did not affect the perceived shape of the hand as a whole. In contrast, stimulation of spatially mismatching fingers eliminated the RHI entirely. The present results show that (i) the sense of agency during illusion induction has specific effects, depending on whether we represent our body for perception or to guide action, and (ii) representations of specific body parts can be altered without affecting perception of the spatial configuration of the body as a whole.
19090638	This article is based on an interpretevist, qualitative research project conducted with individuals labeled with autism who type to communicate. Researchers engaged in participant observation and conducted open-ended interviews with 9 participants who were working to develop independent typing skills. Three findings emerged from this research. First, participants shaped a notion of independence that included dependence on various supports. Second, researchers recognized the concept of agency in the interactions between participants and their communication facilitators. Third, participants exercised control of their lives through these expressions of agency.
19089642	There has been an increasing emphasis on community integration, consumer involvement, and recovery-focused treatment; but the extent to which these recovery-oriented principles have been adopted in state hospitals is unknown. This study surveyed 1,150 staff at three state hospitals and 230 staff at four community mental health centers on personal optimism, consumer optimism, and agency recovery orientation. Responses were obtained from 729 (63.4%) hospital staff and 181 (78.7%) community staff. Staff at state hospitals scored significantly lower on all three recovery measures even after controlling for background differences. Treatment setting may be an important factor in the dissemination of recovery-oriented care principles.
19042747	The following poems are an autoethnographic account of body image from the perspective of a 39-year-old bountiful, White-privileged, mixed-race femme dyke. The purpose of the poetic form is to inspire emotional connection and offer analytic commentary on the social construction of body image, aging, and beauty as a social commodity, from a lesbian perspective. Together, the poems present a perspective on lesbian body image that highlights our socialization as women first. Lesbian consciousness has a role in how we construct body image outside of a primarily male gaze, but it does not supplant heteronormative feminity. The poems also show the critical social gaze as reconstructed within us and by our lovers. In addition to social influences, the poems also show the life of the individual as a site of body image activism. The agency of "I' to reconstruct interactions of body acceptance and self-love is as clear as the contexts in which those struggles take place.
19038380	The sense of agency is the sense that one is causing an action. The inferential account of the sense of agency proposes that we experience the sense of agency when we infer that one's own thoughts are the cause of an action. According to this account, the inference occurs when a thought appears in consciousness prior to an action, is consistent with the action, and is not accompanied by conspicuous other causes of the action. Alternatively, a predictive account of the sense of agency proposes that sensory prediction based on efferent (motor) information plays a critical role in generating the sense of agency. The present study investigated whether the sense of agency depended primarily on the conceptual congruence between preview information (i.e., to elicit a thought) and actual sensory feedback as suggested by the inferential account, or whether it depended primarily on the sensory-motor congruence between prediction and actual sensory feedback as suggested by the predictive account. The results indicated that both of these factors did contribute to the sense of agency, although sensory-motor congruence appears to have a more robust impact.
19015092	Single pulse transcranial magnetic stimulation (TMS) was used to disrupt the right inferior parietal lobe (rIPL) whilst neurologically intact participants made self/other judgments about whole arm reaching movements. Visual feedback of a physically coincident virtual hand was perturbed or left unperturbed (randomly) while TMS was delivered to either the rIPL or the vertex (blocked). Visual feedback of the virtual hand was veridical until the hand became occluded by a virtual bar approximately half way through the movement. TMS was delivered on 50% of trials at random during occlusion of the hand. The position of the virtual hand relative to the real hand was also perturbed during occlusion of the virtual hand on 50% of trials at random. At the end of the reach participants were required to make a verbal judgment as to whether the movement they had seen was self (unperturbed) or other (perturbed). The results revealed that when TMS was applied over rIPL, participants were more likely to misattribute agency to the computer, making more other responses for both perturbed and unperturbed trials. These findings highlight the role of a parietal neural comparator as a low-level mechanism in the experience of agency.
18990030	Ethnicity is associated with genetic, environmental, lifestyle and social constructs. Difficult to define using a single variable, but strongly predictive of health outcomes and useful for planning healthcare services, it is often lacking in administrative databases, necessitating the use of a surrogate measure. A potential surrogate for ethnicity is birthplace. Our aim was to measure the agreement between birthplace and ethnicity among six major ethic groups as recorded at the population-based mammography service for British Columbia, Canada (BC).We used records from the most-recent visits of women attending the Screening Mammography Program of British Columbia to cross-tabulate women's birthplaces and self-reported ethnicities, and separately considered results for the time periods 1990-1999 and 2000-2006. In general, we combined countries according to the system adopted by the United Nations, and defined ethnic groups that correspond to the nation groups. The analysis considered birthplaces and corresponding ethnicities for South Asia, East/Southeast Asia, North Europe, South Europe, East Europe, West Europe and all other nations combined. We used the kappa statistic to measure the concordance between self-reported ethnicity and birthplace.	Except for the 'Other' category, the most-common birthplace was East/Southeast Asia and the most-common ethnicity was East/Southeast Asian. The agreement between birthplace and self-reported ethnicity was poor overall, as evidenced by kappa scores of 0.22 in both 1990-1999 and 2000-2006. There was substantial agreement between ethnicity and birthplace for South Asians, excellent agreement for East/Southeast Asians, but poor agreement for Europeans.	Birthplace can be used as a surrogate for ethnicity amongst people with South Asian and East/Southeast Asian ethnicity in BC.	
18982574	This article grapples with the issues of sameness and difference in the context of the globalization of gay male identity, particularly in terms of the growing identification of upper class Filipinos with "global gayness." The figure of the global gay is investigated as a hegemonic, yet unstable, point of self-identification that enables the production of anxious subjects that are simultaneously privileged and marginalized, local and global, indigenous and cosmopolitan. I attempt to explore these contradictions by rereading the globalization of gay identity as a product of Althusserian interpellation processes, understood in terms of self-identification (subscription rather than ascription) animated by narrative pleasure and by reexamining mimicry as a never-to-be-completed task that involves the reproduction of a regime of Whiteness. I also examine how journeys to "gay" metropoles serve to rupture dreams of belonging and conclude with a preliminary exploration of how globalization carries the potential for an ethics of sexual difference grounded on indeterminacy and in-betweenness.

18954288	Even if the most sophisticated robot now available is unable to learn and move in the same way as humans, two decades of research in artificial intelligence and cognitive systems introduced the concept of embodiment: the mind has to be understood in the context of its relationship to a physical body that interacts with the world. One of the main outcomes of this vision is the dynamic sensorimotor account of conscious experience. Following this vision, the key feature of a cognitive robot should be the possession and exercise of sensorimotor knowledge. The main criticism against this argument is that such a robot will still lack self-awareness. In this paper, we suggest that a psychology of "presence" can offer new insights to overcome this point. In particular, we argue that in humans the evolutive role of presence is the control of agency through the unconscious separation of "internal" and "external" and the transformation (enaction) and/or recognition (reenaction) of intentions in action. How can we develop presence in robots? If we follow the development of presence in humans, we must use an evolutive process. First, the robot must learn to differentiate itself from the external world by correctly coupling perceptions and movements. Then the robot must learn to clearly separate perception and action planning, even if both share the same language: motor code. Finally, it is through social and cooperative activities that the robot may improve its intentional action and interaction.
18948428	Untreated imprisoned sexual offenders (N = 42) completed interviews and questionnaires to establish the priority they assigned, at the time of their offending, to three "goods" from the good lives model and to gain insight into how they operationalized these goods at that time. The relationship between the priorities offenders assigned to the goods of (a) agency, (b) relatedness, and (c) inner peace at the time of offending and their problem-solving ability was also explored. A measure of problem-solving ability was obtained with the Social Problem-Solving Inventory-Revised, and a measure of functional and dysfunctional problem solving was obtained from its scales. The results suggest that sexual offenders tend to experience problems in prioritizing, rather than operationalizing, inner peace, as this good is not related to problem-solving ability but tends to be assigned lower priority than agency and relatedness. Although agency and relatedness tend to be given higher importance, and this is related to better problem-solving ability, there appear to be problems with scope in some offenders' good lives conceptions and problems with the capacity, means, and conflict among the means used to achieve these goods. Directions for future research are suggested.
18928914	This study was designed to examine links between agentic and communal personality traits and disordered eating behavior and related problems (i.e., body shape concern and depressive symptoms) in a sample of 298 undergraduates. As predicted, unmitigated agency was positively associated with uncontrolled eating, and unmitigated communion was positively related to emotional eating and fasting for at least 24 h in order to control weight. When controlling for depressive symptomatology, unmitigated communion was no longer associated with emotional eating. Whereas unmitigated agentic and communal characteristics were positively associated with problematic eating patterns, agency was negatively associated with fasting and body shape concern. Findings suggest that further examination of the potential influence of gender-linked personality traits on disordered eating behavior is warranted.
18837999	Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable.While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders.	Integrated PHRs promote active, ongoing patient collaboration in care delivery and decision making. With some exceptions, however, the integrated PHR model is still a theoretical framework for consumer-centric health care. The authors pose questions that need to be answered so that the field can move forward to realize the potential of integrated PHRs. How can integrated PHRs be moved from concept to practical application? Would a coordinating body expedite this progress? How can existing initiatives and policy levers serve as catalysts to advance integrated PHRs?	
18834284	This article addresses the relation of narcissism to the concept of the self. Based on the concept of the self-as-person, distinction is drawn between the self as a substantial, relatively autonomous source of agency and of both conscious and unconscious mentation and action on one hand and the self as the object of narcissistic investment on the other. The argument presumes abandonment of both the concept of narcissism as libidinal drive cathexis of the self (the most common understanding of narcissism among analysts) and the converse proposition defining the self as derived from and reflecting narcissistic origins. It is proposed that development of self structure arises on the basis of other than narcissistic considerations, but once established it can become the object of narcissistic investment. As such the self cannot be reduced to or defined in terms of narcissistic derivation. Implications for the understanding of self-esteem are explored and clinical implications suggested.
18816289	When people's rationality and agency are implicitly called into question by the more expedient behavior of others, they sometimes respond by feeling morally superior; this is referred to as the sucker-to-saint effect. In Experiment 1, participants who completed a tedious task and then saw a confederate quit the same task elevated their own morality over that of the confederate, whereas participants who simply completed the task or simply saw the confederate quit did not. In Experiment 2, this effect was eliminated by having participants contemplate a valued personal quality before encountering the rebellious confederate, a result suggesting a role for self-threat in producing moralization. These studies demonstrate that moral judgments can be more deeply embedded in judges' immediate social contexts-and driven more by motivations to maintain self-image-than is typically appreciated in contemporary moral-psychology research. Rather than uphold abstract principles of justice, moral judgment may sometimes just help people feel a little less foolish.
18815452	Philosophers define the 'minimal self' as the immediate awareness of being the agent and owner of one's actions and perceptions. Here, we describe a patient with a selective loss of one part of this 'minimal self', namely the immediate sense of self-ownership for perceptions of objects. In contrast, his sense of self-ownership for body perceptions and for self-agency during actions remained intact. 18-Fluorodeoxyglucose positron emission tomography revealed predominantly right inferior temporal hypometabolism in comparison with healthy controls (parahippocampal and fusiform gyri). In addition, dysfunction of the right parieto-occipital junction and precentral cortex were detected. Taken together, we demonstrate selective changes in the quality of the sense of self-ownership for perceptions of objects but not actions and an intact sense of self-agency, which points to anatomically separable systems underpinning different aspects of the 'minimal self'. The associated hypometabolism in inferior temporal, parieto-occipital and motor regions, but not in medial prefrontal areas most consistently associated with self-referential processing, are most parsimoniously explained when self-consciousness is not assumed to be an anatomically localized cognitive function, but instead is conceived as emerging from integration across anatomically distributed networks of regions with different functional specializations, not all of which need to be special for the 'self'.
18783119	This study aimed to further our understanding of young people's perspectives on attention-deficit hyperactivity disorder (ADHD), with particular reference to social context and coping. Twelve young people (aged 10 years 11 months to 17 years 4 months) took part in semi-structured interviews. These were transcribed verbatim and analysed using grounded theory to extract themes and link these into an over-arching model. The model suggested a reciprocal relationship between young people and their social context, with the challenges of ADHD formulated as a mismatch between the two; young people were like square pegs trying to fit into rigid round holes. This 'vicious cycle' led young people to feel out of control and have low self-esteem. ADHD was experienced as less challenging when the environment was adaptable and flexible, and when young people experienced the support and acceptance of others. Such environments may motivate young people to make their own changes, and fostered a sense of agency and positive sense of self. The understanding of others and the willingness to adapt the environment to meet individual needs may ultimately benefit these young people's senses of agency and self-esteem.
18753307	Disturbances of self are a common feature of schizophrenic psychopathology, with patients reporting that their thoughts and actions are controlled by external forces, as shown in first-rank symptoms (FRS). One widely accepted explanatory model of FRS suggests a deficiency in the internal forward model system. Recent studies in the field of cognitive sciences, however, have generated new insights into how complex sensory and motor systems contribute to the sense of self-recognition, and it is becoming clear that the forward model conceptualization does not have unique access to representations about the self. We briefly evaluate the forward model explanation of FRS, reassess the distinction made between the sense of agency and body ownership, and outline recent developments in 4 domains of sensory-motor control that have supplemented our understanding of the processes underlying the sense of self-recognition. The application of these findings to FRS will open up new research directions into the processes underlying these symptoms.
18709365	How it happens that one can recognise oneself as the source of one's own actions? This process of self-recognition is in fact far from trivial: although it operates covertly and effortlessly, it depends upon a set of mechanisms involving the processing of specific neural signals, from sensory as well as from central origin. In this paper, experimental situations where these signals can be dissociated from each other and where self-recognition becomes ambiguous will be used in healthy subjects and in schizophrenic patients. These situations will reveal that there are two levels of self-recognition, an automatic level for action identification, and a conscious level for the sense of agency, which both rely on the same principle of congruence of the action-related signals. The automatic level provides an immediate signal for controlling and adapting actions to their goal, whereas the conscious level provides information about the intentions, plans and desires of the author of these actions. The contribution of schizophrenic patients is to show that these two levels can be dissociated from each other. Whereas the automatic self-identification is functional in these patients, their sense of agency is deeply impaired: the first rank symptoms, which represent one of the major features of the disease, testify to the loss of the ability of schizophrenic patients to attribute their own thoughts, internal speech, covert or overt actions to themselves.
18668295	Many genes and their regulatory relationships are involved in developmental phenomena. However, by chemical information alone, we cannot fully understand changing organ morphologies through tissue growth because deformation and growth of the organ are essentially mechanical processes. Here, we develop a mathematical model to describe the change of organ morphologies through cell proliferation. Our basic idea is that the proper specification of localized volume source (e.g., cell proliferation) is able to guide organ morphogenesis, and that the specification is given by chemical gradients. We call this idea "growth-based morphogenesis." We find that this morphogenetic mechanism works if the tissue is elastic for small deformation and plastic for large deformation. To illustrate our concept, we study the development of vertebrate limb buds, in which a limb bud protrudes from a flat lateral plate and extends distally in a self-organized manner. We show how the proportion of limb bud shape depends on different parameters and also show the conditions needed for normal morphogenesis, which can explain abnormal morphology of some mutants. We believe that the ideas shown in the present paper are useful for the morphogenesis of other organs.
18653358	Contemporary experimental research has emphasised the role of centrally generated signals arising from premotor areas in voluntary muscular force perception. It is therefore generally accepted that judgements of force are based on a central sense, known as the sense of effort, rather than on a sense of intra-muscular tension. Interestingly, the concept of effort is also present in the classical philosophy: to the French philosopher Maine de Biran [Maine de Biran (1805). Mémoire sur la décomposition de la pensée (Tome III), Vrin, Paris (1963)], the sense of effort is the fundamental component of self-experience, the landmark of the exercise of the will. In the present review, after a presentation of the nature and neurophysiological bases of effort sensation, we will examine its possible involvement in the neurocognitive process of agency. We will further focus on delusions of alien control in schizophrenic patients. Experimental data suggest that these patients have an abnormal awareness of effort caused by cerebral anomalies in the frontal and parietal lobes.
18648920	Two experiments were conducted to explore the extent to which individuals with autism experience difficulties in monitoring their own actions, both online and in memory. Participants with autism performed similarly in terms of levels and, importantly, patterns of performance to IQ-matched comparison participants. Each group found it easier to monitor their own actions/agency than to monitor the agency of the experimenter in a computerized task requiring individuals to distinguish person-caused from computer-caused changes in phenomenology. Both groups also showed a typical 'self-reference effect', recalling their own actions better than those of the experimenter. Both tasks appear to be reliable markers of underlying action monitoring ability, performance on the 'Self' conditions of each task being significantly associated, independent of verbal ability.
18633822	The human brain is inherently able to understand the world in moral ways, endowing most of us with an intuitive sense of fairness, concern for others, and observance of cultural norms. We have argued that this moral sensitivity ability depends on a sophisticated integration of cognitive, emotional, and motivational mechanisms, which are modulated by individual experience in different cultural milieus. Different lines of investigation on agency and morality have pointed to overlapping neural systems. Therefore, understanding the relationships between morality and agency may provide key insights into the mechanisms underlying human behavior in several clinical and societal settings. We used functional MRI to investigate the contribution of agency and of specific moral emotions to brain activation using action scripts. Results showed that emotionally neutral agency recruited neural networks previously associated with agency, intentionality and moral cognition, encompassing ventral and subgenual sectors of the medial prefrontal cortex (PFC), insula, anterior temporal cortex and superior temporal sulcus (STS). Compared to emotionally neutral agency, different categories of moral emotions led to distinct activation patterns: (1) prosocial emotions (guilt, embarrassment, compassion) activated the anterior medial PFC and STS, with (2) empathic emotions (guilt and compassion) additionally recruiting the mesolimbic pathway; (3) other-critical emotions (disgust and indignation) were associated with activation of the amygdala-parahippocampal and fusiform areas. These findings indicate that agency related to norm-abiding social behaviors of emotionally neutral scripts share neural substrates both with the "default mode" of brain function and with the moral sensitivity network. Additional activation in specific components of this network is elicited by different classes of moral emotions, in agreement with recent integrative models of moral cognition and emotion.
18619789	To develop and validate a questionnaire based on agency theory to measure continuity of care in a community-based diabetes control program in Shanghai, China.Continuity of care was conceptualized in relation to two domains: information transfer and goal alignment. The questionnaire combined scales adopted from two validated questionnaires: the Primary Care Assessment Survey and the Summary of Diabetes Self-care Activities Measure. Patient interviews were conducted with 156 diabetes patients in the intervention group and 182 in the control group in two community health settings in Shanghai, China. The questionnaire was validated in terms of Likert-scaling assumptions, data completeness, score distribution, construct validity, and sensitivity.	All scales consistently showed strong measurement properties in item reliability and validity. Requirements of data completeness and distribution were achieved in all scales. Principal components analysis of six scales provided a satisfactory explanation of the hypothesized scale-domain construction.	The validation results suggested that the scales in our continuity of care questionnaire are consistent with the concept of continuity of care based on agency theory.	
18611210	Personal habits of children and adolescents related to healthy body image (BI) are influenced by various determinants in the micro- and macroenvironment. These include attitudes and behaviors about eating; exercise and physical appearance modeled by parents, teachers, and peers; as well as opportunities to learn new habits and social praise for healthy choices. The coordinated school health program (CSHP) is compatible with the 5 levels of an ecological approach to developing new health behaviors.Authors systematically applied the ecological model to all 8 components of coordinated school health. Next, strategies for each of the components were developed using the professional literature as well as author expertise in the areas of health education, exercise science, and dietetics.	For each strategy, applicable health and physical education standards, as well as goals for each strategy and additional Web resources, were provided to assist educators and administrators in supporting healthy BI among students.	Educators may effectively use a coordinated approach to guide multiple intervention activities aimed at increasing healthy habits among adolescents and their families. The strength of the CSHP is its collaborative nature with active participation by students, faculty members, family caregivers, agency professionals, community residents, and health care providers.	
18610811	In this article, we examine the apparent resistance of elderly Russian Jewish émigrés to the dominant U.S. biomedical model of diabetes treatment. Cultural competence on the part of medical professionals who make assumptions about Russian culture tends to be based on particularly American values of self-control and individual agency. The American consumer model of health care incorporating risk, individual responsibility, autonomy, and choice, when applied to elderly Russian Jewish émigrés, results in a reading of different values and choices as failed self-management or noncompliance. This article argues for a more reflexive understanding of U.S. biomedical culture as a replacement for the current "sound bite" model of cultural diversity.
18446560	In contemporary Vietnam, young, unmarried, educated women are struggling to negotiate the contradictory expectations of femininity. Qualitative research conducted in Hanoi with 13 unmarried, educated women, aged from 25 to 34 years, explored women's sexual agency in a context of changing discourses on sexuality and gender roles. Interviews were conducted several times with each woman to enable in-depth understanding of sexual experiences and meanings. Either implicitly or explicitly, women in the research were found to resist the power of public discourses on femininity and sexuality. Notions of femininity can be interpreted as a temporary means for women to gain control over sexual relationships. It is crucial to acknowledge the sexual agency of unmarried, educated women and its diverse forms in order to understand complex sexual behaviours and to promote their sexual rights and health.
18557669	One's practice as a school nurse affords numerous privileges. One that stands out in my mind is the privilege of bearing witness to the lives of countless girls as they navigated their own aspirations and the expectations of the culture. The stories they iterated to me in my school nurse office form the basis for this discussion regarding the relationship between anger and mental health. I've come to realize that as a school nurse, I was an anger-story listener. In so being, I was given the opportunity and responsibility to influence positive mental health for numerous girls and young women. This feminist qualitative research project explored girls' lived experiences of anger. The findings suggest that experiences of disrespect, dismissal, denied agency, and a denial of the right to verbalize anger eventually led to self-silencing and an eventual disconnect from this important emotion. The girls described strategies associated with the societal response to their anger that are likened here to the ultra-adaptive strategies that chameleons show to survive.
18540421	Precise and adequate assessment of social functioning and disability is a subject of major interest and concern of the researchers. Until now, no instrument with confirmed psychometric properties was established as a supportive measure of disability in the framework of the rehabilitation process with the participation of the National Insurance Agency. A potentially useful instrument for this purpose is the Groningen Social Disabilities Schedule II (GSDSII).Aim of the study was the evaluation of usefulness of the Polish version of GSDSII as a social disabilities measure in the population of psychiatric inpatients.	130 persons with a broad range of diagnoses (schizophrenia, mood disorders, anxiety disorders) were interviewed. For estimation of convergent validity, the following reference tools were selected: Global Assessment of Functioning (GAF), Social Assessment of Functioning scale (SOFAS), Global Assessment of Relational Functioning (GARF), World Health Organization Disability Assessment Schedule II (WHO-DASII). For criterion validity the Brief Psychiatric Rating Scale (BPRS) 24-item version was applied. RESULTS. The sufficient and good validity indices were obtained for concurrent validity of GSDSII. There was also a significant interrelation between psychopathology assessed with BPRS and disability measured by GSDSII.	Results allow for the supplication of the GSDSII in the research on psychosocial disability in Poland.	

18513994	Positive schizophrenic symptoms, especially passivity phenomena, including auditory hallucinations, may be caused by an abnormal sense of agency, which people with schizotypal personality traits also tend to exhibit. A sense of agency asserts that it is oneself who is causing or generating an action. It is possible that this abnormal sense of self-agency is attributable to the abnormal prediction of one's own movements in motor control.We conducted an experiment using the "disappeared cursor" paradigm in which non-clinical, healthy participants were required to click on a target using an invisible mouse cursor. Prediction error was defined as the distance between the target and the click point.	The results showed that schizotypal personality traits, but not depressive or anxious traits, were correlated with deficits in predicting movements of the subjects' left hand. In particular, auditory hallucination proneness had the strongest relationship with movement prediction error. In this report, we also discuss the error tendency (overestimations or underestimations of one's own movements).	This finding is in accordance with the idea that passivity phenomena or proneness may be caused by the abnormal prediction of one's own actions or movements.	
18507710	A cross-temporal meta-analysis found that narcissism levels have risen over the generations in 85 samples of American college students who completed the 40-item forced-choice Narcissistic Personality Inventory (NPI) between 1979 and 2006 (total n=16,475). Mean narcissism scores were significantly correlated with year of data collection when weighted by sample size (beta=.53, p<.001). Since 1982, NPI scores have increased 0.33 standard deviation. Thus, almost two-thirds of recent college students are above the mean 1979-1985 narcissism score, a 30% increase. The results complement previous studies finding increases in other individualistic traits such as assertiveness, agency, self-esteem, and extraversion.
18504028	This article focuses on the teaching-learning strategies for integration of cultural competence in the first clinical core course in Primary Care of the Middle Aged and Older Adult, a required course for graduate students enrolled in the Adult Health Nurse Practitioner Program, Gerontology Nurse Practitioner Program, and the Family Health Nurse Practitioner Program at the University of Pennsylvania School of Nursing. Multiple teaching-learning strategies for the first clinical course consisted of preliminary online self-assessment, clinical case scenarios, critique of multicultural clinical vignettes, and cultural assessment of the clinical agency. In the outcomes of these teaching-learning strategies, it was shown, through the use of reflective diaries of nurse practitioner students and course evaluations, that the multiple strategic approaches were effective for cultural competence integration within each of the nurse practitioner programs.
18476855	The Lourdes Hospital Inquiry: An inquiry into peripartum hysterectomy at Our Lady of Lourdes Hospital, Drogheda, Ireland, of 2006 recounts in detail the circumstances within which 188 peripartum hysterectomies were carried out at the hospital between 1974 and 1998. The findings of the inquiry have serious ramifications for Irish healthcare delivery and have implications for many professional groups, including midwives. The findings prompt clear questions about the relative position or power of midwives within maternity care. These questions are examined in this article, through the analysis and application of various theoretical perspectives on power. Critical views of power focus on the socio-political nature of oppressive structures within society and seek mechanisms to address these. Stemming from structure versus agency debates, Giddens's structuration theory examines the agency-structure interaction and stresses the centrality of agents' roles in the social reproduction of structures. Postmodernism, particularly drawing on the work of Michel Foucault, focuses on a fluid conception of power while also describing the nature of disciplinary power. It offers midwives a way of viewing power as productive and dispersed. Drawing on different aspects of these perspectives on power, helps us to understand midwives' relative positions and power relations and how to enhance these to prevent future tragic outcomes such as those reported in the inquiry report.
18451003	Mental health advocates and policy makers are increasingly attuned to the importance of the recovery concept, and psychiatrists and neuroscientists increasingly emphasize the medical model and neurobiological mechanisms in relation to schizophrenia. Studies have shown that people with schizophrenia are tremendously heterogeneous in each domain of recovery, and the various domains of recovery are themselves relatively independent from one another. Studies have also shown that current interventions are effective for specific dimensions of the illness and functions, are usually ameliorative rather than curative, and are effective only for a proportion of patients. Hence, the authors suggest defining recovery in terms of improvements in specific domains rather than globally -- for example, "recovery of cognitive functioning" or "recovery of vocational functioning" -- to signify improvements in specific areas. This definition realistically emphasizes states of relative and partial recovery that patients can achieve in response to treatment. The emphasis on a range of improvements in specific areas should allow clinicians to communicate more clearly regarding the current findings and goals of treatment. The article also examines current research on various aspects of recovery, including the effects of treatment on pathophysiology, symptoms, cognitive impairments, quality of life, and self-agency. An operational definition of recovery allows for bridging hope and recovery with important advances in the science of the brain. Future clinical and neuroscience research and service development should emphasize measures of recovery as outcomes for people with schizophrenia.
18446110	Donation after cardiac death (DCD) is being implemented nationwide in the United States to increase the number of organ donors. Pediatric critical care nurses (PCRNs) are key facilitators in the organ donation process. This study assesses their perception, level of knowledge, and understanding of DCD and the effect of an educational intervention.Anonymous questionnaire administered before and after an educational intervention.	Children's hospital with 39 pediatric and cardiac/transplant intensive care unit beds.	PCRNs in these intensive care units.	DCD education.	Response to the initial questionnaire was 93 of 123 (76%): 63% of PCRNs supported organ donation, 69% felt it gives meaning and worth to death, and 76% felt that it contributes positively to the donating family's grieving process. Ninety-five percent agreed that DCD patients have a right to pain medications, and 92% supported such medications even if they hasten death. However, 11% feared that the DCD donor feels pain and suffering. Fourteen percent felt that a 5-min observation period after asystole is insufficient to pronounce death, and 8% feared legal repercussions. PCRNs scored lower on questions assessing their knowledge (p < .01), their comfort answering family questions (p < .05), and their comfort in calling the organ procurement agency about DCD donors compared with similar questions about brain-dead donors. One month after 104 PCRNs attended the educational intervention, 64 (62%) completed a follow-up survey. Correct identification of the DCD process improved from 20% to 79%. Confidence with knowledge, comfort answering family questions, and comfort in calling the organ procurement agency about DCD donors improved by 41%, 25%, and 18%, respectively.	PCRNs are generally supportive of organ donation but have a self-perceived and objectively identified knowledge deficit regarding DCD, resulting in their being unprepared to identify potential DCD donors or handle family questions. A simple educational intervention can improve PCRNs' knowledge of the DCD process and their confidence and comfort with this process. As DCD policies are implemented, specific interventions should target these key members of the intensive care unit team.	
18445861	This study determines the confidence levels of physicians in providing components of pediatric palliative care and identifies their willingness to obtain training and to make palliative care referrals. Surveys were mailed to all physicians at Primary Children's Medical Center. The survey instrument includes 3 demographic items, 9 items designed to assess physician confidence in core palliative care skills, and 4 items designed to assess what steps physicians would be likely to take to assure that patients receive palliative care. Physicians were asked to rate their confidence levels to provide palliative care components on a 4-point scale for each of the items. Five hundred ninety-seven surveys were mailed, with 323 usable surveys returned. The proportion of physicians who rate their ability to provide palliative care as "confident" or "very confident" ranges from 74% for giving difficult news to families to 23% for managing end-of-life symptoms. Thirty-six percent of the physicians say they would be "likely" or "very likely" to attend training to improve their ability to provide palliative care to children. Eighty-six percent would be "likely" or "very likely" to refer for a palliative care consult and 91% to a home health agency or hospice. There is wide variation in the confidence levels of physicians to provide the core components of palliative care. Few are interested in obtaining additional training, but most are willing to obtain consultation or to refer to a palliative care service. These results argue in favor of hospital-based palliative care teams and for specialty training and certification in pediatric palliative care.
18430703	A developmental narrative is presented that centers on bodily based narcissistic injury and sense of shame in response to unrequited oedipal longings. Through an experience of oedipal defeat in relation to both mother and father, a female sense of inadequacy and shame may be internalized and accepted as one's identity, in contrast to the male phallic-omnipotent trajectory. The demise of genital narcissism in females can underlie various expressions of pervasive inhibition and failure to actualize desire. The thesis offered goes beyond separation-individuation theory in suggesting that girls may inhibit sexuality and aggression, and themselves more generally, due to a representation of self as "not having what it takes" genitally, and then bodily and psychically. Mental representations of the self, based on positive imagery of the female body, are needed to give voice to a woman's bodily experience and sexual desire and agency in various realms. Two clinical vignettes illustrate female inhibitions in sexuality and in professional ambition as understood within the framework presented.
18424080	The sense of agency is a central aspect of human self-consciousness and refers to the experience of oneself as the agent of one's own actions. Several different cognitive theories on the sense of agency have been proposed implying divergent empirical approaches and results, especially with respect to neural correlates. A multifactorial and multilevel model of the sense of agency may provide the most constructive framework for integrating divergent theories and findings, meeting the complex nature of this intriguing phenomenon.
18411059	The neurocognitive structure of the acting self has recently been widely studied, yet is still perplexing and remains an often confounded issue in cognitive neuroscience, psychopathology and philosophy. We provide a new systematic account of two of its main features, the sense of agency and the sense of ownership, demonstrating that although both features appear as phenomenally uniform, they each in fact are complex crossmodal phenomena of largely heterogeneous functional and (self-)representational levels. These levels can be arranged within a gradually evolving, onto- and phylogenetically plausible framework which proceeds from basic non-conceptual sensorimotor processes to more complex conceptual and meta-representational processes of agency and ownership, respectively. In particular, three fundamental levels of agency and ownership processing have to be distinguished: The level of feeling, thinking and social interaction. This naturalistic account will not only allow to "ground the self in action", but also provide an empirically testable taxonomy for cognitive neuroscience and a new tool for disentangling agency and ownership disturbances in psychopathology (e.g. alien hand, anarchic hand, anosognosia for one's own hemiparesis).
18399957	Do agency and communion strivings provide functionally similar but predictively independent pathways to enhanced well-being? We tested this idea via a year-long study of 493 diverse community adults. Our process model, based on self-determination and motive disposition theories, fit the data well. First, the need for achievement predicted initial autonomous motivation for agentic (work and school) role-goals and the need for intimacy predicted felt autonomy for communal (relationship and parenting) goals. For both agentic and communal goals, autonomous motivation predicted corresponding initial expectancies that predicted later goal attainment. Finally, each type of attainment predicted improved adjustment or role-satisfaction over the year. Besides being similar across agency and communion, the model was also similar across race and gender, except that the beneficial effects of communal goal attainment were stronger for high need for intimacy women and Blacks. Implications for agency/communion theories, motivation theories, and theories of well-being are discussed.
18382820	To examine the impact of home modifications on self-rated ability in everyday life from various aspects for people ageing with disabilities.The study sample was recruited from an agency providing home modification services in Sweden and comprised 73 subjects whose referrals had been approved and who were scheduled to receive home modifications (intervention group) and 41 subjects waiting for their applications to be assessed for approval (comparison group). The subjects rated their ability in everyday life using the Client-Clinician Assessment Protocol Part I on 2 occasions: at baseline and follow-up. The Client-Clinician Assessment Protocol Part I provides data on the clients' self-rated independence, difficulty and safety in everyday life. The data were first subjected to Rasch analysis in order to convert the raw scores into interval measures. Further analyses to investigate changes in self-rated ability were conducted with parametric statistics.	Subjects who had received home modifications reported a statistically significant improvement in their self-rated ability in everyday life compared with those in the comparison group. Subjects who had received home modifications reported less difficulty and increased safety, especially in tasks related to self-care in the bathroom and transfers, such as getting in and out of the home.	Home modifications have a positive impact on self-rated ability in everyday life, especially on decreasing the level of difficulty and increasing safety.	
18365931	This study responds to the identified need for evidence-based substance abuse interventions by examining the effects of an innovative dual processing substance use intervention aimed at decreasing the risk for substance relapse by targeting emotional regulation capacity. The study was completed in partnership with a Latino-serving community-based substance user treatment agency in a rural Northeastern region of the United States in 2005-2006 and was supported with pilot monies from the University at Albany School of Social Welfare NIDA-funded research center. The sample (N = 29) was comprised of adults with a diagnosis of substance dependence seeking treatment in an outpatient program. Study findings indicated that individuals who participated in the dual-processing treatment group decreased their craving with a trend toward increased self-efficacy over time in treatment and did not show treatment response differences across Latino and non-Latino clients, suggesting that treatment application was similar across these groups. The study's limitations are noted.
18354654	We report on the implementation of an end-to-end imaging demonstrator to validate the concept of optical fiber use in high-resolution aperture synthesis in astronomy. As the coherent transport of light has been conclusively investigated, this study is focused primarily on the accuracy and reliability of the experimental data. In the framework of the European Space Agency project Optical Aperture Synthesis Technologies (OAST), the telescope array's complexity is minimized such that a realistic concept for a future space mission can be proposed. The reconstructed images are obtained by use of a particular self-calibration procedure that was designed to process the visibility contrast and the related weak phase information (one phase closure for each visibility triplet).
18349344	This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who experienced more intimate partner violence had a significantly higher likelihood of inconsistent condom use and therefore a greater risk for HIV/STDs. Girls' sense of sexual control in their relationships was not directly associated with inconsistent condom use but was inversely related to verbal and emotional abuse. Interventions aimed at reducing HIV/STD risk for adolescent girls need to address patterns of dominance and control in adolescent relationships as well as multiple forms of partner violence. This suggests the need for multilevel intervention approaches that promote girls' agency and multiple ways to keep girls safe from perpetrators of partner abuse.
18340602	Some patients with Alzheimer's disease (AD) reveal low-level impairment in their concepts of living things (i.e., forgetting that zebras are striped). To test for more profound impairment, we investigated the concept alive--a "higher order" concept spanning every member of the domain. Many elderly controls were animists, attributing life to inanimates capable of self-generated activity (the sun, fire). Most AD patients were animists, with half even attributing life to inanimates whose activity is not self-generated (cars, lamps). Adult animists, like young children who have not yet acquired biological concepts, overattributed life to active inanimates. We believe this reflects an innate disposition to view active entities as agents, and that agency interferes with the biological concept alive. This interference, we suggest, reflects degradation of biological concepts in the face of spared perception of agents. It sheds light on the nature of fundamental questions concerning conceptual organization, innate endowment, and conceptual change.
18325789	When looking to our reflection, or moving a video-game character, we see our own movement preformed by an agent which is physically separated from our body. Yet, we consider the agent to be ourself. Using fMRI, we sought to explore the neural underpinnings of disembodiment, the cognitive mechanism under which the properties of the self are projected away from the boundaries of one's own body towards an external entity. Seventeen participants watched a video-game in which three players threw each other a ball. Subjects' key-press could either be synchronous or asynchronous with one of the players' action (TASK: Agency vs. Control). The game was shown from one of four viewpoints which could either be fixed or change every trial (VIEWS: Fixed vs. Changeable). Consistent with previous studies, the left insula was activated when the agent's movements were synchronous with those of the participants (main effect of TASK, p<0.05, SVC). The analysis of the interaction TASKVIEWS revealed activation (p<0.05, corrected) of the right parieto-temporal-occipital (PTO) junction when the agent whose movements were synchronous to the participants was processed in a spatial position each time different with respect to the preceding trials. Our findings implicate the right PTO junction in assigning one's own movements to an agent which is physically independent of oneself. They also suggest that the ability to disembody, and thereby objectify, bodily or mental states concerning the self is common to all experimental paradigms which led to an activation of the PTO junction.
18299207	We can easily discriminate self-produced from externally generated sensory signals. Recent studies suggest that the prediction of the sensory consequences of one's own actions made by forward model can be used to attenuate the sensory effects of self-produced movements, thereby enabling a differentiation of the self-produced sensation from the externally generated one. The present study showed that attenuation of sensation occurred both when participants themselves performed a goal-directed action and when they observed experimenter performing the same action, although they clearly reported that the tones were produced by other during action observation and by themselves during their own action. These results suggest that sensory prediction of action modulates ongoing auditory processing irrespective of who produces the sounds and that the explicit judgment of agency does not necessarily rely on the same mechanisms on which implicit perceptual measures such as sensory attenuation rely.
18297400	The effect of providing youth school-based mentoring (SBM), in addition to other school-based support services, was examined with a sample of 516 predominately Latino students across 19 schools. Participants in a multi-component, school-based intervention program run by a youth development agency were randomly assigned to one of two conditions: (1) supportive services alone or (2) supportive services plus SBM. Compared to community-based mentoring, the duration of the SBM was brief (averaging eight meetings), partly because the agency experienced barriers to retaining mentors. Intent-to-treat (ITT) main effects of SBM were tested using hierarchical linear modeling (HLM) and revealed small, positive main effects of mentoring on self-reported connectedness to peers, self-esteem (global and present-oriented), and social support from friends, but not on several other measures, including grades and social skills. Three-way cross-level interactions of sex and school level (elementary, middle, and high school) revealed that elementary school boys and high school girls benefited the most from mentoring. Among elementary school boys, those in the mentoring condition reported higher social skills (empathy and cooperation), hopefulness, and connectedness both to school and to culturally different peers. Among high school girls, those mentored reported greater connectedness to culturally different peers, self-esteem, and support from friends. Findings suggest no or iatrogenic effects of mentoring for older boys and younger girls. Therefore, practitioners coordinating multi-component programs that include SBM would be wise to provide mentors to the youth most likely to benefit from SBM and bolster program practices that help to support and retain mentors.
18289150	Schizotypy can be seen as an indicator of a predisposition to schizophrenia. It is possible that schizotypal people have an abnormal self-consciousness, especially with regard to the sense of self-agency. Students were rated using the Schizotypy Traits Questionnaire (STA). They were asked to press a button, which generated a tone after some delay. They were then required to judge whether they felt they or someone else had generated the tone. The results showed that the high schizotypy group had a weaker sense of self-agency than the low schizotypy group. The present study used an experimental method to show that schizotypal traits are correlated with an abnormal sense of self-agency.
18275339	Individuals can experience negative emotions (e.g., embarrassment) accompanying self-evaluation immediately after recognizing their own facial image, especially if it deviates strongly from their mental representation of ideals or standards. The aim of this study was to identify the cortical regions involved in self-recognition and self-evaluation along with self-conscious emotions. To increase the range of emotions accompanying self-evaluation, we used facial feedback images chosen from a video recording, some of which deviated significantly from normal images. In total, 19 participants were asked to rate images of their own face (SELF) and those of others (OTHERS) according to how photogenic they appeared to be. After scanning the images, the participants rated how embarrassed they felt upon viewing each face. As the photogenic scores decreased, the embarrassment ratings dramatically increased for the participant's own face compared with those of others. The SELF versus OTHERS contrast significantly increased the activation of the right prefrontal cortex, bilateral insular cortex, anterior cingulate cortex, and bilateral occipital cortex. Within the right prefrontal cortex, activity in the right precentral gyrus reflected the trait of awareness of observable aspects of the self; this provided strong evidence that the right precentral gyrus is specifically involved in self-face recognition. By contrast, activity in the anterior region, which is located in the right middle inferior frontal gyrus, was modulated by the extent of embarrassment. This finding suggests that the right middle inferior frontal gyrus is engaged in self-evaluation preceded by self-face recognition based on the relevance to a standard self.
18267996	The purpose of this methodological secondary data analysis study is to examine the reliability, construct validity, and dimensionality of the Appraisal of Self-care Agency Scale (ASAS) in an American sample of adults with diabetes mellitus.The sample consisted of 141 insulin-requiring adults with diabetes mellitus recruited from a Diabetes Care Center in the southern United States. The ASAS, along with Hurley's Insulin Management Diabetes Self-efficacy and Insulin Management Diabetes Self-care Scales, was used in the study to determine convergent validity, thus contributing to the construct validity of the ASAS. Other data analysis consisted of internal consistency estimates of reliability, Pearson correlations, and factor analysis.	The findings suggest that the ASAS consists of a single substantive dimension and has adequate construct validity and reliability.	Revision of certain items and conducting further analysis of the scale, prior to its adoption in clinical practice, should be considered.	
18262508	What is it like to have a body? The present study takes a psychometric approach to this question. We collected structured introspective reports of the rubber hand illusion, to systematically investigate the structure of bodily self-consciousness. Participants observed a rubber hand that was stroked either synchronously or asynchronously with their own hand and then made proprioceptive judgments of the location of their own hand and used Likert scales to rate their agreement or disagreement with 27 statements relating to their subjective experience of the illusion. Principal components analysis of this data revealed four major components of the experience across conditions, which we interpret as: embodiment of rubber hand, loss of own hand, movement, and affect. In the asynchronous condition, an additional fifth component, deafference, was found. Secondary analysis of the embodiment of runner hand component revealed three subcomponents in both conditions: ownership, location, and agency. The ownership and location components were independent significant predictors of proprioceptive biases induced by the illusion. These results suggest that psychometric tools may provide a rich method for studying the structure of conscious experience, and point the way towards an empirically rigorous phenomenology.
18235164	The interview is both popular and problematic in social research. In this article, we describe and make problematic interviews from a study conducted with impoverished elders in Melbourne, Australia. Participants were paid $20 for each of two interviews. The result of the paid-for participation was double-edged in that it provided funds for impoverished participants, but the payment modified the exchange of free and open discussion. We describe key exchanges within the research interviews to exemplify how participants managed their experience and presentation of stigma and dignity. We demonstrate, with examples from the transcripts, strategies used by participants to gain agency over the process, while at the same time maintain enough of a semblance of conversational genre to make paid-for participation legitimate. We see this as an interesting methodological event that should inform analysis, interpretations, and the validity of interviews, rather than a problem with the interviewee.
25160049	The present study examined whether the effects of temporal orientation on illness self-management in older women with osteoarthritis (N = 74) were moderated by perceived threats to life goals. When perceived goal threat was lower, individuals who were highly future-oriented engaged in a greater number of arthritis management behaviors, especially proactive strategies (e.g., exercise and dietary supplements). When individuals perceived more threat to life goals, having a greater present orientation predicted greater use of arthritis management behaviors, particularly reactive strategies (e.g., taking pain medication). Results suggest that temporal orientation is important in determining whether individuals take a more reactive or proactive approach to illness management, particularly when considering the potential consequences of illness on quality of life. 
18207046	Pediatric nurses often struggle to find ways to encourage adolescents with cystic fibrosis (CF) to engage in self-care that is essential to their health and life. A study of predictors of self-care was conducted to provide a stronger evidence base for nursing practice with these youth. Orem's theories of self-care and self-care deficit were tested to explain and predict the universal and health deviation self-care of 123 adolescents with CF. Four dimensions of self-care agency emerged as predictors of universal self-care, two of which were also predictive of health deviation self-care. Seventy percent of the variance or change in universal self-care scores and 40% of health deviation self-care variance were explained. Clarification and extension of Orem's theories were also an important outcome. Development of nursing interventions designed to strengthen predictors of universal and health deviation-specific self-care identified in this research holds the potential to improve length and quality of life for adolescents with CF.
18183471	Perception is an intentional action through space in time by which the finite brain explores the infinite world. By acting, the brain thrusts its body into the future space-time of the world while predicting the sensory consequences. Through perceiving its actions and their results, it remembers its predictions, its actions, and their consequences. To perform these operations the brain, through chaotic dynamics, constructs and uses finite perceptual matrices of space-time and infers causation. Perceived time differs from world time in ways that are determined by the neural mechanisms of intentionality. In particular, perception of the self in action, through the mechanism of preafference, gives structure and content to the concepts of continuity, contiguity, duration, temporal order, cause, and effect. We expand our perceptual scales beyond kinesthesia by converting time into space by use of clocks and calendars. Remembered time differs from perceived time in being dependent on awareness, which makes it episodic, fragmentary, and subject to large variations in rates of time lapse in the flow of meanings. The attribution of causal agency to objects and events in the world results from the experience of temporal sequencing in the action-perception cycle: "I act" [cause] "I feel" [effect] during Piaget's somatomotor phase in early human development.
22844654	Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months (38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment.
18096228	The purpose of this longitudinal study was to examine the relationship between several proposed protective factors and trauma symptoms among highly vulnerable youth in the child welfare system.Participants were 142 youth identified with a sexual behavior problem and their caregivers. Two waves of data were collected for each participant an average of 18 months apart. Foster parents reported on perceived level of support from the child welfare agency, youth involvement in club activities, and perception of youths' interpersonal and emotional competence. Youth provided self-reports of their sexual and physical abuse experiences, trauma symptoms at both time 1 and time 2, and ratings of parenting practices.	Youth with higher rates of sexual abuse showed more negative affect and higher levels of sexual and non-sexual rumination at time 2, controlling for time 1 scores. Boys and youth who experienced better parenting practices displayed lower negative affect. Youth with higher levels of emotional and interpersonal competence showed lower levels of non-sexual rumination. Moderation analyses revealed that youth with more significant sexual abuse histories whose foster parents did not feel supported by their child welfare caseworkers had higher levels of sexually ruminative thoughts. Finally, the results revealed that only youth without sexual abuse histories experienced the benefits of club involvement in terms of lower sexual rumination scores.	This study demonstrated that youth with significant vulnerabilities can still exhibit a degree of protection from trauma symptomatology in the presence of a wide range of personal and social variables. These findings support the efforts of stakeholders to promote strengths at the level of the individual, family, and broader social network and community.	
18086722	This discourse analytic study shows how 10 older women, who exercise regularly or attend the University of the Third Age, adjust to the ageing body in their ;everyday talk' through taking a dualist position. The part of the body which is discursively constructed as ageing becomes objectified through appealing to a wider cultural discourse of ageing as biological decline. This dualist position is embedded within a wider cultural discourse of personal agency. The individual's control of the ageing body is emphasized, the ability to monitor and manage ;ageing body parts' through exerting the ;active mind' and the ;busy body' in activities, or simply focusing on ;looking good'.
18085941	Intentional binding refers to a temporal attraction in the perceived times of actions and effects. So far, it has solely been investigated using judgments of the perceived time of actions or their effects. The authors report 3 experiments using an alternative method: the estimation of a time interval between a voluntary action and its subsequent effect. Interval estimates were obtained for intervals bounded by different kinds of actions and effects: The actions were either performed by the participants themselves or by the experimenter. The effects, in turn, were movements either applied to the body of the participant or to the experimenter. First, the results validated interval estimation as a method for exploring action awareness. Second, intentional binding was stronger for self-generated compared with observed actions, indicating that private information about the action contributes to action awareness. In contrast, intentional binding did not depend on whether a somatic effect was applied to the participant's or to another person's body. Third, for self-generated actions, external events gave rise to a stronger intentional binding than did somatic effects. This finding indicates that intentional binding especially links actions with their consequences in the external world.
18075952	Traumatic brain injury (TBI) due to closed mechanisms causes strain injuries to axons that increase in number and severity as injury severity increases. Axons that project up from the brain stem are vulnerable, even in milder concussive injuries, and include axons that participate in key monoaminergic pathways. Although called diffuse axonal injury, the supra-tentorial injury component typically shows an anterior preponderance in humans. As the injury forces increase, cerebral contusions may be superimposed on the axonal strain injuries, and these contusions show an anterior preponderance as well. The chronic neuropsychiatric manifestations of TBI reflect this injury distribution. In the cognitive sphere, these manifestations almost always include power function disturbances marked by difficulties with cognitive processing speed, multitasking, and cognitive endurance. These disturbances may then be followed by disturbances in executive function and self-awareness as injury severity increases. In the behavioral sphere, mood disturbances and disorders of behavioral control and regulation are particularly common.
18062764	This study assessed the health needs and barriers to healthcare among women with a history of intimate partner violence (IPV) as told by women themselves.Qualitative interviews were conducted with 25 women clients and 10 staff members at a crisis center in metropolitan North Carolina. Clients also completed a structured survey.	Eleven shelter clients and 14 walk-ins completed the survey and interview. Client participants were demographically mixed, and 20% were Spanish-speaking immigrants. Most clients were unemployed and uninsured. Women reported worse health in the interviews than on the surveys; clients' major health needs were chronic pain, chronic diseases, and mental illness. Reported barriers to healthcare were cost, psychological control by the abuser, and low self-esteem and self-efficacy. Staff's perceptions of clients health needs differed from clients,' focusing on reproductive health, HIV/sexually transmitted infection (STI), mental illness, and inadequate preventive healthcare. Staff and clients' perceptions of barriers to healthcare were more congruent. Suggestions for improving the center's response were to offer more health education groups and more health-related staff trainings. Agency barriers to implementing these changes were limited funding, focus on crisis management, and perceived disconnect with the healthcare system.	Health needs of women who have experienced IPV are significant and include physical and mental concerns. IPV creates unique barriers to accessing healthcare, which can be addressed only partially by a crisis center. Greater coordination with the healthcare system is needed to respond more appropriately to the health needs of women who have experienced IPV.	
20925839	Aim.  To examine relationships between psycho-social and patho-physiological measures in explaining medication compliance in older heart failure (HF) patients. Background.  Self-efficacy is a predictor not only of medication compliance, but also health recovery. How older HF patients conceptualize and manage this life-threatening event is central to ongoing rehabilitation. Regulating ongoing medical and lifestyle changes in the rehabilitation process requires that any underlying negative affect be productively managed by the use of appropriate coping strategies. Method.  Using an exploratory correlational design, 51 older HF patients were asked to complete the Beck Depression Inventory, Beliefs about Medication and Diet Questionnaire, Reactions to Daily Events Questionnaire and Self-regulation scale. A self-report measure of medication compliance was obtained as part of a semi-structured interview. The study was conducted in 2003-2004. Results.  Using descriptive statistics, patho-physiological and psychosocial characteristics were given. Independent t-tests were used to assess the gender effects. Pairwise correlations were used to examine the relationships between presenting circumstances, psychosocial characteristics, medication compliance beliefs and self-reported medication compliance behaviours. All positive coping strategies and self-regulation were associated with positive intentions in medication compliance. Males were more inclined towards proactive coping and self-regulatory strategies than were females. Increased depressive symptoms were linked to carelessness in compliance. A belief in medication compliance was associated with a reduced likelihood of carelessness Conclusion.  Bandura's three conditions for agency in rehabilitation, self-efficacy and goal-directed intention appeared to be important even in the early phase of the programme. Positive coping strategies and self-regulation suggests a positive basis for medication compliance and more successful ongoing rehabilitation for older HF patients. We identify a significantly enhanced educative role for nurses in this context. Relevance to clinical practice.  We suggest that nurses dealing with compliance issues among older patients need to monitor behaviour through addressing both the quality of affect during the patient's response to HF (self-concept, -esteem and -efficacy) as well as the quality of health-related metacognitive knowledge underlying the self-regulatory decisions (such as the patients conceptions of 'wellness' and the strategic knowledge underpinning its achievement and maintenance).
18038727	People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/ AIDS in NewYork State. The survey was conducted anonymously, and case managers were sampled at the agency level. Results showed that two-thirds of case managers routinely discuss disclosure issues with their HIV-positive clients. However, case managers often felt that they lacked the resources to provide assistance with disclosure decisions, and 66 percent of those who routinely discuss disclosure issues had not received training in assisting with disclosure to sex and injection drug-sharing partners. HIV disclosure issues were also seen by case managers as only one of many pressing issues facing their HIV-positive clients; other pressing issues were housing, food, medical care, mental health treatment, and preventing HIV transmission. These results indicate a need for training and resources to facilitate HIV status disclosure assistance services offered by case managers.
18033150	Experiencing oneself as the author of an action defines the sense of agency, which is a component of the self. A deficit affecting this process is thought to cause the principle symptoms characterizing schizophrenia - e.g. delusions of control and auditive hallucinations would exist because patients do not experience themselves as the author of their own actions.To explore this specific problem of the sense of agency in schizophrenia, Frith et al. collected a serie of experimental data that lead them to propose that the sense of agency relied on the automatic motor system, processes that enable the predictive adjustment of action. An impairment in these processes (called <<internal models>> in the literature) would lead to the problem of dissociation between our own actions and those performed by others. More specifically, the problem would lay in the comparison between the predicted state and the desired state (figure 1). Jeannerod et al. from Lyon used attribution judgements that suggested that the sense of agency would not depend uniquely on the motor mechanisms but would also involve conscious processes. Recently, Frith et al. have published new data that integrates both preceding models. According to this theory, the sense of agency would depend on the processes involved in the predictive control of action but at a conscious level: the attenuation of the sensory feedback, specific of our own actions. This attenuation would depend on the accuracy of comparison between the predicted state and the actual state. Moreover, the sense of agency would also imply the management of social frame, which normally gives the means to cope with human interaction.	The conception of the sense of agency has greatly evolved over the years, mainly because of the various experimental methods employed. The consequences of this are the various theoretical interpretations given to the characteristics of the sense of agency. They can be explained in two main points: a non-unified definition of the sense of agency and an absence of experimental data testing alternative interpretations. First, protocols using attribution judgements have proven to be useful to gain better understanding of the attribution mechanism in schizophrenia. However, findings obtained with these judgments have often been used to conclude on deficits of the sense of agency in schizophrenia, whereas the sense of agency is only a sub component of these judgements.	More work must be conducted in order to show that generalization from judgements to self-agency is possible. Secondly, data have not been collected in order to go against the accepted proposition that the sense of agency (1) implies conscious processes, comes (2) secondary to action execution because based on sensory attenuation and (3) has subjective consequences only. Further studies would be useful to explore these points, so as to improve our understanding of the physiopathologyogy of schizophrenia.	
18018959	Vocteer is a university and community support agency collaborative program that matches undergraduate and graduate students with persons diagnosed with severe psychiatric disabilities in community-based volunteer positions. The program aims to improve self-esteem, community inclusion, and vocational skills of program participants. In addition, Vocteer helps participants develop skills necessary for employment or independent volunteering. The program, reports of participant satisfaction, and findings are described. Reports from the literature are presented and provide support for further exploration and development of such programs.
18003847	We used the quantitative 14C-deoxyglucose method to map the activity pattern throughout the frontal cortex of rhesus monkeys, which either grasped a three-dimensional object or observed the same grasping movements executed by a human. We found that virtually the same frontal cortical networks were recruited for the generation and the perception of action, including the primary motor cortex (MI/F1), premotor cortical areas (F2, F5, and F6), the primary (SI) and supplementary (SSA) somatosensory cortex, medial cortical areas (8m and 9m), and the anterior cingulate. The overlapping networks for action execution and action observation support the notion that mental simulation of action could underlie the perception of others' actions. We suggest that the premotor and the somatotopic MI/F1 activations induced by action observation reflect motor grasp of the observed action, whereas the somatotopic SI and the SSA activations reflect recruitment of learned sensory-motor associations enabling perceptual understanding of the anticipated somatosensory feedback. We also found that the premotor activations were stronger for action observation, in contrast to the primary somatosensory-motor ones, which were stronger for action execution, and that activations induced by observation were bilateral, whereas those induced by execution were contralateral to the moving forelimb. We suggest that these differences in intensity and lateralization of activations between the executive and the perceptual networks help attribute the action to the correct agent, i.e., to the "self" during action execution and to the "other" during action observation. Accordingly, the "sense of agency" could be articulated within the core components of the circuitry supporting action execution/observation.
17983298	On the basis of previous research, the authors hypothesize that (a) person descriptive terms can be organized into the broad dimensions of agency and communion of which communion is the primary one; (b) the main distinction between these dimensions pertains to their profitability for the self (agency) vs. for other persons (communion); hence, agency is more desirable and important in the self-perspective, and communion is more desirable and important in the other-perspective; (c) self-other outcome dependency increases importance of another person's agency. Study 1 showed that a large number of trait names can be reduced to these broad dimensions, that communion comprises more item variance, and that agency is predicted by self-profitability and communion by other-profitability. Studies 2 and 3 showed that agency is more relevant and desired for self, and communion is more relevant and desired for others. Study 4 showed that agency is more important in a close friend than an unrelated peer, and this difference is completely mediated by the perceived outcome dependency.
17958485	Internal monitoring or state estimation of movements is essential for human motor control to compensate for inherent delays and noise in sensorimotor loops. Two types of internal estimation of movements exist: self-generated movements, and externally generated movements. We used functional magnetic resonance imaging to investigate differences in brain activity for internal monitoring of self- versus externally generated movements during visual occlusion. Participants tracked a sinusoidally moving target with a mouse cursor. On some trials, vision of either target (externally generated) or cursor (self-generated) movement was transiently occluded, during which subjects continued tracking by estimating current position of either the invisible target or cursor on screen. Analysis revealed that both occlusion conditions were associated with increased activity in the presupplementary motor area and decreased activity in the right lateral occipital cortex compared to a control condition with no occlusion. Moreover, the right and left posterior parietal cortex (PPC) showed greater activation during occlusion of target and cursor movements, respectively. This study suggests lateralization of the PPC for internal monitoring of internally versus externally generated movements, fully consistent with previously reported clinical findings.
17826699	The purpose of this formative evaluation was to examine the impact of an innovative inquiry-based science education curriculum for middle school students, called Choice, Control, and Change, that is designed to foster healthful eating and physical activity and a healthy weight through enhancing agency and competence. The 24-session curriculum helps students develop understandings about the interactions between biology, personal behavior, and the environment and personal agency through cognitive self-regulation skills in navigating today's complex food system and sedentary environment. An extended theory of planned behavior served as the design framework. The study used a pretest-posttest evaluation design involving 278 middle school students in 19 science classes within 5 schools. Based on paired t tests, students significantly improved on several curriculum-specific eating and physical activity behaviors: they decreased several sedentary activities and increased their frequencies of fruit and vegetable intake. They decreased the frequency of sweetened beverages, packaged snacks, and eating at a fast-food restaurant, and ate and drank smaller portions of some items. Their outcome beliefs and overall self-efficacy, but not their attitudes, became more positive. A strategy based on fostering personal agency, cognitive self-regulation, and competence can be effective in increasing healthful eating and physical activity behaviors in middle school children and should be explored further.
17955534	This study's goal was to assess the effects of preassault, assault, and postassault psychosocial factors on current posttraumatic stress disorder (PTSD) symptoms of sexual assault survivors. An ethnically diverse sample of over 600 female sexual assault survivors was recruited from college, community, and mental health agency sources (response rate = 90%). Regression analyses tested the hypothesis that postassault psychosocial variables, including survivors' responses to rape and social reactions from support providers, would be stronger correlates of PTSD symptom severity than preassault or assault characteristics. As expected, few demographic or assault characteristics predicted symptoms, whereas trauma histories, perceived life threat during the assault, postassault characterological self-blame, avoidance coping, and negative social reactions from others were all related to greater PTSD symptom severity. The only protective factor was survivors' perception that they had greater control over their recovery process in the present, which predicted fewer symptoms. Recommendations for intervention and treatment with sexual assault survivors are discussed.
17953942	It has been hypothesized that socioeconomic status may act as an effect modifier of the association between air pollution and health. In this study, we investigated whether income inequality may modify the association between fine particulate pollution and self-reported health.We combined several different sources of data. Demographic and socio-economic data, at the individual level, were drawn from the 2001 US Behavioral Risk Factor Surveillance System (BRFSS). County-level particulate pollution data for the year 2001 were provided by the US Environmental Protection Agency. State-level income inequality was measured by the Gini index using US census data from the year 2000. We used a hierarchical logistic regression to model the association between general self-reported health and fine particulate pollution accounting for income inequality as an effect modifier and controlling for the usual confounders.	We found that when income inequality is low (10th percentile of the Gini distribution), the odds of reporting fair or poor health for a 10microg/m3 increase in particulate pollution is 1.34 (95% confidence interval 1.21-1.48). The analogous odds ratio for higher income inequality (60th percentile of the Gini distribution) is 1.11 (95% confidence interval 1.06-1.16).	Income inequality was found to be an effect modifier of the association between general self-reported health and particulate pollution. However, these findings challenged our hypothesis that people living in higher income inequality areas are more vulnerable to the impact of air pollution. We discuss the factors driving these results.	
17944696	This paper aims to describe existing community nursing practices and to explore factors that are associated with the transition of clinical practice from acute care settings to community care settings.This qualitative case study assessment described existing community nurse practices and explored factors that were associated with the transition to community practice from acute care settings. The 48 participants in this case study were registered nurses who were working in community care nursing during the interview process.	The results of this investigation revealed themes derived from data collection, including autonomy, client and family, education, and community as nursing work. This study indicated that making the transition to community-based nursing includes conceptual as well as emotional adjustments. Community nursing practice was seen by the participants as nursing that captures a holistic approach incorporating multiple dimensions from psychological, sociological, economic, and physical to spiritual aspects that provides services in interaction between the community nurse, the client, and the family. The findings indicate a need for additional supportive preparation strategies incorporated into nursing orientation and continuing education programs. Future research investigating agency culture and socialization would provide a more definitive survey of perceptions and competencies needed for role.	
17944292	This qualitative study explored participants' experiences of a supported-employment program. Understanding participants' opinions of a supported-employment program may provide insights into what processes and outcomes are meaningful and important for participants and may enable an evaluation of such processes and outcomes for their congruence with occupational therapy practice.Supported-employment program participants with schizophrenia (N= 7) were recruited from an agency and interviewed individually with open-ended questions. Data were analyzed using a grounded-theory approach.	We developed a tentative grounded theory with three themes of supported-employment program outcomes: (a) removing barriers to job seeking, (b) improving psychological well-being, and (c) participating in work.	Supported-employment program participants can achieve meaningful personal outcomes even though they do not obtain competitive employment. These programs removed barriers to job seeking, but personal readiness and efforts in job seeking contributed most to obtaining employment.	

17920447	To test the hypothesis of a participation of inner speech in self-referential activity we reviewed 59 studies measuring brain activity during processing of self-information in the following self-domains: agency, self-recognition, emotions, personality traits, autobiographical memory, preference judgments, and REST. The left inferior frontal gyrus (LIFG) has been shown to sustain inner speech use. We calculated the percentage of studies reporting LIFG activity for each self-dimension. 55.9% of all studies reviewed identified LIFG (and presumably inner speech) activity during self-awareness tasks. Furthermore, the LIFG was more frequently recruited during conceptual tasks (e.g., emotions, traits) than during perceptual tasks (e.g., agency, self-recognition). This supports the view of a relative involvement of inner speech in self-reflective processes.
17905500	It is well established in the literature that people are active decision makers in relation to help seeking and medicine taking. This paper uses data from two qualitative studies that focused on mood-modifying medicines to illustrate how active engagement, demonstrated through help seeking and decisions about treatment, was perceived to be a crucial part of recovery. Data were generated from semi-structured interviews with 23 men and women in the UK and 12 women in Denmark. We argue that being active in decisions relating to help seeking and medicine taking for problems with mood is perceived as central in order to (re)find an 'authentic' sense of self. There is, however, an inherent contradiction in the fact that the majority of the respondents believed medicine taking to be necessary, yet the act of taking a mood-modifying medicine was in most cases perceived as a potential threat to agency and ultimately the achievement of an authentic self.
17904717	Informed consent is a concept which attempts to capture and convey what is regarded as the appropriate relationship between researcher and research participant. Definitions have traditionally emphasised respect for autonomy and the right to self-determination of the individual. However, the meaning of informed consent and the values on which it is based are grounded in society and the practicalities of social relationships. As society changes, so too do the meaning and practice of informed consent. In this paper, we trace the ways in which the meaning and practice of informed consent has changed over the last 35 years with reference to four qualitative studies of parenting and children in the UK which we have undertaken at different points in our research careers. We focus in particular on the shifting boundaries between the professional and personal, and changing expressions of agency and power in a context of heightened perceptions of risk in everyday life. We also discuss developments in information and communication technologies as a factor in changing both the formal requirements for and the situated practicalities of obtaining informed consent. We conclude by considering the implications for informed consent of both increasing bureaucratic regulation and increasingly sophisticated information and communication technologies and suggest strategies for rethinking and managing 'consent' in qualitative research practice.
17877863	Emerging views of schizophrenia emphasize that part of recovery involves persons reclaiming a sense of their own identity, agency and personal worth. While this intuitively seems a matter where psychotherapy might be uniquely useful, it raises the issue of how this should be facilitated particularly among persons who experience themselves as unable to engage in dialogue with others. In this article, we explore how integrative psychotherapy might address issues of self-narrative and recovery from schizophrenia among persons experiencing, in particular profound levels of emptiness or barrenness. Illustrated with two case examples, we explore barriers posed to psychotherapy by clients' minimalist self-presentations and describe three stages for integrative interventions that can revitalize dialogues within the client and between the client and others, ultimately enabling the reconstruction of a client's personal narrative within which a life plan might be articulated, guiding future action.
17825726	Research on adolescent mothers has revealed increasing rates of depressive symptoms in the postpartum period. This review integrated 12 research-based articles to provide a better understanding of depression among adolescent mothers in the first year postpartum. The results revealed that more family conflict, fewer social supports, and low self-esteem all were associated with increased rates of depressive symptoms in adolescent mothers during the first postpartum year. To prevent adverse outcomes associated with depression, it is important that nurse practitioners working with these families screen adolescent mothers for depression and refer them for treatment as needed.
17760318	Borderline personality disorder is characterized as an identity disturbance or pathology of the self-structure. The author employs concepts from deconstruction philosophy and object relations theory to explore how persons with borderline personality disorder attempt to generate meaning, eliminate ambiguity, and maintain idealizations by assigning polarized attributions of value, agency, and motivation to their experiences. The author proposes that these binary attributions interact to form multiple, discrete self-structures or states of being. Each state is characterized by stereotyped expectations for self and other and patterns of relatedness that are self-perpetuating. The author delineates four common states, labeled as helpless victim, guilty perpetrator, angry victim, and demigod perpetrator, and suggests treatment strategies to deconstruct each state and to facilitate the development of an integrated and differentiated self.
17710522	Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus, we compared high-functioning adults with autism to healthy control subjects using an action monitoring and attribution task. Subjects with autism did not show deficits in this task, yet they showed significant mentalizing deficits. Our findings indicate a dissociation between the sense of agency and ascription of mental states in autism. We propose that social-cognitive deficits in autism may arise on a higher level than that of action monitoring and awareness.
17703118	Nursing practice is embedded in contexts that inhibit or constrain emancipatory relationships. This article explores willingness in relation to agency and actualization fostered by emancipative relationships in nursing practice. Opportunities for emancipative choice are possible only when nurses are willing to engage in critical reflection, authentic discourses, and risk congruent action within the constraints of dominant paradigms.
17670910	Epidemiologic studies have demonstrated that physical inactivity is an important determinant of numerous chronic diseases. However, self-reported estimates of physical activity contain measurement errors responsible for attenuating relative risk estimates. A validation study conducted in 2002-2003 at the Alberta Cancer Board (Canada) included a physical activity questionnaire, four 7-day physical activity logs, and four sets of accelerometer data from 154 study subjects (51% women) aged 35-65 years. The authors used a measurement error model to evaluate validity of the different types of physical activity assessment, and the attenuation factors, after taking into account error correlations between self-reported measurements. The validity coefficients, which express the correlation between measured and true exposure, were higher for accelerometers (0.81, 95% confidence interval (CI): 0.76, 0.85) compared with the physical activity log (0.57, 95% CI: 0.47, 0.66) and questionnaire measurements (0.26, 95% CI: 0.12, 0.40). The estimate of the attenuation factor for questionnaires was 0.13 (95% CI: 0.05, 0.23). Accuracy of physical activity questionnaire measurements was higher for men than for women, for younger individuals, and for those with a lower body mass index. Because the degree of attenuation in relative risk estimates is substantial, after the role of error correlations was considered, validation studies quantifying the impact of measurement errors on physical activity estimates are essential to evaluate the impact of physical inactivity on health.
17665707	Abstract: The United States Agency for Development in Bolivia (USAID/Bolivia) created in 2002 PROSALUD- Partners for Development Project (PfD) with the aim of improving the population's well-being. The project used three components: small grant scheme, technical assistance and database system management. Through the small grants scheme, the PfD supported a Community Participation Strategy (CPS) project over a three year period. The project involved the rural areas of six Bolivian departments and suburban areas of three Bolivian cities. The main objective was to increase health service utilization with a particular emphasis on empowerment of women, strengthening of local organizations and increasing the demand for health services. Women from both the urban and rural areas, and from different indigenous groups, were trained in project management, health promotion, reproductive health and family planning, advocacy and community participation. Participatory methodologies have allowed empowering women in decision making and capacity building throughout the entire project process. The experience shows that it is important to work with formally established grass-root community organizations and strengthen leadership within them. Additionally, the sub-projects demonstrated that interventions are more successful when promoters speak and write native languages, women are more motivated and empowered, projects are designed to be responsive to daily necessities identified by the communities and health services are culturally suitable. A preliminary evaluation, in both quantitative and qualitative terms, shows an overall improvement in health knowledge and practice, and utilization of health services.
17661538	Drawing upon literature reviews in psychiatry, the social sciences, and philosophy, this article defines the concept of the "personal self" and briefly describes its importance to the following areas of psychiatry: (1) mental illness, (2) psychiatric ethics, (3) diagnosis, (4) the clinician, (5) clinical research, (6) psychiatric pluralism, and (7) the goals of psychiatric treatment. The personal self is a Western common-sense concept which is characterized by five aspects: agency, identity, trajectory, history, and perspective. Because of the intimate and often ambiguous relationship between the personal self and mental illness, the personal self has considerable psychiatric significance in moral, professional, research, and existential realms.
17655543	To capture personal reflections on being a preceptor and to identify the supports and challenges to enacting the role.Prior to graduation from a nursing programme, students begin the transition in roles from student to practicing health-care professional. To ease this transition, preceptorship programmes have been implemented to foster professional socialization and help students achieve confidence in their practice during their final clinical placement (consolidation experience). Preparation for the preceptor role is dependent upon the information offered by the agency as well as by the educational institution. Nursing staff are requested for much of the calendar year to work with increasing numbers of undergraduate students at various levels, function as preceptors in the final clinical experience (consolidation) as well as be involved in the orientation of newly hired nurses.	This qualitative study used one-on-one tape recorded interviews with nurses who had previous experience as a preceptor. Thematic analysis of the transcribed data resulted in the emergence of an overall theme and categories.	Eight nurses were interviewed from a variety of units including medical surgical as well as critical care. The overriding theme from the analysis was 'safe passage'. This safe passage was for the patient and the student and was accomplished through the process of teaching and a clear view of the preceptor role. Challenges to the role were lack of recognition by other nursing staff as well as limited support from some faculty advisors. Supports for the role were the visible presence and ongoing support by faculty advisors as well as the hospital workshop.	This study highlighted the importance of support from nursing faculty as well as recognition by fellow nurses of the workload involved when being a preceptor.	Preceptors play an important role with students prior to graduation. Both the hospital and educational institutions need to ensure that nurses are given the necessary support, recognition and resources.	
17632013	The notion of minimal, basic, pre-reflective or core self is currently debated in the philosophy of mind, cognitive sciences and developmental psychology. However, it is not clear which experiential features such a self is believed to possess. Studying the schizophrenic experience may help exploring the following aspects of the minimal self: the notion of perspective and first person perspective, the 'mineness' of the phenomenal field, the questions of transparency, embodiment of point of view, and the issues of agency and ownership, considered as different and less fundamental than the feeling of mineness. Two clinical vignettes of patients with the diagnosis of schizophrenia will be presented: the first one, illustrating early illness stages, and the second case, of chronic schizophrenia, symptomatically marked by persistent hallucinations. Through their analysis, we will discuss the experiential dimensions of minimal self.
17616469	The recent distinction between sense of agency and sense of body-ownership has attracted considerable empirical and theoretical interest. The respective contributions of central motor signals and peripheral afferent signals to these two varieties of body experience remain unknown. In the present review, we consider the methodological problems encountered in the empirical study of agency and body-ownership, and we then present a series of experiments that study the interplay between motor and sensory information. In particular, we focus on how multisensory signals interact with body representations to generate the sense of body-ownership, and how the sense of agency modulates the sense of body-ownership. Finally, we consider the respective roles of efferent and afferent signals for the experience of one's own body and actions, in relation to self-recognition and the recognition of other people's actions. We suggest that the coherent experience of the body depends on the integration of efferent information with afferent information in action contexts. Overall, whereas afferent signals provide the distinctive content of one's own body experience, efferent signals seem to structure the experience of one's own body in an integrative and coherent way.
17615014	This study investigates the relationships between maternal cognitive, behavioral, and psychosocial factors and brushing practices in low-income African-American preschool children.Data are from a population-based sample of 1021 African-American families with at least one child <6 years of age and living in the 39 low-income Census tracts in Detroit, Michigan. Analyses were limited to 1-5-year-old children and their mothers (n = 719). Mothers were surveyed about oral health-related self-efficacy (OHSE), knowledge about appropriate bottle use (KBU), knowledge about children's oral hygiene (KCOH), oral health fatalism (OHF), their own toothbrushing behavior, depressive symptoms (CES-D), parenting stress, practical social support, and their child's dental history. Children's 1-week reported brushing frequency was the main outcome measure. Analyses were conducted in SUDAAN to account for the complex sampling design.	Children's 1-week brushing frequency (range 0-40) averaged 8.50 times per week among 1-3-year olds and 9.75 among the 4-5-year olds. Maternal OHSE was a strong and significant predictor of children's brushing frequency; for each unit increase in OHSE, 1-3-year olds were expected to brush 18% more frequently on average during 1 week [incidence density ratios (IDR) = 1.18, 95% confidence interval (CI) 1.08-1.28; P < 0.001], and 4-5-year olds were expected to brush 9% more often (IDR = 1.09, 95% CI 1.00-1.19; P < 0.10). Mothers' KCOH score was also significantly positively associated with brushing frequency; for each unit increase on the KCOH scale, 1-3-year olds were expected to brush 22% more frequently (IDR = 1.22, 95% CI 1.10-1.35; P < 0.001) and 4-5-year olds were expected to brush 13% more frequently (IDR = 1.13, 95% CI 1.02-1.26; P < 0.05). If a mother brushed her own teeth at bedtime during the week, her 1-3-year old child's brushing frequency was expected to increase by one-third (IDR = 1.34, 95% CI 1.12-1.60; P < 0.01) and among the 4-5-year olds, the child's frequency was expected to increase by one-quarter (IDR = 1.26, 95% CI 1.12-1.42; P < 0.001). Availability of help with transportation and financial support were also relevant variables for 1-3-year olds. Higher family income and dental insurance coverage were both positively associated with brushing among 4-5-year olds.	Several maternal cognitive, behavioral, and psychosocial factors were associated with young children's brushing practices. Oral health-specific self-efficacy and knowledge measures are potentially modifiable cognitions; findings suggest that intervening on these factors could help foster healthy dental habits and increase children's brushing frequency early in life.	
17589694	1) To assess the opinion of teachers involved in visual screening of school-age children and their referral to ophthalmologic examination within the "Eye-to-Eye National Campaign for Visual Disorders Prevention and Rehabilitation" (Campanha Nacional de Prevenção e Reabilitação Visual Olho no Olho); 2) To identify the teachers' perception with respect to the training received for conducting the campaign.A descriptive study has been conducted, based on data recorded from the application of a questionnaire to 1,517 elementary school teachers working in public schools in 27 Brazilian states. The following items were examined: received orientation, use of educational videos and handbooks, supplied explanations, difficulties, questions and overall campaign assessment.	82.0% of the teachers stated they had received orientation and 92.0% stated they had read the "Teacher Orientation Manual". Among those who received orientation, 47.0% stated it had been supplied by school officials; 30.0%, by healthcare agents, and 23.0% by ophthalmologists. In the self-assessment of performance, 58.0% reported no difficulties; 32.0% reported questions concerning the campaign activities and the professionals who most frequently asked to provide clarification were those from the State Education Agency (38.0%), followed by the school director (20.0%).	Most teachers considered themselves adequately trained and oriented to take part in the campaign. Teachers' training was provided by administrative officials, previously trained by ophthalmologists ("multiplying effect") and the small percentage of questions raised indicated the validity of the procedure. Concerns have been raised as to the information about the ophthalmologic examination, transportation of the children and delivery of glasses. This kind of program always presents some difficulties and requires adjustments. It should, indeed, be improved, perhaps through a closer involvement of the community and families during its development.	
17550868	People with schizotypal traits may possess abnormal self-awareness, particularly with regard to their sense of self-agency, that is, the sense that it is oneself who is causing or generating an action. Participants in Experiments 1A (N = 11), 1B (N = 12), and 2 (N = 20) moved a mouse device and viewed resultant feedback, which was biased either temporally or spatially. They then judged whether there was a bias or whether they felt they had moved the cursor on their own. The authors found, for the 1st time, that a sense of self-agency can be experienced even if some degree of temporal bias is perceived. Furthermore, they determined that highly schizotypal people have an abnormal (weaker) sense of self-agency.
17550597	Policies and procedures (P&Ps) have been suggested as one possible strategy for moving research evidence into practice among nursing staff in hospitals. Research in the area of P&Ps is limited, however. This paper explores: 1) nurses' use of eight specific research-based practices (RBPs) and RBP overall, 2) nurses' use and understanding of P&Ps, and 3) the role of P&Ps in promoting research utilization.Staff nurses from the eight health regions governing acute care services across the Canadian province of Newfoundland and Labrador completed an anonymous questionnaire regarding their use of eight RBPs and associated P&Ps. Data were also obtained from authorities in six of the eight regions about existing relevant P&Ps. We used descriptive statistics and multivariate regression analysis to assess the relationship between key independent variables and self-reported use of RBP.	Use of the eight RBPs ranged from 7.8% to 88.6%, depending on the practice. Nurses ranked P&P manuals as their number one source of practice knowledge. Most respondents (84.8%) reported that the main reason they consult the P&P manual is to confirm they are practicing according to agency rules. Multivariate regression analysis identified three significant predictors of being a user versus non-user of RBP overall: awareness, awareness by regular use, and persuasion. Six significant predictors of being a consistent versus less consistent user of RBP overall were also identified: perception of P&P existence, unit, nursing experience, personal experience as a source of practice knowledge, number of existing research-based P&Ps, and lack of time as a barrier to consulting P&P manuals.	Findings suggest that nurses use P&Ps to guide their practice. However, the mere existence of P&Ps is not sufficient to translate research into nursing practice. Individual and organizational factors related to nurses' understanding and use of P&Ps also play key roles. Thus, moving research evidence into practice will require careful interplay between the organization and the individual. P&Ps may be the interface through which this occurs.	
17510574	Women with urinary incontinence (UI) report that the disease negatively impacts their quality of life but, paradoxically, under-report symptoms.A predictive model using Orem's self-care deficit theory was developed exploring the effect of body experience on self-care agency to manage UI. A sample of postmenopausal women was drawn from a larger trial. Structural equation modeling was used to test the proposed model.	Minor modification of the model produced a well-fitting model (chi(9) = 3.20, P = .96, n = 235). Results supported the positive effect of nursing agency on self-care agency.	Group education about UI may increase self-care agency in postmenopausal women.	
17503101	We used functional magnetic resonance imaging (fMRI) to investigate the neural systems responding to the sight and to the sound of an action. Subjects saw a video of paper tearing in silence (V), heard the sound of paper tearing (A), and saw and heard the action simultaneously (A + V). Compared to a non-action control stimulus, we found that hearing action sounds (A) activated the anterior inferior frontal gyrus and middle frontal gyrus in addition to primary auditory cortex. The anterior inferior frontal gyrus, which is known to be activated by environmental sounds, also seems to be involved in recognizing actions by sound. Consistent with previous research, seeing an action video (V) compared with seeing a non-action video activated the premotor cortex, intraparietal cortex, and the pars opercularis of the inferior frontal gyrus. An A + V facilitation effect was found in the ventral premotor cortex on the border of areas 44, 6, 3a, and 3b for the action stimuli but not for the control stimuli. This region may be involved in integrating multimodal information about actions. These data provide evidence that the ventral premotor cortex may provide an action representation that abstracts across both agency (self and other) and sensory modality (hearing and seeing). This function may be an important precursor of language functions.
17490989	Involvement of the right inferior parietal area in action awareness was investigated while taking into account differences in the conscious experiences of one's own actions; especially, the awareness that an intended action is consistent with movement consequences and the awareness of the authorship of the action (i.e., the sense of agency). We hypothesized that these experiences are both associated with processes implemented in inferior parietal cortex, specifically, right angular gyrus (Ag). Two blood-oxygenation-level-dependent functional magnetic resonance imaging studies employed a novel delayed visual feedback technique to distinguish the neural correlates of these 2 forms of action awareness. We showed that right Ag is associated with both awareness of discrepancy between intended and movement consequences and awareness of action authorship. We propose that this region is involved in higher-order aspects of motor control that allows one to consciously access different aspects of one's own actions. Specifically, this region processes discrepancies between intended action and movement consequences in such a way that these will be consciously detected by the subject. This joint processing is at the core of the various experiences one uses to interpret an action.
17482480	There is an increasing amount of empirical work investigating the sense of agency, i.e. the registration that we are the initiators of our own actions. Many studies try to relate the sense of agency to an internal feed-forward mechanism, called the "comparator model". In this paper, we draw a sharp distinction between a non-conceptual level of feeling of agency and a conceptual level of judgement of agency. By analyzing recent empirical studies, we show that the comparator model is not able to explain either. Rather, we argue for a two-step account: a multifactorial weighting process of different agency indicators accounts for the feeling of agency, which is, in a second step, further processed by conceptual modules to form an attribution judgement. This new framework is then applied to disruptions of agency in schizophrenia, for which the comparator model also fails. Two further extensions are discussed: We show that the comparator model can neither be extended to account for the sense of ownership (which also has to be differentiated into a feeling and a judgement of ownership) nor for the sense of agency for thoughts. Our framework, however, is able to provide a unified account for the sense of agency for both actions and thoughts.
17478105	The extrastriate body area (EBA) is traditionally considered a category-selective region for the visual processing of static images of the human body. Recent evidence challenges this view by showing motor-related modulations of EBA activity during self-generated movements. Here, we used functional MRI to investigate whether the EBA distinguishes self- from other-generated movements, a prerequisite for the sense of agency. Subjects performed joystick movements while the visual feedback was manipulated on half of the trials. The EBA was more active when the visual feedback was incongruent to the subjects' own executed movements. Furthermore, during correct feedback evaluation, the EBA showed enhanced functional connectivity to posterior parietal cortex, which has repeatedly been implicated in the detection of sensorimotor incongruence and the sense of agency. Our results suggest that the EBA represents the human body in a more integrative and dynamic manner, being able to detect an incongruence of internal body or action representations and external visual signals. In this way, the EBA might be able to support the disentangling of one's own behavior from another's.
17469980	Theories of agency--the feeling of being in control of one's actions and their effects--emphasize either perceptual or cognitive aspects. This study addresses both aspects simultaneously in a finger-tapping paradigm. The tasks required participants to detect when synchronization of their taps with computer-controlled tones changed to self-controlled production of tones, or the reverse. For comparison, the tone sequences recorded in these active tapping conditions were also presented in passive listening conditions, in which participants had to detect the transition from computer to human control, or vice versa. Signal detection theory was applied to separate sensitivity from bias. Sensorimotor cues to agency were found to increase sensitivity in the active conditions compared with the passive conditions, which provided only perceptual cues. Analysis of bias revealed a tendency to attribute action effects to self-control. Thus, judgments of agency rely on veridical sensorimotor cues but can also be subject to cognitive bias.
17430371	Evidence is emerging that exercise can reduce psychological distress in cancer patients undergoing treatment. The present study aimed to (qualitatively) explore the experiences of advanced disease cancer patients participating in a 6-week, 9-hours weekly, structured, group-based multidimensional exercise intervention while undergoing chemotherapy. Unstructured diaries from a purposive sample of three females and two males (28-52 years old) who participated in the program served as the database. Data were analyzed using a phenomenological, narrative method. The analysis yielded three themes: shifting position, self-surveillance, and negotiated strength. The intervention highlighted situations making it possible for the participants to negate psychological and physical constraints. The concept of structured exercise contains viable psychotherapeutic potentials by allowing the development of alternative bodily and mental realities complying with cancer patients' demands and abilities to regain autonomy and commitment to discover and adopt a sense of agency and shared self-reliance.
17393397	The free will problem is defined and three solutions are discussed: no-freedom theory, libertarianism, and compatibilism. Strict determinism is often assumed in arguing for libertarianism or no-freedom theory. It assumes that the history of the universe is fixed, but modern physics admits a certain degree of randomness in the determination of events. However, this is not enough for a compatibilist position-which is favored here-since freedom is not randomness. It is the I that chooses what to do. It is argued that the core of the free will problem is what this I is. A materialist view is favored: The I is an activity of the brain. In addition to absence of external and internal compulsion, freedom involves absence of causal sufficiency of influences acting on the I. A more elaborate compatibilist view is proposed, according to which causal determination is complete when we add events occurring in the I (of which the subject is not conscious). Contrary to what several authors have argued, the onset of the readiness potential before the decision to act is no problem here. The experience of agency is incomplete and fallible, rather than illusory. Some consequences of different views about freedom for the ascription of responsibility are discussed.
17355400	Developmental psychology and psychopathology has in the past been more concerned with the quality of self-representation than with the development of the subjective agency which underpins our experience of feeling, thought and action, a key function of mentalisation. This review begins by contrasting a Cartesian view of pre-wired introspective subjectivity with a constructionist model based on the assumption of an innate contingency detector which orients the infant towards aspects of the social world that react congruently and in a specifically cued informative manner that expresses and facilitates the assimilation of cultural knowledge. Research on the neural mechanisms associated with mentalisation and social influences on its development are reviewed. It is suggested that the infant focuses on the attachment figure as a source of reliable information about the world. The construction of the sense of a subjective self is then an aspect of acquiring knowledge about the world through the caregiver's pedagogical communicative displays which in this context focuses on the child's thoughts and feelings. We argue that a number of possible mechanisms, including complementary activation of attachment and mentalisation, the disruptive effect of maltreatment on parent-child communication, the biobehavioural overlap of cues for learning and cues for attachment, may have a role in ensuring that the quality of relationship with the caregiver influences the development of the child's experience of thoughts and feelings.
17334114	This paper reports a study carried out in four primary care NHS trusts (PCTs) in the Midlands in order to inform inter-agency training and service planning around autism spectrum disorder (ASD). The aim of the study was to identify generic health visitors' perceptions of their role with families where children may have an ASD. The qualitative methodology is explained and key findings presented. Eleven health visitors participated as volunteers in one-to-one semi-structured interviews that were tape-recorded. Analysis of the data found some perceived tensions between health visitors' public health role and their work with individual families, especially when children had possible disabilities. Health visitors identified a role in the early identification of children developing atypically and in family support. Health visitors' perceptions are described and implications discussed. Recommendations are made regarding developmental assessment, training and service planning.
17302097	Registered nurses and nurse educators are often unaware of how nursing students experience the nursing profession. In the current practice climate of increased workloads, reduced funding, and higher patient acuity, nurse educators are likely to hear from colleagues how unprepared newly qualified nurses are for the needs of practice. It is difficult for many nursing students to see value in their practice because they become preoccupied with their perceived lack of knowledge and technical skills. Nurses and nurse educators should be aware of how this brands new graduates and informs their sense of developing professional identity. Despite their feelings of deficit in terms of skills and knowledge, it is clear that many nursing students are, in fact, effectively negotiating relational ethics. This article presents a collaborative account of the important relational work being undertaken by one group of nursing students in New Zealand.
17272713	Participants compared the mental capacities of various human and nonhuman characters via online surveys. Factor analysis revealed two dimensions of mind perception, Experience (for example, capacity for hunger) and Agency (for example, capacity for self-control). The dimensions predicted different moral judgments but were both related to valuing of mind.
17269223	Describing how hospitalised people who have been diagnosed as having high blood pressure carry out self-care activities.A descriptive design, having a quantitative approach, was used for evaluating the self-care agency ability of 90 people who had been hospitalised in Bogotá diagnosed as suffering from high blood pressure. Evers and Isenberg's SAA (self-care agency appreciation) scale was used.	The results showed that 53% of people hospitalised suffering from high blood pressure had deficient SAA. Regarding the SAA instrument's items obtaining the highest scores, it was found that the participants were able to maximise attention and vigilance, had motivation or self-care-orientated goals, reasoned within a self-care reference framework, had self-care abilities (cognitive, perception, communication and interpersonal) and integrated self-care operations with other aspects of life.	Caring for hypertense people is a challenge for health-care personnel and the whole community. Nursing care should focus on helping individuals to look after themselves, engage in self-care action for conserving their health and lives, recover from illness and confront its consequences.	
17237779	Although the neural mechanisms underlying altruism remain unknown, empathy and its component abilities, such as the perception of the actions and intentions of others, have been proposed as key contributors. Tasks requiring the perception of agency activate the posterior superior temporal cortex (pSTC), particularly in the right hemisphere. Here, we demonstrate that differential activation of the human pSTC during action perception versus action performance predicts self-reported altruism.
17227169	In this study, the authors investigated the effect of an individual's political skill on the relationships between 5 different impression management tactics (intimidation, exemplification, ingratiation, self-promotion, and supplication) and supervisor evaluations of performance. To test these relationships, the authors used a matched sample of 173 supervisor-subordinate dyads who worked full time in a state agency. Findings showed that individuals who used high levels of any of the tactics and who were politically skilled achieved more desirable supervisor ratings than did those who used the tactics but were not politically skilled. Opposite results were found when impression management usage was low. That is, individuals who were not politically skilled created a more desirable image in their supervisors' eyes than did their politically skilled counterparts when they did not use these tactics. Practical and research implications for the findings as well as directions for future research are offered.
17220390	The purpose of this feminist grounded theory study was to understand the meaning and experience of postmenopausal women's sexual desire. Data collection from 22 postmenopausal women who were ongoing participants of the TREMIN Research Program on Women's Health occurred via audiotaped, telephone-based, semistructured interviews. Women's descriptions of their sexual needs and desires led to the discovery of the core category, negotiating sexual agency, which refers to women's ability to act on behalf of their sexual needs, desires, and wishes. Women negotiated their sexual agency within three main domains (or axial codes): their own sexual self, their partners, and the medical system. An important finding was women's internalization of sociocultural assumptions that privilege their male partners' sexual needs over their own. The findings of this study, especially the contexts in which women negotiate their sexual agency, are important for women, women's health care providers, and women's life partners to understand.
17209724	Feelings of competency in the parental role, termed parenting self-efficacy, have been associated with well-being and positive parenting outcomes. Given the unique stresses inherent in raising a child with autism, parents may find it challenging to maintain a positive sense of well-being and self-efficacy. Study aims were to investigate associations between maternal self-efficacy and parenting cognitions among mothers of children with autism. Mothers (n = 170) completed questionnaires on paper or via the Internet. In a hierarchical linear regression, depression, parenting stress, agency, and guilt each accounted for unique variance in maternal self-efficacy when controlling for time since diagnosis and the presence of a second child with a disability. Autism knowledge was not associated with parenting self-efficacy. Self-efficacy appears to be associated with well-being, agency, and feelings of guilt among mothers of children with autism. Parent- and family-based interventions designed to support parental well-being and focusing on parenting cognitions may enhance parenting self-efficacy.
17190774	This article reports a secondary statistical analysis of data from a study investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population (Callaghan, 2005). The purpose of this study was to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 256 adolescents. The research instruments used to collect data for this study include: Health-Promoting Lifestyle Profile II Scale; Self-Rated Abilities for Health Practices Scale; Exercise of Self-Care Agency Scale; demographic questionnaire assessing basic conditioning factors. The results of this analysis identified significant relationships between the following basic conditioning factors and adolescents' practice of healthy behaviors, self-efficacy of those behaviors, and self-care abilities: support system, adequate income, adequate living conditions, gender, routine practice of religion, and reported medical problems/disabilities. These findings can give adolescent health nurses direction in developing interventions that promote the self-care and health in this specific population.
17181082	To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care.A quasi-experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylated hemoglobin (HbAlc), psychosocial, and clinical variables.	Results showed a significant decrease in HbAlc in the experimental group, as well as positive effects of self-care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self-care actions.	The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self-care agency, adaptation, and barriers were predictors of self-care measures and level of HbA1c.	
17144749	According to appraisal theorists, anger involves a negative event, usually blocking a goal, caused by another person. Critics argue that other-agency is unnecessary, since people can be angry at themselves, and thus that appraisal theory is wrong about anger. In two studies, we compared anger, self-anger, shame, and guilt, and found that self-anger shared some appraisals, action tendencies, and associated emotions with anger, others with shame and guilt. Self-anger was not simply anger with a different agency appraisal. Anger, shame, and guilt almost always involved other people, but almost half of the occurrences of self-anger were solitary. We discuss the incompatibility of appraisal theories with any strict categorical view of emotions, and the inadequacy of emotion words to capture emotional experience.
17120515	Externalization of problems as a component of narrative therapy has been well defined by such authors as Epston and White, and Freedman and Combs. This study reflects the voices and experiences of 17 participants who engaged in an innovative externalization exercise combining sculpture and journaling over a period of 4 weeks. In an attempt to better understand the experience of the participants, the principal investigator also engaged in the exercise. Findings indicated that the intervention helped participants express emotions, increased their awareness of personal resources and agency, helped separate problems from self decreased symptoms and problem behaviors, and fostered a sense of empowerment. This study reveals the potential usefulness of physically externalizing problems and interacting with them deliberately over time. Such interventions may be useful components of narrative therapy or augmentations to brief therapy. They may help reach populations who have limited access to therapy services or who are reluctant to present for therapy.
17101622	Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere. This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test-re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions. The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.
17101509	Despite a plethora of studies counting, examining, assessing, and diagnosing Filipino children living in poverty, children's own perceptions and concerns about their health and security are rarely elicited. This article draws from fieldwork in an urban neighbourhood in the Visayan Philippines among children who, every day, face a complex and precarious landscape dominated by multigenerational poverty, social marginalization, recurring hunger, and the hazards of living and playing amidst mounting garbage and effluent. I discuss children's perspectives on body and illness in this challenging environment and examine their ideas within the larger context of adult-child, hierarchical relationships, and colonial and contemporary government discourses on children, health, and citizenship. I also examine children's sense of place, agency, and vulnerability, and I discuss the view held by many adults in this community: their children's ideas hold little value.
17100990	This qualitative study explored the impact of genetic risk information from BRCA1/2 testing on individuals' subjective understandings of self and self-identity. In-depth interviews were conducted with 39 participants (34 women and 5 men) who had received test results from BRCA1/2 testing. Themes emerging from qualitative data analysis revealed that participants linked their positive results to becoming more aware of their physical selves (embodied self), their selves in relation to family (familial-relational self) and their selves in relation to wider kinship or social groups (social self). Genetic information was generally viewed as enabling; it allowed participants to take measures (surveillance or prophylactic surgery) to confront the disease. However, for a small minority of women, knowledge about their genetic risk had a profound and limiting effect on their agency. Rather than giving them a sense of control, they saw little opportunity to fight the disease. For a few people, identification of a genetic mutation thrust them into an uncertain state, that is in a position of being neither ill nor completely well. In one case, BRCA information led to a disruption of social identity. Further work is needed to assess the impact of age and life stage on psychological responses to genetic information on cancer susceptibility.
17088049	Several studies have indicated that schizophrenic patients show impaired performance in various aspects of social cognition, including theory of mind, emotion processing, and agency judgments. Neuroimaging studies that have compared patients and healthy subjects during such mental activity indicate an abnormal hemodynamic response in the medial prefrontal cortex, the prefrontal cortex, the amygdala, the inferior parietal lobe, i.e., a set of regions known to be critically involved in social cognition. This paper addresses a number of issues raised by schizophrenia research into theory of mind, emotion perception and self-agency with regards to the neural systems that mediate social cognition. In healthy subjects, typical brain patterns are associated with theory of mind, emotion perception and self-agency; some activated clusters overlap, while others are distinct. For instance, activations in the paracingulate gyrus are almost systematically associated with theory of mind tasks, while the amygdala is mainly involved in emotion perception tasks. Additional foci are frequently found activated during those tasks: superior temporal sulcus, inferior frontal area. Moreover, the inferior parietal lobe is thought to contribute to agency judgments. In the light of the data on brain abnormalities and neurochemical dysfunctions in schizophrenia, we discuss the interaction of social cognitive dysfunction with the supposed information processing abnormalities caused by dopamine dysregulation.
17085617	This study examined how well recipients of psychiatric or substance abuse services self-report their care.Self-reported use of behavioral health services, as reported by 1,012 respondents to a survey mailed to Minnesota Medicaid managed care enrollees receiving services with a behavioral health diagnosis other than severe mental illness in 2000, was compared with Medicaid agency records.	Overall, 15 percent of respondents said they had not received services, although administrative data indicated otherwise. In bivariate analyses, failure to report treatment was associated with gender, age, education, and diagnosis but not with race or ethnicity or with residence. The effects of gender and diagnosis were insignificant after analyses controlled for age and education.	Self-reports of behavioral health service use are a relatively accurate method of obtaining information on use. The finding that underreporting of receipt of behavioral health services was not random suggests that reporting errors could introduce bias when comparing groups that differ on age or education.	
17072770	What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the clinical educator's role), (b) having a sense of relationship with others (and the place of this "interactive self" as a central feature of clinical education), (c) having a sense of being a clinical educator (and how this understanding relates to the previous two dimensions), (d) having a sense of agency (which is vital to the performance of many clinical education roles), (e) seeking dynamic self-congruence, and (e) growth as a clinical educator. This paper presents an overview of the model, discusses its strengths and limitations as a representation of speech pathology clinical educators' experiences, and briefly considers its value for professional development.
17053290	A world divided by health inequalities poses ethical challenges for global health. International and national responses to health disparities must be rooted in ethical values about health and its distribution; this is because ethical claims have the power to motivate, delineate principles, duties and responsibilities, and hold global and national actors morally responsible for achieving common goals. Theories of justice are necessary to define duties and obligations of institutions and actors in reducing inequalities. The problem is the lack of a moral framework for solving problems of global health justice.To study why global health inequalities are morally troubling, why efforts to reduce them are morally justified, how they should be measured and evaluated; how much priority disadvantaged groups should receive; and to delineate roles and responsibilities of national and international actors and institutions.	Duties and obligations of international and state actors in reducing global health inequalities are outlined. The ethical principles endorsed include the intrinsic value of health to well-being and equal respect for all human life, the importance of health for individual and collective agency, the concept of a shortfall from the health status of a reference group, and the need for a disproportionate effort to help disadvantaged groups. This approach does not seek to find ways in which global and national actors address global health inequalities by virtue of their self-interest, national interest, collective security or humanitarian assistance. It endorses the more robust concept of "human flourishing" and the desire to live in a world where all people have the capability to be healthy. Unlike cosmopolitan theory, this approach places the role of the nation-state in the forefront with primary, though not sole, moral responsibility. Rather shared health governance is essential for delivering health equity on a global scale.	
17035262	We examined: (a) the social-cognitions of those who differ in preferred level of proxy-assistance in both proxy-led and independent exercise contexts; and (b) the relationships between proxy-agency and reliance. Sixty-five fitness class participants completed measures of self-regulatory efficacy, task self-efficacy, exercise intentions, proxy-efficacy and perceived reliance. A 2 (exercise context) by 2 (preferred assistance) MANOVA revealed significant main effects for assistance and context. Also, significant assistance by context interactions was found for both efficacies. When facing exercise without a proxy, individuals preferring high proxy assistance expressed lower self-regulatory and task self-efficacy. Finally, proxy- and self-regulatory efficacy were shown to be separate predictors of reliance on a proxy. Results support Bandura's theorizing about the proxy-led context and its influence on self-regulatory efficacy.
16972608	This study investigated the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an older adult population. The purpose of this study was to identify the relationships among these concepts as well as the specific influence of spiritual growth, a component of health-promoting self-care behaviors, on self-care agency. The instruments used in this study included the Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practices Scale, and Exercise of Self-Care Agency Scale. A canonical correlation identified a significant variate having a correlation of .74 (p = .000) that accounted for 55% of the variance explained. The loading variables included spiritual growth, self-concept, initiative, and responsibility. The conclusion was made that spiritual growth influences older adults' self-care agency to a greater extent than self-care self-efficacy.
16967736	To explore the nature of the relationship between agency workers and permanent staff within care homes.A qualitative design was used with an interpretative phenomenological analysis.	Four key themes were identified: issues about the psychological contract of agency workers; agency stigmatisation; issues on both sides of the relationship; and power and shifts in attitude.	This study builds on our psychological understanding of workplace practices and relationships between agency and permanent staff. It should enable practical and effective improvements to be made to the quality of working life and self-identity of all who work in care homes.	
16938025	The authors hypothesized that economically motivated voluntary settlement in the frontier fosters independent agency. While illuminating the historical origin of American individualism, this hypothesis can be most powerfully tested in a region that is embedded in a broader culture of interdependence and yet has undergone a recent history of such settlement. The authors therefore examined residents of Japan's northern island (Hokkaido). Hokkaido was extensively settled by ethnic Japanese beginning in the 1870s and for several decades thereafter. Many of the current residents of Hokkaido are the descendents of the original settlers from this period. As predicted, Japanese socialized and/or immersed in Hokkaido were nearly as likely as European Americans in North America to associate happiness with personal achievement (Study 1), to show a personal dissonance effect wherein self-justification is motivated by a threat to personal self-images (Study 2), and to commit a dispositional bias in causal attribution (Study 3). In contrast, these marker effects of independent agency were largely absent for non-Hokkaido residents in Japan. Implications for theories of cultural change and persistence are discussed.
16901245	This study examines the relationship between three types of Internet use (information, entertainment, and interactive contacts) and two types of political efficacy (external and internal) among U.S. college students. Information related Internet use and interactive contacts predict college students' internal political efficacy. An unexpected finding was that visiting public agency sites negatively influenced college students' external political efficacy. This implies that the quality of current public sites is below the expectation of college students and that respondents who visited those sites might develop political cynicism. This study also reveals that online news sites are becoming a primary news source for college students.
16895828	This article draws on data from ethnographic fieldwork in an urban housing project to examine the social context and meanings of surgical sterilization for low-income women in Brazil. Low-income women resort to sterilization because they distrust or are unsatisfied with alternative methods and because it helps them to fulfill the requirements of modern, responsible motherhood. Although sterilization is an option among few alternatives, and one that has subjected women to greater medical management and intervention, I argue that sterilization also represents poor women's active struggle to improve their lives and to resist the burdens placed on them by unequal gender relations. This article contributes to a growing anthropological literature that demonstrates how reproduction has become a central site where social values are constituted and contested, and it details women's diverse responses to the process of medicalization.
16893827	Sex researchers and mental health clinicians have long recognized that the stigma surrounding homosexuality plays an important role in shaping the social psychological adjustment of gay, lesbian, and bisexual (g/l/b) people. In recent years, researchers have suggested that sexual identity- related distress may influence the physical health status of g/l/b people, primarily because of the ways these self-related feelings and beliefs impact patterns of health-related behavior. This study examines the influence of sexual identity distress and social support on g/l/b youth's drug and alcohol use, psychological distress, and risky sexual behavior. The data come from a services research demonstration program conducted at the Indiana Youth Group, Inc., a g/l/b youth development agency based in Indianapolis, Indiana. Results indicate that sexual identity distress is strongly associated with psychological distress, less frequent use of alcohol, and using fewer types of illegal drugs. Being out to more people in one's support network, however, attenuates the severity of youth's sexual identity-related distress. Youth who report more support ties to g/l/b people indicate engaging in more frequent risky sexual behavior. The implications of these findings for theories of g/l/b youth's sexual identity development are discussed.
16892982	In this article, we bring together recent findings from developmental science and cognitive neuroscience to argue that perception-action coupling constitutes the fundamental mechanism of motor cognition. A variety of empirical evidence suggests that observed and executed actions are coded in a common cognitive and neural framework, enabling individuals to construct shared representations of self and other actions. We review work to suggest that such shared representations support action anticipation, organization, and imitation. These processes, along with additional computational mechanisms for determining a sense of agency and behavioral regulation, form the fabric of socialinteraction. In addition, humans possess the capacity to move beyond these basic aspects of action analysis to interpret behavior at a deeper level, an ability that may be outside the scope of the mirror system. Understanding the nature of shared representations from the vantage point of developmental and cognitive science and neuroscience has the potential to inform a range of motor and social processes. This perspective also elucidates intriguing new directions and research questions and generates specific hypotheses regarding the impact of early disorders (e.g., developmental movement disorders) on subsequent action processing.
16880413	This article presents secondary statistical analyses of data from a 2003 study by the author investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adult population. The purpose of this article is to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care. The sample consisted of 379 adult participants who completed four research instruments: Health-Promoting Lifestyle Profile II Scale, Self-Rated Abilities for Health Practices Scale, Exercise of Self-Care Agency Scale, and a demographic questionnaire assessing basic conditioning factors. Statistically significant relationships were found between the following basic conditioning factors and the study variables: age, gender, income, marital status, education, race, and routine practice of religion. These results give direction for nursing interventions that promote self-care and holistic health in an adult population.
16869347	This paper aims to examine the management strategies adopted by older people living with HIV/AIDS (PHAs) to conceal their positive status in healthcare settings, and their responses taken and means used to cope with the stigmatizing and exclusionary effects as a result of the disclosure of their status by/to healthcare workers.Under the auspices of a local NGO in Hong Kong, a total of seven male older PHAs aged 55 or above from pre-existing HIV/AIDS self-help groups were recruited for two separate focus groups. A thematic approach was adopted for data analysis and specific themes identification.	An analysis of the data revealed that older PHAs did exercise their own agency in preventing against and managing stigma in their access to and use of health care services. Two more specific themes around "sign of disapproval" and "discriminatory practice" as barriers to access were also identified.	Because of the small sample size, the pattern of stigmatization experiences and coping strategies cannot claim to be representative of the complete picture of the stigma associated with HIV/AIDS.	This is the first exploratory study of the stigmatization and devaluation suffered by older PHAs in healthcare settings in the context of Hong Kong. It also explored in details the pros and cons of the stigma management strategies employed by this vulnerable group of patients. The implications for practice both on the side of healthcare workers and policy makers and that of PHAs were discussed.	
16839298	Human self-consciousness relies on the ability to distinguish between oneself and others. We sought to explore the neural correlates involved in self-other representations by investigating two critical processes: perspective taking and agency. Although recent research has shed light on the neural processes underlying these phenomena, little is known about how they overlap or interact at the neural level. In a two-factorial functional magnetic resonance imaging (fMRI) experiment, participants played a ball-tossing game with two virtual characters ("avatars"). During an active/agency (ACT) task, subjects threw a ball to one of the avatars by pressing a button. During a passive/nonagency (PAS) task, they indicated which of the other avatars threw the ball. Both tasks were performed from a first-person perspective (1PP), in which subjects interacted from their own perspective, and a third-person perspective (3PP), in which subjects interacted from the perspective of an avatar with another location in space. fMRI analyses revealed overlapping activity in medial prefrontal regions associated with representations of one's own perspective and actions (1PP and ACT), and overlapping activity in temporal-occipital, premotor, and inferior frontal, as well as posterior parietal regions associated with representation of others' perspectives and actions (3PP and PAS). These findings provide evidence for distinct neural substrates underlying representations of the self and others and provide support for the idea that the medial prefrontal cortex crucially contributes to a neural basis of the self. The lack of a statistically significant interaction suggests that perspective taking and agency represent independent constituents of self-consciousness.
16772716	The objective of the open-label, multicenter Migraine--Satisfaction with Treatment: Reality with Almogran study was to assess efficacy, tolerability, and satisfaction with almotriptan 12.5 mg among migraineurs who were not achieving adequate results with their current acute therapy. Data from 434 patients (342 evaluable), were obtained for 929 attacks by 154 neurologists in France. Using a questionnaire developed by the National Agency for Accreditation and Evaluation in Health (ANAES), almotriptan was associated with an increased proportion of patients experiencing significant relief at 2 h (69.3 vs. 26.6%), tolerating the medication well (91.2 vs. 76.0%), able to resume activities (70.5 vs. 24.9%), and taking only 1 dose (59.4 vs. 28.1%) compared with previous therapies. At 2 h, headache pain had disappeared in 33.4% of attacks and was mild in 26.9%. Recurrence rate was 28.4% and rescue analgesics were used in 20.9% of attacks. The rate of adverse event-related discontinuations was 2.6%. The proportion of patients who were very satisfied/satisfied overall with almotriptan treatment was 69%. Almotriptan 12.5 mg was effective, well-tolerated and associated with a high rate of treatment satisfaction in patients whose previous acute migraine therapy was inadequate according to the ANAES recommendations.
16738220	Extensive work on learning in reaching and pointing tasks has demonstrated high degrees of plasticity in our ability to optimize goal-directed motor behavior. However, studies focusing on the perceptual awareness of our own actions during motor adaptation are still rare. Here we present the first simultaneous investigation of sensorimotor adaptation on both levels, i.e., action and action perception. We hypothesized that self-action perception relies on internal predictions about the sensory action outcome that are updated in a way similar to that of motor control. Twenty human subjects performed out-and-back pointing movements that were fed back visually. Feedback was initially presented in spatiotemporal correspondence with respect to the actual finger position, but later rotated by a constant angle. When distorted feedback was applied repetitively, subjects' perceived pointing direction shifted in the direction of the trajectory rotation. A comparable perceptual reinterpretation was observed in control trials without visual feedback, indicating that subjects learned to predict the new visual outcome of their actions based on nonvisual, internal information. The perception of the world, however, remained unchanged. The changes in perception of one's own movements were accompanied by adaptive changes in motor performance of the same amount, i.e., a secondary motor compensation opposite to the direction of the imposed visual rotation. Our results show that the perception of one's own actions depends on adaptable internal predictions about the sensory action outcome, allowing us to attribute new sensory consequences of our actions to our own agency. Furthermore, they indicate that the updated sensory prediction can be used to optimize motor control.
16686792	This study used latent growth modeling to investigate longitudinal relationships between self-system processes and depressive symptoms among maltreated (n = 142) and nonmaltreated children (n = 109) aged 6-11 years. On average, self-esteem and self-agency increased and depressive symptoms decreased over time. Multivariate growth modeling indicated that, regardless of gender, physical abuse was negatively related to initial levels of self-esteem, and physical abuse and physical neglect were positively associated with initial levels of depressive symptoms. Emotional maltreatment was predictive of changes in self-esteem and changes in depressive symptoms. Initial levels of self-esteem were negatively associated with initial levels of depressive symptoms. The findings contribute to enhancing our understanding of the developmental processes whereby early maltreatment experiences are linked to later maladjustment.
16635761	To check if the expected association is observed between children and adolescents' self-perceived health-related quality of life (HRQL) and the use of health care services.The data come from the pilot test of a European measure of HRQL for children and adolescents (KIDSCREEN). Children answered the KIDSCREEN 52-item pilot version. Visits to a health professional in the past four weeks and hospitalisation in the past 12 months were collected from parents. A logistic regression model was adjusted to analyse the relationship between the use of health services and HRQL.	A total of 2526 children and their parents were included in the analysis. Factors associated to visits in the past four weeks were poor physical well-being (odds ratio [OR] 1.83; 95% confidence interval [CI] 1.42-2.35), and poor school environment (OR 1.32; 95% CI 1.02-1.71). Low scores on moods and emotions was the associated factor to hospitalization in the past 12 months (OR 2.13; 95% CI 1.29-3.81).	Children and adolescents are a feasible source for their self-assessment of HRQL. They should be taken into account in health care needs studies.	
16624451	Heightened awareness and increasingly sophisticated psychological tests have seen a dramatic rise in the numbers of people diagnosed with dyslexia. Accordingly, there is a reported increase in the numbers of students with dyslexia entering Higher Education (HE) in the United Kingdom (UK) [Singleton, C.H., Chair, 1999. Dyslexia in higher education: policy, provision and practice. Report of the national working party on dyslexia in higher education. University of Hull on behalf of the Higher Education Funding Councils of England and Scotland, Hull], [Higher Education Statistics Agency. HESA. Available from: <URL http://www.hesa.ac.uk> (accessed 21.12.05)]. Studies researching the effects of dyslexia on the clinical practice of nurses are almost non-existent. This paper reports part of a UK study exploring the clinical experiences of student nurses with dyslexia. In depth interviewing of 18 adult branch student nurses revealed a range of difficulties encountered and a variety of coping mechanisms to manage these. Other than in exceptional circumstances there is no legal requirement to disclose a dyslexia diagnosis. The decision to conceal or disclose their dyslexia was particularly prominent and contentious for these participants. This related to the attitudes of co-workers, concerns for patient safety, expectations of support, confidentiality issues and potential discrimination. Dyslexia continues to attract an unwarranted stigma and can adversely affect the learning experience. The need for disability awareness training in the workplace and improved education/service partnerships to support these students is considered crucial.
16611185	This study examined goals and agency as the 2 core aspects of self in learning among Chinese adolescents. A sample of 259 adolescents aged 12-19 responded to open-ended probes about themselves. Counter to the common view that Chinese selves are predominantly social, adolescents expressed many more individual than social goals and agency. Moreover, older adolescents showed overall more goals and agency than younger adolescents. However, their specific goals did not differ by age. Regarding agency, older adolescents articulated more of the so-called "learning virtues." Yet their social agency did not differ by age. We interpret these findings as in reference to the Confucian learning tradition, the existing research on goals and agency, and self in culture from a domain-specific perspective.
16571538	Alien motor phenomena arise in neurological and psychiatric contexts and are likely to implicate several distributed brain systems.A selective literature review, focusing on cognitive neurobiological accounts of alien/anarchic limb, somatoparaphrenia, and delusions of alien control (passivity phenomena); supplemented by an account of the cognitive neuroanatomy of action and agency (subjective sense of causation) in the normal state.	Alien motor phenomena reflect impairments of agency through at least two mechanisms. (1) A disinhibition of ''lower'' motor centres giving rise to relatively stereotypic and contextually inappropriate motor routines (as emerge following medial frontal and corpus callosal lesions). (2) A disturbance of the perception of self-initiated movement, so that control of movement (causation) is attributed to an alien entity (phenomena associated with right parietal lobe lesions, focal epilepsy, and hyperactivity in acute schizophrenia).	Whereas alien/anarchic limb dysfunction may be relatively easily explained in cognitive neurobiological terms, a comprehensive account of alien control will require further empirical ingenuity. Current models invoke disturbed feed-forward mechanisms, imitation, and the sense of another's agency (''nonself attribution'').	
16566822	Because of the rapid aging population, the demand for residential care exceeds availability. This paper presents the results of a study that focuses on the demand of elderly people for residential care and determinants (elderly people's personal characteristics, needs and resources) that are associated with this demand. Furthermore, the accuracy of the waiting list as a reflection of this demand has been examined.67 elderly people waiting for admission into a home for the elderly, are subjected to semi-structured interviews. The data are analyzed by using multivariate statistics.	Elderly people who indicate that they would refuse an offer of admission into a home for the elderly feel healthier (p = 0.02), have greater self-care agency (p = 0.02) and perceive less necessity of admission (p < 0.01), compared to those who would accept such an offer. Especially the inability to manage everyday activities and the lack of a social network are highly associated with the elderly people's demand for residential care. Furthermore, it is evident that waiting lists for homes for the elderly do not accurately reflect the demand for residential care, since 35% of the elderly people on a waiting list did not actually experience an immediate demand for residential care and stated that they would not accept an offer of admission. Quite a lot of respondents just registered out of a sense of precaution; a strategic decision dictated by current shortages in care provision and a vulnerable health status.	The results contribute to the understanding of waiting lists and the demand for residential care. It became apparent that not everybody who asks for admission into a home for the elderly, really needed it. The importance of elderly people's resources like social networks and the ability to manage everyday activities in relation to the demand for care became clear. These findings are important because they indicate that resources also play a role in predicting elderly people's demand and as a result can guide the development and the (re)design of adequate health care services.	
16536648	Four studies examined gender differences in self-construals and the role of social comparison in generating these differences. Consistent with previous research, Study 1 (N=461) showed that women define themselves as higher in relational interdependence than men, and men define themselves as higher in independence/agency than women. Study 2 (N=301) showed that within-gender social comparison decreases gender differences in self-construals relative to a control condition, whereas between-genders comparison increases gender differences on both relational interdependence and independence/agency. Studies 3 (N=169) and 4 (N=278) confirmed these findings and showed that changing self-construal changes gender differences in social dominance orientation. Across the 4 studies, strong evidence for the role of in-group stereotyping as mediator of the effect of gender on self-construal was observed on the relational dimension but not on the agentic dimension.
16520571	The purpose of this study was to identify the factors influencing symptom self management (SSM) in the patient with a chronic mental disorder.Data was collected by questionnaires from 204 chronic mental disorders in an outpatient clinic in a General Hospital and Public Mental Health Centers in Seoul and Kyunggi Province. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression.	The score of SSM showed a significantly positive correlation with the score of the level of self efficacy (SE) (r=.33, p=.00), social support (SS) (r=.27, p=.00), self care agency (SCA) (r=.36, p=.00) and daily living ability (DLA) (r=.34, p=.00). The score of DLA showed a significantly positive correlation with the score of level of SE (r=.46, p=.00), SS (r=.51, p=.00), and SCA (r=.52, p=.00). The most powerful predictor of SSM was SCA (14%). A combination of SCA, DLA, and SS account for 20% of the variance in SSM.	This study suggests that SCA, DLA, and SS are significant influencing factors on SSM in patients with chronic mental disorders.	
16504162	"Ikigai" is culturally defined in the society of Japan as a comprehensive concept describing subjective well-being. It is considered to be related to life-satisfaction, self-esteem, morale, happiness as well as evaluation towards meaning of one's life. Although previous studies examined factors associated with Ikigai with smaller samples, consistent results have not been obtained, especially from the viewpoint of gender differences. Identification of gender-specific factors related with Ikigai among the elderly, may be of value to enhance subjective well-being.Self-administered questionnaires were distributed among 4,737 randomly selected members of the Silver Human Resources Centre (SHRC), a public temporary employment agency for seniors, in Osaka, Japan. This represents about 10% of all registered members (n = 41,593) in the 38 SHRC centres in Osaka. A total of 4,376 subjects (male: 2,913; female: 1,463) provided a satisfactory response to the questionnaire (response rate: 92%). The status whether they have "Ikigai" or not was evaluated by self-anchoring scale ranging from 0 to 5 (0 = lowest rate and 5 = highest rate of having "Ikigai"). Also, self-rated life-change score through work (-3 to 3) was evaluated by three items, i.e.) changes in (1) the number of friends through work, (2) social interests and (3) the quantity of conversation with others (1 = increase, 0 = no change, and -1 = decrease).	The factors associated with "Ikigai" for total subjects were the number of rooms in one's residence, annual income, healthy life style score (Breslow), the number of working days through SHRC, satisfaction with one's life history and life-change sore through work. The multivariable odds ratio (95% CI) of having "Ikigai" was 1.9 (1.1-3.3) for persons with no change in life thorough work compared with subjects with a score of < or = -1. Moreover, the multivariable odds ratios were 3.5 (1.9-6.6) for a life-change score = 1, 3.1 (1.7-5.7) for a score = 2 and 7.8 (4.0-15.2) for a score = 3 compared with persons with a score of < or = -1. For male subjects, other factors associated with having "Ikigai" were the number of rooms in their residence, annual income, the number of working days through SHRC, subjective assessment of health condition, and degree of satisfaction with their life history. For female, the corresponding factors were the presence of a spouse and degree of satisfaction with their life history.	Scores for life-changes through work were associated with a higher prevalence of having "Ikigai" for both male and female. For male, "Ikigai" tended to be associated with physical condition and socioeconomic factors such as the size of their residence or annual income, while for female, family relations such as having spouse and psychological factors such as satisfaction with one's life history were significant factors. In spite of the design limitations of this study, it is possible to conclude that the recognition of life change through obtaining work may enhance "Ikigai" among people who wish to engage in productive activities in their later stages of life for both male and female. SHRC has a potential to provide resources for fulfilling one's "Ikigai" through supporting working opportunities to realize life changes for both elder male and female.	
16475442	Recent literature emphasizes that recovery from schizophrenia involves recovery within one's own narrative of an integral sense of identity, agency, social connection, and worth. While this is intuitively appealing and consistent with a wide range of literature, it raises the issue of how to best help people do this in individual psychotherapy. In this article, we explore how psychotherapy might help people construct new narratives or storied understandings of their lives and thereby promote recovery from schizophrenia. Exemplified with two individual examples, we first discuss the barriers that challenge and the techniques that help psychotherapists seeking to enter into dialogue with people with severe mental illness. We also offer a theoretical model of how the revitalization of dialogues within therapy can be conceptualized as a process that promotes recovery and discuss the objective measurement of such outcomes.
16460715	A large number of cognitive neuroscience studies point to the similarities in the neural circuits activated during the generation, imagination, as well as observation of one's own and other's behavior. Such findings support the shared representations account of social cognition, which is suggested to provide the basic mechanism for social interaction. Mental simulation may also be a representational tool to understand the self and others. However, successfully navigating these shared representations--both within oneself and between individuals--constitutes an essential functional property of any autonomous agent. It will be argued that self-awareness and agency, mediated by the temporoparietal (TPJ) area and the prefrontal cortex, are critical aspects of the social mind. Thus, differences as well as similarities between self and other representations at the neural level may be related to the degrees of self-awareness and agency. Overall, these data support the view that social cognition draws on both domain-general mechanisms and domain-specific embodied representations.
16450932	This study examined the feasibility of a structured peer provider training program and its effect on peer providers with respect to their own personal and vocational recovery.Sixty-six individuals participated in an evaluation of a 60-hour, 5-week long peer training program. Participants were assessed prior to and after the training on scales to measure recovery, empowerment and self-concept. Analyses of variance were used to examine subjective changes in these measures. Job acquisition and retention data were also examined at posttest.	Participants experienced gains in perceived empowerment, attitudes toward recovery and self-concept. Trainees went on to obtain peer provider positions within the mental health agency in which they received the training and 89% of those trained retained employment at 12 months. Twenty-nine percent of the initial jobs into which the peer providers were placed were full-time; 52% were part-time and 19% were hourly.	Findings suggest that a standardized program designed to provide peer training was used successfully and participants' recovery and employability were improved. Further studies are recommended to rigorously test peer providers' impact on their clients and to examine the advantages that accrue to the agency when mental health recipients are employed as peer providers.	
16435592	The Canadian Occupational Performance Measure (COPM) has gained wide acceptance in general occupational therapy research and practice, however, the use of the COPM in assistive technology assessments and outcomes is not as well documented.This clinical report discusses the utility of the COPM in assistive technology, as illustrated by the assessment and follow-up of clients requiring high technology vision aids.	The COPM makes important contributions to the outcomes of providing vision aids. The COPM ensures a needs review that incorporates all areas of occupational performance, which in turn directs the clinician to match the technology to client needs. From a clinical perspective, the quantitative follow-up data are helpful to determine clients' improvement in occupational performance as well as their satisfaction with the assistive technology. For administrative purposes, the COPM results provides accountability to the funding agency.	The COPM can be readily integrated into the assessment and follow-up of assistive technology service delivery and adds value to both components of the process.	
16399806	Functional neuroimaging studies have started unravelling unexpected functional attributes for the posteromedial portion of the parietal lobe, the precuneus. This cortical area has traditionally received little attention, mainly because of its hidden location and the virtual absence of focal lesion studies. However, recent functional imaging findings in healthy subjects suggest a central role for the precuneus in a wide spectrum of highly integrated tasks, including visuo-spatial imagery, episodic memory retrieval and self-processing operations, namely first-person perspective taking and an experience of agency. Furthermore, precuneus and surrounding posteromedial areas are amongst the brain structures displaying the highest resting metabolic rates (hot spots) and are characterized by transient decreases in the tonic activity during engagement in non-self-referential goal-directed actions (default mode of brain function). Therefore, it has recently been proposed that precuneus is involved in the interwoven network of the neural correlates of self-consciousness, engaged in self-related mental representations during rest. This hypothesis is consistent with the selective hypometabolism in the posteromedial cortex reported in a wide range of altered conscious states, such as sleep, drug-induced anaesthesia and vegetative states. This review summarizes the current knowledge about the macroscopic and microscopic anatomy of precuneus, together with its wide-spread connectivity with both cortical and subcortical structures, as shown by connectional and neurophysiological findings in non-human primates, and links these notions with the multifaceted spectrum of its behavioural correlates. By means of a critical analysis of precuneus activation patterns in response to different mental tasks, this paper provides a useful conceptual framework for matching the functional imaging findings with the specific role(s) played by this structure in the higher-order cognitive functions in which it has been implicated. Specifically, activation patterns appear to converge with anatomical and connectivity data in providing preliminary evidence for a functional subdivision within the precuneus into an anterior region, involved in self-centred mental imagery strategies, and a posterior region, subserving successful episodic memory retrieval.
16365959	The conclusions from an expert working group on persons who fail to disclose their HIV status were published in the 1 March 2005 edition of the Public Health Agency of Canada's Communicable Disease Report. The recommendations recognize that legal and ethical considerations must inform and guide both policy and practice as they relate to non-disclosure of HIV/AIDS. The expert working group favoured a graduated response model based on a public health approached to the issue rather than a criminal law approach.
16343947	We investigated how motor agency in the voluntary control of body movement influences body awareness. In the Rubber Hand Illusion (RHI), synchronous tactile stimulation of a rubber hand and the participant's hand leads to a feeling of the rubber hand being incorporated in the participant's own body. One quantifiable behavioural correlate of the illusion is an induced shift in the perceived location of the participant's hand towards the rubber hand. Previous studies showed that the induced changes in body awareness are local and fragmented: the proprioceptive drift is largely restricted to the stimulated finger. In the present study, we investigated whether active and passive movements, rather than tactile stimulation, would lead to similarly fragmented body awareness. Participants watched a projected image of their hand under three conditions: active finger movement, passive finger movement, and tactile stimulation. Visual feedback was either synchronous or asynchronous with respect to stimulation of the hand. A significant overall RHI, defined as greater drifts following synchronous than asynchronous stimulation, was found in all cases. However, the distribution of the RHI across stimulated and non-stimulated fingers depended on the kind of stimulation. Localised proprioceptive drifts, specific to the stimulated finger, were found for tactile and passive stimulation. Conversely, during active movement of a single digit, the proprioceptive drifts were not localised to that digit, but were spread across the whole hand. Whereas a purely proprioceptive sense of body-ownership is local and fragmented, the motor sense of agency integrates distinct body-parts into a coherent, unified awareness of the body.
16343305	Starting from the premise that people are essentially narrative beings, I argue that the onset of severe mental illness compromises the narrative enterprise of being able to construct one's Self and one's relationships in meaningful and coherent ways. This is due to both the curtailment of opportunities for narrative engagement and the dispossession of those whose narratives do not conform to the current conceptualization of narrative and narrativity. In these circumstances, supporting the narrative enterprise is an ethical endeavour that requires that we examine not only which narratives we construct, but also how we construct them. This requires a re-thinking of what might constitute narrative and how we might facilitate or enhance the narrativity of people with severe mental illness. Following this, I suggest four means to support the narrativity of people with severe mental illness: through maintaining narrative continuity, maintaining narrative agency, countering master narratives and attention to small stories.
16260138	This Husserlian phenomenological study explored the lived experience of eight full-time agency nurses working in the environment of intensive care in London, United Kingdom. In-depth interviews were used to ascertain the participants' experiences of full-time agency nursing in intensive care. Colaizzi's [Colaizzi P. Psychological research as the phenomenologist views it. In: Vale R, King M, editors. Existential-phenomenological alternatives for psychology. London: Oxford University Press; 1978, p. 48-71] method of data analysis was utilised. Thematic analysis identified three cluster themes: the shared experience of lacking confidence; the shared experience of deskilling; and the shared experience of feelings of isolation. The theme of the shared experience of lacking confidence identified the importance of support and understanding of agency nurses' needs in the ICU. The theme of the shared experience of deskilling illuminated participants concern at not having the opportunity to care for patients of higher acuity. The theme of the shared experience of feelings of isolation highlighted that often participants did not feel they "belonged to a team". Study findings suggest the need to include: the implementation of protocols within the clinical setting; the provision of performance feedback to agency nurses; and the consideration of ongoing structured professional development and education for ICU agency nurses.
16240616	This paper has two purposes: to study a central psychological feature of anorexia nervosa, the disturbed sense of self, and to demonstrate the utility of an empirical research method to explore a psychoanalytic concept such as self-representation. The aim of the study was to distinguish the sense of self of anorexia-nervosa patients from that of other psychiatric patients, as well as from non-patients. We obtained open-ended self-descriptions, which provide access to self-representations, from 77 young women between the ages of 14 and 24 who made up three groups-anorexia-nervosa patients (n = 15), control psychiatric patients (n = 15), and control non-patients (n = 48). The self-descriptions, when rated on 18 scales that fell into four factors (Agency, Reflectivity, Differentiation, and Relatedness) and two affective scales (Anxiety and Depression), showed that the two patient groups shared characteristics that significantly differentiated them from women who were not patients-a lower sense of agency and relatedness. What significantly differentiated the anorexia-nervosa patients from the other psychiatric patients, as well as from the nonpatients, were a heightened and harsh self-reflectivity and more openly expressed depressive and anxious affect in the self-descriptions. The implications for treatment and for understanding eating disorders are discussed.
16200877	We conducted three studies to translate the Snyder Hope Sales into Japanese, examine reliability and validity of the Japanese version, and investigate the relationship between the tendency to be hopeful and subjective well-being. In Study 1, confirmatory factor analysis was performed of the Hope Scale in the Japanese version: agency and pathways. Its test-retest reliability coefficients for the data from 113 undergraduates ranged from .81 to .84. In Study 2, concurrent validity of the Japanese version Hope Scale was examined with the data from 550 respondents, which looked at the correlations between hope and optimism, self-esteem, and self-efficacy. Results suggested that the Japanese version had high validity. In addition, the tendency to be hopeful had negative correlations with stress response, hopelessness, depressive tendency, and trait anxiety, and positive one with feeling of happiness. In Study 3, 175 undergraduates completed the Hope Scale and State-Trait Anxiety Inventory (STAI) immediately prior to final examinations. Results of regression analysis suggested that the tendency to be hopeful moderated examination anxiety. Taken together, results of the studies supported the hypothesis that hope had positive effects on subjective well-being.
16199597	Counsellors, like other members of the caring professions, are required to practise within an ethical framework, at least in so far as they seek professional accreditation. As such, the counsellor is called upon to exercise her moral agency. In most professional contexts this requirement is, in itself, unproblematic. It has been suggested, however, that counselling practice does present a problem in this respect, in so far as the counsellor is expected to take a non-judgemental stance and an attitude of "unconditional positive regard" toward the client. If, as might appear to be the case, this stance and attitude are at odds with the making of moral judgments, the possibility of an adequate ethics of counselling is called into question. This paper explores the nature and extent of the problem suggesting that, understood in a Kantian context, non-judgmentalism can be seen to be at odds with neither the moral agency of the counsellor nor that of the client. Instead, it is argued, the relationship between the non-judgmental counsellor and her client is a fundamentally moral relationship, based on respect for the client's unconditional worth as a moral agent.
16177460	Patients have the potential to play an important role in preventing medical errors. Yet little is known about how to effectively engage patients in this role as a "vigilant partner" in care. Respondents were asked to assess the perceived effectiveness of fourteen recommended actions for preventing medical errors. The findings indicate that most of the actions are viewed as effective. However, respondents also indicate that they are unlikely to engage in many of the recommended actions. Having a greater sense of self-efficacy in being able to prevent medical errors is significantly linked with a greater reported likelihood of engaging in preventive action.
16144240	Costly complications of diabetes often arise from poor glycemic control. Appropriate diabetes self-care management may improve control. This study examined whether self-care management affects glycemic control and mediates relationships between self-efficacy and self-care agency with glycemic control. In a cross-sectional correlational design, data from a prior study of 141 insulin-requiring adults with type 1 or type 2 diabetes were examined using descriptive statistics, Pearson's correlation, and multiple hierarchical regression. Findings indicated that greater self-care agency and self-efficacy lead to greater self-care management, in turn leading to better glycemic control. Self-care management did not mediate between self-efficacy or self-care agency and glycemic control. Thus, beliefs or capabilities for self-care are insufficient to improve glycemic control; doing so requires self-care management.
16142526	Subversive redemption--the sense of overturning the conventional order of things in order to recover lost parts of the self--is a virtually neglected topic in psychoanalysis. With free association, Freud empowered patients to harness unconventional thoughts and feelings. Patients who engage in subversive redemption frequently have a strong sense of agency prompting them to open up in new ways in lieu of "playing it safe." When patients begin to express certain forbidden ideas, the boundaries of analysis are broadened, freeing the analytic pair to become fully authentic. Psychoanalysis provides patients with an arena to renew themselves as they risk "killing off" their status quo positions to achieve the paradox of living more dangerously in the safety of the analytic surrounds. Patients then feel more confident about undertaking the process of subversive redemption in the wider world.
16109340	This small, prospective cohort study of 162 12- to 15-year-old girls examines timing of changes in sexual cognitions and behaviors (breast fondling, genital contact, and sexual intercourse) over a 1-year period.Girls from community sites in New York City provided information about sexual experiences and related cognitions (arousability, sexual agency, abstinence attitudes, perceived parental and peer approval, and sexual self-esteem) in 2 interviews 1 year apart.	Percentages who reported breast fondling, genital contact, and sexual intercourse (18%, 24%, and 6%) increased significantly over the year (42%, 44%, and 19%) and with age. For each behavior, analyses compared girls who did not report the behavior at either Time 1 or 2, those who reported by Time 2 but not 1, or those who reported at both time points. Girls with no breast fondling experience at either time point had stronger abstinence values, and lower arousability, agency, peer approval, and sexual self-esteem scores compared to girls who initiated breast fondling over the year (transitioners). Transitioners were markedly similar in sexual cognitions to girls with this experience before Time 1, suggesting that changes in sexual cognitions precede actual experience. A similar pattern was found between groups for genital contact. Few differences between groups by comparison were noted for sexual intercourse, which occurs later in the trajectory.	Sexual experiences that occur before intercourse (e.g., breast fondling) are central to research on sexual development and related to greater changes in girls' sexual cognitions than is intercourse. Changes in cognitions precede, rather than follow, new sexual experiences.	
16105680	To date, studies pertaining to possible links between body modification and risk-taking behaviours have been conducted mainly among targeted groups. The objective of this study is to examine the influence of a number of risk-taking behaviours on the probability of being pierced or tattooed among a general adolescent population.Data come from a cross-sectional study conducted among a sample of 2180 students aged 12-18. Data were collected directly from students through a self-report survey.	Findings confirm the "risky" nature of these practices even though the tattooed and pierced subjects of this study were from a general adolescent population. Factors that contribute significantly to the likelihood of teenagers being tattooed or pierced, for both genders, are associated with "externalized risk behaviours" such as multiple drug use, illegal activities, gang affiliation, problem gambling, school truancy and rave attendance.	Nowadays, tattooing and body piercing are perceived by many as body decoration, increasingly belonging to the realm of generational conformity. Contrary to this view, our results suggest that these practices among adolescents are mostly adopted by those who are involved in various deviant or illegal activities, which are often interrelated.	
16091264	Three experiments examined whether the mere priming of potential action effects enhances people's feeling of causing these effects when they occur. In a computer task, participants and the computer independently moved a rapidly moving square on a display. Participants had to press a key, thereby stopping the movement. However, the participant or the computer could have caused the square to stop on the observed position, and accordingly, the stopped position of the square could be conceived of as the potential effect resulting from participants' action of pressing the stop key. The location of this position was primed or not just before participants had to stop the movement. Results showed that (subliminal as well as supraliminal) priming of the position enhanced experienced authorship of stopping the square. Additional experimentation demonstrated that this priming of agency was not mediated by the goal or intention to produce the effect.
16083404	A secondary statistical analysis of data from a study investigating the relations among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an older adult population is reported (Callaghan, in press). Influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 235 older adults is presented. The research instruments used to collect data for this study include the following: Health-Promoting Lifestyle Profile II scale, Self-Rated Abilities for Health Practices scale, Exercise of Self-Care Agency scale, and a demographic questionnaire assessing basic conditioning factors. Statistically significant relations were found between the following basic conditioning factors and the study variables: education, income, health insurance, race, support system, routine practice of religion, medical problems, marital status, gender, age, and number of children. Community health nurses can use these results in directing interventions that promote the self-care and health of older adults.
16036688	From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point--even a backbone--for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.
15993529	This paper is an exploratory study of ways of talking about mental health. Drawing upon data collected from mental health service users in the Republic of Ireland, it employs discourse analysis within a case study approach to embellish three 'types' of service user identified in the sociology literature. Rather than being seen as specific types it is proposed that patient, consumer and survivor be regarded as a discursive typology which function as discursive resources for service users. The re-conceptualisation of these types, as discourses, allows the researcher to gain thicker descriptions of the ways in which service users socially construct their own perspectives on mental illness. Through a process of discourse analysis, discourses of patients, consumers and survivors are extrapolated out from interview talk with members of mental health social movement organisations or groups. The identified discourses contain intrinsically different ways of talking about mental illness and allude to different conceptions of agency on the part of the service user. It is argued that they offer an insight into bottom-up social constructions of mental illness. It is proposed that these discourses suggest that notions of patients, consumers and survivors have entered the service users' discursive canon and that they are actively utilised by service users to socially construct their perspectives on mental health.
15964277	Psychopathological symptoms in schizophrenia patients suggest that the concept of self might be disturbed in these individuals [1]. Delusions of influence make them feel that someone else is guiding their actions, and certain kinds of their hallucinations seem to be misinterpretations of their own inner voice as an external voice, the common denominator being that self-produced information is perceived as if coming from outside. If this interpretation were correct, we might expect that schizophrenia patients might also attribute the sensory consequences of their own eye movements to the environment rather than to themselves, challenging the percept of a stable world. Indeed, this seems to be the case because we found a clear correlation between the strength of delusions of influence and the ability of schizophrenia patients to cancel out such self-induced retinal information in motion perception. This correlation reflects direct experimental evidence supporting the view that delusions of influence in schizophrenia might be due to a specific deficit in the perceptual compensation of the sensory consequences of one's own actions [1, 2, 3, 4, 5 and 6].
15955407	Statistics indicate that sexual health problems like HIV/AIDS and teenage pregnancies are prevalent among young South African low-income women. To improve the effectiveness of preventative programmes for adolescents it is important to focus on adolescents' own understanding and experience of their sexual behaviour within the contexts in which it occurs. Female adolescents' experiences of their own sexuality are shaped by a range of contexts: from the very specific context of their intimate relationships to the broader contexts of gender, ethnicity and social class. It is therefore imperative to adopt a research approach that stratifies groups and develops interventions that are based on the needs, interests, sexual beliefs and behaviours of specific communities rather than developing general educational messages. The current paper is part of a larger study exploring female adolescent sexuality in a South African low-income rural coloured community. Twenty-five adolescent coloured women aged 14-18 years were interviewed about how they viewed their sexuality. The grounded theory analysis indicated that the participants demonstrated a limited sense of sexual agency in these constructions of their sexuality. The mothers of these young women were powerful agents in the young womens' constructions of their own sexuality and they unintentionally contributed to their daughters' limited sense of sexual agency. Mothers presented sex as a dangerous activity to their daughters. This discourse of sex as danger contributed towards a mutual understanding that sex should not be talked about. Daughters' deception of their mothers about their sexual activity maintained mother-daughter connections, but left them without an interactional space where they could talk freely to their mothers about sexuality.
15934561	This study investigated the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population. The purpose of this study was to identify the relationships among these concepts as well as the specific influence of spiritual growth, a component of health-promoting self-care behaviors, on self-care agency. The instruments used in this study included the Health-Promoting Lifestyle Profile II (HPLPII) scale, the Self-Rated Abilities for Health Practices (SRAHP) scale, and the Exercise of Self-Care Agency (ESCA) scale. A canonical correlation identified a significant variate having a correlation of .95 (p < .000) accounting for 90% of the variance explained. The loading variables included the HPLPII subscale of spiritual growth and the ESCA subscale of initiative and responsibility. The study results indicate that spiritual growth is significantly related to an adolescent's initiative and responsibility for self-care.
15925800	Experiencing oneself as the cause of an action is a fundamental building block for a sense of self. A recent study by Sato and Yasuda provides evidence that motor prediction contributes to the experience of agency. Their findings demonstrate that agency is experienced not only for intended, but also for erroneous, unintended actions. This extends our knowledge on the phenomenology of action, and raises questions about the relation between explicit reports and agency-related changes in sensation and perception.
15921127	Public health nurses from 13 local public health agencies and nurse educators from five schools of nursing developed population-based public health nursing competencies for new graduates and novice public health nurses. Educators in one nursing program used a portfolio assignment to measure achievement of the competencies by traditional and RN to BSN students in a community health nursing course. Data were collected from surveys and focus groups to determine students' responses to the portfolio and their use of population-based public health nursing concepts. The assignment enhanced students' critical thinking skills; however, concerns about the structure and evaluation of the portfolio decreased student satisfaction. Recommendations are made for improving the portfolio format, increasing students' valuing of the portfolio, managing the tension between assessment and learning, and orienting clinical agency staff and nursing instructors.
15860788	Two areas of controversy are examined in this article, arising from contemporary debate on identity in later life. The first centers on whether adults are essentially similar regardless of age or whether different stages of life confer different life priorities. The second addresses the management of self in later life, with special attention being given to alternative interpretations of the relationship between interior and exterior experience. An increasing awareness of diversity in life-course patterns suggests that issues concerning uniformity, distinctiveness, and the uses of masquerade in intergenerational contexts should be revisited. Here, the influence of simple and complex states of mind is examined as a factor in intergenerational power, and the expression of agency in later life is discussed. These issues not only propel us forward in our understanding of gerontological phenomena, they also point to potential sources of research bias associated with specifically intergenerational contexts. Finally, suggestions are made with respect to research training.
15822427	In an increasingly unsettled and violent world, with swelling numbers of children who are abused, abandoned, or neglected, emotionally if not physically, and an increasing population of aggressive preschool children with anxiety and disruptive behavior disorders who cannot be contained in ordinary settings, psychoanalysts can make a contribution. Early intervention is essential. In very early childhood, new procedural memories for interacting with others and for regulating affects can be formed more easily than they can ever be again. Intervention should aim toward helping the child develop a sense of agency, establish moral standards, assume self-responsibility, and attain the capacity for emotional regulation. The principles of complex dynamic systems can inform psychoanalytic treatment strategies, as demonstrated with five children whose cases are presented.
15805820	Schizophrenia spectrum disorders often involve a profound diminishment in people's ability to coherently narrate their lives. Unknown is whether narrative difficulties of persons with schizophrenia differ from those with other disabilities, and how they relate to clinical or neurocognitive aspects of schizophrenia. To address both issues, personal narratives were obtained for 25 participants with schizophrenia spectrum disorders and a comparison group of eight legally blind participants and four with major depressive disorders. Flexibility of abstract thought and positive, negative, and emotional discomfort symptoms were assessed among the schizophrenia group. ANCOVA comparing scores on our scale to assess narrative development, controlling for age, found the schizophrenia group narratives significantly more impoverished than the comparison group on multiple dimensions, including self-worth and agency. Neurocognitive impairment and negative symptoms were significant predictors of impoverishment in the schizophrenia group. Results may highlight deficits that could be addressed in psychotherapy or rehabilitation to promote recovery.
15795453	This article explores the relation between targeted nutrition and food assistance programs and the recipient communities. The author begins by suggesting that the renewed current emphasis on targeting has resulted from the high cost of universal entitlements in poor countries and from the need to increase the food security and resilience of the poor in these countries. They stress the fundamental human right of communities to have involvement in all steps of program targeting as elemental to good democratic governance. Next, the article reviews the issues surrounding different levels of community involvement in the components of program targeting, namely needs assessment, definition and implementation of eligibility criteria, delivery of services and benefits, and monitoring and evaluation of results. Four types of targeting eligibility are described: self-targeting, means tested, categorical, and community based. It is noted that the type and the level of engagement of programs with communities depends on whose concept of community welfare is being pursued (the development summit's or the community's), and on how broadly nutrition improvement is defined. Examples are used to illustrate the potentially severe consequences of ignoring community governance and social structures in the targeting of programs. A framework is then presented with important variables to consider when planning a targeted program: state governance contexts, the nature of the local community's institutions of governance, the ratio of the need to the available benefit, and the stability of the context. Finally, the article presents recommendations for filling in the large research gaps on this topic.
15776752	Diabetes is a major source of morbidity, mortality, and economic expense in the United States. The majority of researchers and clinicians believe that diabetes is a self-care management disease, and that patients should be reliable, capable, and sufficiently responsible to take care of themselves. However, individuals with diabetes may or may not have diabetes knowledge, social support, self-care agency (an individual's capability to perform self-care actions), and self-efficacy (an individual's beliefs in his or her capability to perform self-care actions) that would help them to engage in diabetes self-care management. Therefore, this study examined the relationship among those factors using a cross-sectional model testing design. A convenient sample of 141 insulin-requiring individuals with either diabetes type 1 or type 2, 21 years old and over, was recruited from an outpatient diabetes care center located in a Southeast region of the United States. Simple linear regression, multiple standard regression, and multiple hierarchical regression were used to analyze the data. Individuals with greater diabetes knowledge had greater self-care agency and self-efficacy. Those with a higher score in social support had greater self-care agency and better diabetes self-care management, and those with greater self-efficacy had better diabetes self-care management. In addition, self-care agency mediated the effects of diabetes knowledge on self-efficacy and the effects of social support on diabetes self-care management. Self-efficacy mediated the effects of self-care agency on diabetes self-care management. Furthermore, the linear combination of diabetes knowledge, social support, self-care agency, and self-efficacy, taken together, positively affected diabetes self-care management. Enhancing an individual's diabetes knowledge, social support, self-care agency, and self-efficacy may be a strategy which can promote better engagement in diabetes self-care.
15715739	To study the relative contribution of consumer, clinician and service factors to whether or not consumers completed a self-rating measure in the context of routine outcome measurement.Four Victorian mental health services commenced routine outcome measurement in their adult services in mid-2000. Clinician-completed measures (Health of the Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP)) and a consumer self-rated measure (Behaviour and Symptom Identification Scale (BASIS)) were entered into specialized software. Analyses were restricted to assessments conducted at review in the community.	Wide differences were observed between the four agencies in the rates of completion of the self-rating measure. Overall, consumer characteristics associated with greater likelihood of completion were lower age, non-organic diagnosis, lesser severity as measured by the HoNOS, and lesser disability as measured by the LSP. A more focused analysis showed that agency, lower age, and higher compliance were most reliably associated with completion. Significant proportions of clinicians had no recorded instances of consumer self-rating associated with their assessments.	Service and clinician factors appear to be equally important as consumer factors in whether or not a self-rating measure was completed. Information systems designed for outcomes measurement should include indications of whether or not a self-rating was invited, and, if not, why not. The results suggest that consumer self-rating is not yet firmly established in the outcomes measurement culture.	
15632275	Folk psychology postulates a spatial unity of self and body, a "real me" that resides in one's body and is the subject of experience. The spatial unity of self and body has been challenged by various philosophical considerations but also by several phenomena, perhaps most notoriously the "out-of-body experience" (OBE) during which one's visuo-spatial perspective and one's self are experienced to have departed from their habitual position within one's body. Here the authors marshal evidence from neurology, cognitive neuroscience, and neuroimaging that suggests that OBEs are related to a failure to integrate multisensory information from one's own body at the temporo-parietal junction (TPJ). It is argued that this multisensory disintegration at the TPJ leads to the disruption of several phenomenological and cognitive aspects of self-processing, causing illusory reduplication, illusory self-location, illusory perspective, and illusory agency that are experienced as an OBE.
15627036	To estimate the prevalence of, and identify factors associated with, HIV testing in Britain.A large, stratified probability sample survey of sexual attitudes and lifestyles.	A total of 12,110 16-44 year olds completed a computer-assisted face-to-face interview and self-interview. Self-reports of HIV testing, i.e. the timing, reasons for and location of testing, were included.	A total of 32.4% of men and 31.7% of women reported ever having had an HIV test, the majority of whom were tested through blood donation. When screening for blood donation and pregnancy were excluded, 9.0% of men and 4.6% of women had had a voluntary confidential HIV test (VCT) in the past 5 years. However, one third of injecting drug users and men who have sex with men had a VCT in the past 5 years. VCT in the past 5 years was significantly associated with age, residence, ethnicity, self-perceived HIV risk, reporting greater numbers of sexual partners, new sexual partners from abroad, previous sexually transmitted infection diagnosis, and injecting non-prescribed drugs for men and women, and same-sex partners (men only). Whereas sexually transmitted disease clinics were important sites for VCT, general practice accounted for almost a quarter of VCT.	HIV testing is relatively common in Britain; however, it remains largely associated with population-based blood donation and antenatal screening programmes. In contrast, VCT remains highly associated with high-risk (sexual or drug-injecting) behaviours or population sub-groups at high risk. Strategies to reduce undiagnosed prevalent HIV infection will require further normalization and wider uptake of HIV testing.	
21038257	Recent neuroscientific research has developed the concept of the embodied agent as a scientifically viable approach to the psychological concept of the self. Both the awareness of one's own actions and awareness of one's own body are necessary conditions for the experience of selfhood. The relative contributions of efferent and afferent information in self-awareness are yet to be fully understood. We review experimental evidence that highlights the phenomenological and functional differences between the "acting self" and the "sensory self." These differences may underlie the ubiquitous modulation of perception in voluntary action. We focus on three main research fields: somatosensory perception, time-awareness, and self-recognition. A series of experiments, designed so as to dissociate afferent from efferent information, are reviewed. As a whole the results suggest that intentional action functions as a general context for awareness, modulating the perception of one's own body. The "acting self," owner of the efferent information, modulates the phenomenal experience of the "sensory self" because of the intrinsically agentic nature of voluntary movement. Finally, it is suggested that this sense of agency is efferent-driven, originating from pre-action processes.
15617673	It is proposed that knowledge of motor commands is used to distinguish self-generated sensation from externally generated sensation. In this paper, we show that the sense of self-agency, that is the sense that I am the one who is generating an action, largely depends on the degree of discrepancy resulting from comparison between the predicted and actual sensory feedback. In Experiment 1, the sense of self-agency was reduced when the presentation of the tone was unpredictable in terms of timing and its frequency, although in fact the tone was self-produced. In Experiment 2, the opposite case was found to occur. That is, participants experienced illusionary sense of self-agency when the externally generated sensations happened to match the prediction made by forward model. In Experiment 3, the sense of self-agency was reduced when there was a discrepancy between the predicted and actual sensory consequences, regardless of presence or absence of a discrepancy between the intended and actual consequences of actions. In all the experiments, a discrepancy between the predicted and actual feedback had no effects on sense of self-ownership, that is the sense that I am the one who is undergoing an experience. These results may suggest that both senses of self are mutually independent.
15551725	This article explores the impact of economic liberalization on psychiatric theory and practice in Latvia. Through a close reading of four psychiatric consultations it examines the way in which contradictions between a market economy, its attendant philosophy of unlimited individual opportunity and the implementation of these ideas in the lives of individuals are negotiated by psychiatrists and their patients. It examines the uses of psychological and somatic vocabularies and questions their claimed connections to an enlarged sense of agency or its denial.

15448304	Two studies investigated how contextually activating attachment relationships influences the working self-concept in terms of agency and communion. In Study 1, 245 participants were primed with a secure, avoidant, or anxious-ambivalent relationship and the implicit accessibility of agency and communion was assessed using word fragments. Activating a secure relationship increased the accessibility of communion, whereas activating an anxious-ambivalent relationship increased the accessibility of agency. In Study 2, 123 participants were primed with a secure, preoccupied, avoidant-dismissive, or avoidant-fearful relationship and explicit self-perceptions of agency and communion traits were assessed using the Extended Personality Attributes Questionnaire (EPAQ). Gender interacted with the attachment prime, such that men primed with a secure relationship reported higher communion than did men primed with an avoidant (dismissive or fearful) relationship, whereas women primed with an anxious (preoccupied or fearful) relationship reported higher agency than did women primed with a secure relationship.
15332721	In the first part of this article, the authors argue that any conception of well-being is culturally embedded and depends on how the notions of "well" and "being" are defined and practiced in different cultural communities. To support this argument, they conduct a comprehensive review of the empirical literature, which shows that members of individualistic and collectivistic cultures differ in their emotional experience of well-being. This difference has been traced to the indigenous psychology of selfhood in those cultures. In the second part of the article, the authors debunk the myth of infinite cultural variability, while retaining the basic insight concerning the cultural constitution of well-being. They develop a theoretical model of well-being, in which agency and communion are universal dimensions of well-being, and people in different cultures require different combinations of agency and communion to experience well-being. Following this theoretical development, the authors examine cultural impediments to the good life in individualistic and collectivistic cultures. The mutual incompatibility of agency and communion is ruled out as a possible cause of why it is so difficult to live the good life. Instead, the authors propose a dialectical synthesis of agency and communion as a way of dealing with this challenge of living the good life.
15330692	The purpose of this article is to illustrate how confirmatory factor analysis can be used to extend and clarify a researcher's insight into a survey instrument beyond that afforded through the typical exploratory factor analytic approach. The authors use as an example a survey instrument developed to measure individual differences in professional role orientation among physical therapists, the Professional Role Orientation Inventory for Physical Therapists (PROI-PT).Five hundred three physical therapists responded to a mail survey instrument that was sent to a random sample of 2,000 American Physical Therapy Association members.	An adapted version of the Professional Role Orientation Inventory, a 40-item Likert-scale instrument developed to assess professional role orientation on 4 dimensions (authority, responsibility, agency, and autonomy), was used. Exploratory and confirmatory factor analyses were used to examine the factorial validity of the PROI-PT.	Exploratory factor analysis served as a starting point for examining the factor structure of the instrument. Confirmatory factor analysis then was used to test the hypothesized factor structure and to suggest refinements to the PROI-PT that would improve a psychometric property (internal consistency).	Although further refinement of the PROI-PT is needed, an instrument that yields valid and reliable measurements of individual differences in professionalism among physical therapists could further our understanding of the psychosocial aspects of physical therapist practice. Exploratory and confirmatory factor analyses can be used by researchers who study various psychosocial constructs in physical therapy.	
15288756	The present study was designed to examine construct validity of two identity status measures, the Ego Identity Process Questionnaire (EIPQ; J. Adolescence 18 (1995) 179) and the Extended Objective Measure of Ego Identity Status II (EOM-EIS-II; J. Adolescent Res. 1 (1986) 183). Construct validity was operationalized in terms of how identity status classifications generated by the EIPQ and EOM-EIS related to a measure of psychological agency, the Multi-Measure Agentic Personality Scale (MAPS; J. Adolescence 20 (1997) 421). Results indicated that, for the most part, the agentic personality scales differentiated the EIPQ diffused and moratorium statuses from the foreclosed and achieved statuses, whereas the agentic personality scales differentiated the EOM-EIS-II achieved status from the other three statuses. The EIPQ is recommended as the preferred instrument for making contrasts between or among identity statuses, whereas the EOM-EIS-II is recommended when the objective is to consider continuous measures of the identity statuses.
15256358	This manuscript explores mid-life women's views of corporeality and the links that these have to their health. Using ethnographic interview techniques, community based interviewers talked with 24 women from rural settings. Our findings suggest that mid-life women have an embodied view of their minds and spirits, and that dualism is generally reserved for thinking about and interacting with the biomedical system. They have a sense of themselves as unique individuals who have a large role in caregiving, multiple other roles, and have luck but also agency in and control of their health and well-being. Motion was a strong theme throughout the interviews. Women embraced this mobility as a characteristic of their well-being as they coped with multiple changes associated with mid-life. In contrast to what some philosophers maintain, women seem to partner both corporeal changes and metaphor. While the sample was limited in scope, the findings support the importance to women's health of understanding the intersections between compositional and contextual variables in various settings.
15210016	Dispositional traits and life narratives represent two different levels of personality that have not previously been empirically linked. The current study tested five hypotheses connecting Big-Five traits to life-narrative indices of emotional tone, theme, and structure. Students (Study 1) and adults (Study 2) completed a self-report measure of the Big-Five traits and provided extended written accounts of either ten (students) or eight (adults) key life-narrative scenes, including life high points, low points, and turning points. Content analysis of the narrative data revealed that for both samples Neuroticism was positively associated with an emotionally negative life-narrative tone, Agreeableness was correlated with narrative themes of communion (e.g., friendship, caring for others), and Openness was strongly associated with the structural complexity of life narrative accounts. Contrary to prediction, however, Conscientiousness was not consistently associated with themes of agency (e.g., achievement, self-mastery) and Extraversion was unrelated to positive narrative tone. The results are discussed in the context of contemporary research and theorizing on the narrative study of lives and the relation of narrative research in personality to more conventional, trait-based approaches.
15193576	To evaluate the efficacy of a brief computer-mediated intervention, relative to no intervention, in altering HIV/AIDS-related knowledge, protective attitudes, and self-efficacy for risk reduction among early adolescent females aged 11 through 14 years.Recruited through the auspices of a large social services agency with multiple sites across New York City, a volunteer sample of 205 Black, White, and Hispanic young women participated in this research. The efficacy of the software intervention was examined in a randomized blocks design with site as the unit of randomization. Young women at experimental arm sites interacted with the software in a single 30-minute session. Youths at control arm sites participated in regular programs offered at these sites, but did not receive the intervention until all planned assessments were concluded. Before and after intervention, participants completed measures of HIV/AIDS-related knowledge, protective attitudes, and self-efficacy for HIV risk reduction. Analyses of covariance were used to test for significant between-arm effects.	Between-arm effects were observed for HIV/AIDS-related knowledge and risk reduction self-efficacy. Experimental arm youths evidenced greater improvements from pretest to posttest than control-arm youths on these outcomes.	Computer-mediated interventions may improve HIV/AIDS-related knowledge and risk reduction self-efficacy among early adolescent females. However, additional research is needed to find effective computer-mediated approaches for enhancing protective attitudes among this population.	
15189627	The authors examined the relations of social interactions with cardiovascular response in the context of two friends disclosing a problem. They also examined the relations of the sex composition of the dyad and partner gender-related traits (communion/agency) with social interactions. Same-sex and opposite-sex dyads (N = 79) came to the lab. One friend disclosed a real-life problem while the partner provided support; cardiovascular response was monitored. Women provided more emotional support than men, and this sex difference was due to women's higher levels of communion. Agency was linked with greater advice, whereas unmitigated communion was linked with greater negative interactions. Negative interactions predicted slower diastolic blood pressure (DBP) recovery, whereas advice predicted slower heart rate (HR) recovery. Sex composition of dyad moderated some of these effects.
15156845	This study investigated the needs of relative caregivers of children in the child welfare system whose parents had HIV. Families of children supported by the state child welfare agency were invited to participate in the study; 17 families reported that HIV affected them and 11 families did not identify HIV as an issue. The findings indicate that complex emotional and behavioral issues stressed the HIV-affected kin caregivers; these issues included the children's behavioral problems, HIV-related concerns, adolescent issues, emotional difficulties, and sexual abuse, HIV-affected caregivers had more concern about their health and multiple roles. Nonaffected caregivers were less likely to report severe parenting stress and more likely to report financial stress. HIV-affected caregivers require attention and intervention by social workers, child welfare workers, and case managers.
15141393	Psychological mindedness (PM) is theorized to be a cognitively toned personality variable, yet, there is a paucity of research addressing the cognitive components of PM. This study was intended to redress this issue by testing the empirical associations between PM and Ambiguity Tolerance, as measured by the Revised Scale for Ambiguity Tolerance (MacDonald, 1970); Locus of Control, as measured by the Locus of Control Scale (Rotter, 1966); and Magical Thinking, as measured by the Magical Ideation Scale (Eckblad & Chapman, 1983). The results indicated that PM is positively associated with ambiguity tolerance, whereas it is inversely related to external locus of control and magical thinking. These findings suggest a cognitive style profile for PM that includes flexibility, a sense of personal agency, and a propensity for realistic thinking. High-PM individuals are likely to bring these cognitive resources to bear in psychotherapy, a tendency that might explain why high PM patients make better use of treatment.
15082334	Accumulative empirical evidence has been reviewed in support of the notion that the production and perception of action as well as the interpretation of others' actions are functionally connected, and indeed, rely on common distributed neural systems in the premotor and parietal cortices. We suggest that these neural systems sustain shared representations between self and other that are crucial in social interactions. The inferior parietal cortex plays a special role in the sense of agency, which is a fundamental aspect to navigate within this neural network. The role of other brain areas that implement and regulate these shared representations remains to be specified.
15062911	This was a pilot study with the purpose of determining the effect of health education in enhancing the self-care agency of pregnant women and to define the role of their background characteristics in the success of this education. Subjects of this study were 30 pregnant women who visited a university hospital for check. The success of the given education was measured by pre- and post-tests that were applied before and after health education using "self-care agency scale". Data were evaluated according to t-test and variance analysis. After health education, the self-agency scores of the pregnant women increased significantly (P < 0.05). It was defined that pregnant women with the least self-care agency scores before health education, displayed the best progress after the education.
15030021	Moral agency is an important constituent of the nursing role. We explored issues of ethical development in Greek nursing students during clinical practice at the beginning of their studies. Specifically, we aimed to explore students' lived experience of ethics, and their perceptions and understanding of encountered ethical conflicts through phenomenological analysis of written narratives. The process of developing an awareness of personal values through empathizing with patients was identified as the core theme of the students' experience. Six more common themes were identified. Development of the students' moral awareness was conceptualized as a set of stages, commencing with empathizing with patients and nurses, moving on to taking a moral stand and, finally, concluding by becoming aware of their personal values and showing evidence of an emerging professional moral personhood. The notions of empathy, caring and emotion were in evidence throughout the students' experience. Implications for practice and nurse education are discussed.
15020005	Social class understood as social relations of ownership and control over productive assets taps into parts of the social variation in health that are not captured by conventional measures of social stratification. The objectives of this study are to analyse the association between self-reported health status and social class and to examine the role of work organisation, material standards and household labour as potential mediating factors in explaining this association. We used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. This was a stratified sample, strata being the 10 districts of the city. The present study was conducted on the working population, aged 16-64 years (2345 men and 1874 women). Social class position was measured with Erik Olin Wright's indicators according to ownership and control over productive assets. The dependent variable was self-reported health status. The independent variables were social class, age, psychosocial and physical working conditions, job insecurity, type of labour contract, number of hours worked per week, possession of appliances at home, as well as household labour (number of hours per week, doing the housework alone and having children, elderly or disabled at home). Several hierarchical logistic regression models were performed by adding different blocks of independent variables. Among men the prevalence of poor reported health was higher among small employers and petit bourgeois, supervisors, semi-skilled (adjusted odds ratio-aOR: 4.92; 95% CI: 1.88-12.88) and unskilled workers (aOR: 7.69; 95%CI: 3.01-19.64). Work organisation and household material standards were associated with poor health status with the exception of number of hours worked per week. Work organisation variables were the main explanatory variables of social class inequalities in health, although material standards also contributed. Among women, only unskilled workers had poorer health status than the referent category of manager and skilled supervisors (aOR: 3.25; 95%CI: 1.37-7.74). All indicators of work organisation and household material standards reached statistical significance, excepting the number of hours worked per week. In contrast to men, among women the number of hours per week of household labour was associated with poor health status (aOR: 1.02; 95% CI: 1.01-1.03). Showing a different pattern from men in the full model, household material deprivation and hours of household labour per week were associated with poor health status among women. Our findings suggest that among men, part of the association between social class positions and poor health can be accounted for psychosocial and physical working conditions and job insecurity. Among women, the association between the worker (non-owner, non-managerial, and un-credentiated) class positions and health is substantially explained by working conditions, material well being at home and amount of household labour.
15018717	The Internet is now a site where women with breast cancer both read and write about the illness, and in doing so negotiate identity and definitions of situation in disembodied space. Cyberspace has been imagined as a liberatory realm where women can transgress gender roles, invent selves and create new forms of knowledge. This study explores the personal web pages of women with breast cancer with an interest in exploring the issue of 'cyber-agency' or empowerment in cyberspace. I suggest here that women's web pages might offer potentially critical opportunities for women's knowledge-making in relation to what are often highly political aspects of the body, gender and illness. However, the Internet is not an inherently empowering technology, and it can be a medium for affirming norms of femininity, consumerism, individualism and other powerful social messages.
14992620	Ratings of patient efficacy to manage illness, made by 191 congestive heart failure patients and their spouses, were examined as predictors of patients' survival over the next 4 years. When considered alone, both the patient's self-efficacy and the spouse's confidence ratings predicted survival, but only spouse confidence remained significant when both partners" efficacy ratings were included in the same Cox regression model. The overlapping prognostic significance of spouse confidence and a global, multicomponent measure of marital quality positioned the former as a proxy for the latter, reflecting a fundamentally social protective factor in patient survival. Successful adaptation to heart failure appears to involve more than the patient's personal agency, and psychosocial data from spouses can improve prediction of patient outcomes.
14989287	In this paper I argue that the genetic manipulation of sexual orientation at the embryo stage could have a detrimental effect on the subsequent person's later capacity for autonomous agency. By focussing on an example of sexist oppression I show that the norms and expectations expressed with this type of genetic manipulation can threaten the development of autonomous agency and the kind of social environment that makes its exercise likely.
14967341	To test the utility of a brief measure of developmental assets for predicting risk and health-promoting behaviors.Six "assets" questions were added to an existing school-based survey of health-related behaviors. "Asset" questions dealt with students' grades in school, their communication with parents about school, students' perceptions of their role in school decision-making, students' participation in after-school activities and volunteering, and students' perceptions that they "matter" in their community. Participants were 30,916 Vermont students in grades 8-12. The sample included approximately equal numbers of girls and boys. It was 92% white. Fifty-nine percent of students' mothers had completed at least some postsecondary education (according to student report). Data were analyzed by Chi-square techniques and logistic regression.	Number of assets (0-6) was negatively related to students' engagement in each of seven risk behaviors, and positively related to three health-promoting behaviors. The effects of number of assets were in most cases independent of demographic variables. Among the six assets, academic success (grades in school) contributed the greatest effect for most of the outcome measures; however, each of the assets contributed significant independent effects to multiple risk- and health-behaviors.	Students' assets, even if relatively few, may make important contributions to wellness, independent of other well-established demographic factors.	
14870478	Familiehulp, the largest home care organization in Flanders, Belgium, has 40,000 clients and 7,400 employees. Believing its staff is its most valuable capital, Familiehulp has instituted the concept of self-steering teams. The United Kingdom's home care was unregulated until April 2003. A major objective of that country is to get the disabled back to work. In the United States, the average tenure of home care aides for this presenter's agency is eight years. He shares his secrets for recruiting and retaining the best.
14755359	Information and education is needed to empower autonomy and self-determination of patients (informed consent). Furthermore reliable and accurate medical information is necessary for patients who want to take an active part in medical decision-making. The aim of this work is to define the requirements helping to assure the development of good qualified information material relevant for women and female patients as "a guideline on women information". An example of its use is given by embeding this guideline in the guideline for early detection of breast cancer in Germany by defining the specific elements required for developing qualified information on this issue for women.A systematic, stepwise methodological process according to a level two guideline of the German Association of the Scientific Medical Societies (AWMF) and the Agency for Quality in Medicine (AZQ) was performed with the following elements: 1. Establishing an expert panel, 2. Generating the guideline statements by a formal, consensus based nominal group process, 3. External review process and finding supportive partners for the guideline on women information, 4. Using the guideline for guidelines: implementing the concept in the guideline of early detection of breast cancer in Germany.	The "guideline women information" comprises nine elements of quality assuring requirements for the development of gender-specific information material and eleven specific elements which directly relate to the guideline statements on early detection of breast cancer. After external review 30 organisations gave their written support for future implementation of the guideline. The "guideline women information" was integrated as a tool for quality assurance of lay information into the "guideline for early detection of breast cancer in Germany".	The "guideline women information" is a systematically developed, consensus-based recommendation to improve the development of qualified lay information at the point of its process by defining gender-specific aspects required for good lay information and its evaluation. As a guideline for guidelines its use is demonstrated by integrating this guideline into the "guideline for early detection of breast cancer in Germany" to ensure the development of qualified guideline compliant information.	
14744231	Psychological processes influence culture. Culture influences psychological processes. Individual thoughts and actions influence cultural norms and practices as they evolve over time, and these cultural norms and practices influence the thoughts and actions of individuals. Large bodies of literature support these conclusions within the context of research on evolutionary processes, epistemic needs, interpersonal communication, attention, perception, attributional thinking, self-regulation, human agency, self-worth, and contextual activation of cultural paradigms. Cross-cultural research has greatly enriched psychology, and key issues for continued growth and maturation of the field of cultural psychology are articulated.
14723454	Using a national sample of 127 legal, accounting, and human resource professionals, from 1,500 solicited, this study identified two dispositions related to social agency at work. After controlling for several individual factors, the analysis indicated that work social agency was associated with increased self-esteem and decreased Machiavellianism.
14677326	The goal of Diabetes Today, a program of the Centers for Disease Control and Prevention (CDC), is to develop coalitions and train coalition members in assessment, planning, and evaluation to address diabetes in their communities. CDC established the Pacific Diabetes Today Resource Center (PDTRC) in 1998 to tailor the program for Pacific Islander communities in Hawaii, American Samoa, Guam, the Commonwealth of the Northern Marianas Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and Palau. PDTRC's work is guided by the principles of community building and the goal of empowering coalitions to take action around diabetes. Culturally appropriate strategies are used to gain access to the community, transfer knowledge and skills, build coalitions, and provide technical assistance. Evidence of empowerment is seen in increased individual competence, enhanced community capacity, reduced barriers, and improved supports to address diabetes. To maintain the gains of community building in the Pacific, three factors appear critical: an engaged leader, a host agency for the coalition, and continuing access to technical assistance and funds.
14650477	An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving rise to an embodied view of the birthing woman.
14625354	The powerful illusion of a unified, Cartesian self responsible for intentional action is contrasted with the biologically sounder model of competitive processes that yield an only partially coherent agency, and the existence of the illusion of self is explained as an evolved feature of communicating agents, capable of responding to requests and queries about their own decisions and actions.
14609298	Three pediatric cases of Trichotillomania were treated with direct hypnotic suggestion with exclusive emphasis on sensitizing and alerting the patients to impending scalp hair pulling behaviors. These children had presented with total lack of awareness of their scalp hair pulling behaviors until they had actually twisted and pulled off clumps of hair. It was also suggested, under hypnosis, that upon learning to recognize impending scalp hair pulling behaviors, the patients would become free to choose to willfully pull their hair or to resist the impulse and not pull. At no point was the explicit suggestion given that they stop pulling their hair. A preliminary condition was agreed to by the parents that redefined the patients' hair as their own property and affirmed their sole responsibility for its care and maintenance. An element of secondary gain was identified in each of these cases. Scalp hair pulling was hypothesized to provide these particular patients with a vehicle with which to oppose their overbearing and over-involved parents. The technique of direct suggestion under hypnosis, aimed at alerting the patients to impending scalp hair pulling behaviors was combined with forming contracts with the parents to relinquish their authority over matters regarding the patients' hair. This combination provided an effective treatment that extinguished the scalp hair pulling in 7 visits or less. These cases received follow-up at intervals up to 6 months and no evidence of relapse was found.
14556418	The authors of this exploratory study used textual analysis of transcribed interviews to examine the mental constructs that individuals form around advance care terminology and to learn how elderly veterans conceptualize the language used in the Veterans Administration advance directive. They found that respondents often negotiated meaning by drawing on rigid schemas, specific mental constructs already in place: The Lord's Will, Machine Talk, Being a Burden, and Being Productive. The authors also examined the transcripts for agency. In addition to assigning external agency for end-of-life care decisions, respondents often expressed a complex interaction of "self" and "other" agency. These results challenge us to develop communication methods that allow patients to claim agency and participate fully in decisions regarding their health care, especially at the end of life.
14498773	This article describes some of the special health and safety concerns that many lesbian, gay, bisexual, and questioning youth face in schools. Among these problems are increased drug and alcohol use, sexually transmitted infections and pregnancy risks, depression and suicidality, and increased likelihood of being a victim of harassment or assault. School nurses can play a unique role in the lives of these students. A needs assessment is reviewed that describes school nurses' perceived professional responsibility and their actual practice with regard to lesbian, gay, bisexual, and questioning youth. Five barriers to optimal health care for these students are discussed. Methods that encourage students to view the school nurse as an ally, as well as issues surrounding disclosure or "coming out," are discussed. Special considerations of confidentiality, community agency referral, and family disclosure are discussed. Appropriate interventions at school and ways to begin to change the school climate are also presented.
12926648	Back pain is ubiquitous and probably plagues almost everyone in all cultures and ethnic groups at some time (around 20% annually), and in up to 50% of these at least once a year. The WHO-COPCORD epidemiologic investigations have established its prevalence even in countries that had been unaware of its frequency in their populace, and factors involving type of work and training probably accounted for this misperception. Medical journals are replete with articles addressing diagnosis and treatment, but the majority fail to meet the standards needed for metaanalysis or comparison. A task force of the Agency for Health Care Policy and Research of the United States Department of Health and Human Services screened more than 10,000 abstracts, eliminated the majority of these studies and papers, and still was unable to recommend the best approach even to acute back pain; the problem of subacute and chronic back pain is even more formidable. Yet back pain has been identified as perhaps the major cause of disability and absenteeism from the workplace worldwide. WHO chiefly addressed subacute back pain, as most acute back pain is self-limited and ends spontaneously, almost regardless of the treatment. Subacute pain is the intermediate stage toward chronic pain, which defies most treatments. Specific causes for back pain, such as infections, tumors, osteoporosis, spondyloarthropathies, and trauma, actually represent a minority of such pain syndromes, qualifying for specific therapeutic approaches. A major problem in defining the burden of disease for back pain has been a dearth of agreed-upon outcome measures by which to judge the various interventions, and this was the task that the WHO Low Back Pain Initiative took upon itself. Among measures recommended to be included in all studies, so that valid comparisons could be made, were measurement of pain by visual analog scales, somatic perception, the Oswestry disability and modified Zung questionnaires, and a modified Schober test of spinal mobility. These measures are needed for studies, not for diagnosis or treatment of individual patients. They have been translated into various major languages and validated by back-translations, and applied in comparative studies in various cultures to medical, chiropractic, and other common interventions. The importance of such scientifically sound studies cannot be overemphasized, as the costs of health care are mounting everywhere and it therefore becomes imperative to develop cost-effective approaches. All the more so as conversion of acute back pain to chronic back pain is often iatrogenic, with strong psychosocial factors as well, so that not only what to do but also what not to do become important public health issues. The general lack of attention to back pain by governments and organizations probably results from the fact that it is perceived as a syndromic presentation with myriad causes rather than as a specific disease entity. Even if the "disease" names classify like presentations but are not necessarily etiologically discrete, syndromic diagnoses that subsume a variety of causes receive less attention; international rankings of common disabilities and public health problems tend to emphasize the named disorders rather than the grouped disorders. Moreover, back pain is often self-treated with nonprescription medications or alternative therapies, and by nonmedical practitioners or treatments in many parts of the world. Validation of outcomes therefore not only reduces invalidism and direct costs but also reduces the indirect costs of absenteeism and medical care.
12926575	The prospect of industrial accidents motivated the U.S. Congress to require in the Clean Air Act of 1990 that manufacturing facilities develop Risk Management Plans (RMP) to submit to the U.S. Environmental Protection Agency (USEPA) by July 1999. Industry worried that the requirement to communicate to the public a "worst-case scenario" would arouse unnecessary and counterproductive fears among industry neighbors. We report here the results of focus groups and surveys with such neighbors, focusing particularly upon their reactions to messages about a hypothetical worst-case scenario and management of these risks by industry, government, and other parties. Our findings confirmed our hypotheses that citizens would be skeptical of the competence and trustworthiness of these managers and that this stance would color their views of industrial-facility accident risks. People with job ties to industry or who saw industrial benefits to the community as exceeding its risks had more positive views of industrial risks, but still expressed great concern about the risk and doubt about accident management. Notwithstanding these reactions, overall respondents welcomed this and other related information, which they wanted their local industries to supply. Respondents were not more reassured by additional text describing management of accidents by government and industry. However, respondents did react very positively to the concept of community oversight to review plant safety. Claims about the firm's moral obligation or financial self-interest in preventing accidents were also received positively. Further research on innovative communication and management of accident risks is warranted by these results, even before recent terrorist attacks made this topic more salient.
12911018	This is a structured, evidence-based review of all available studies addressing the concept of nonorganic findings: Waddell signs (WSs).To determine what evidence, if any, exists for the various interpretations for the presence of WSs on physical examination.	WSs are a group of eight physical findings divided into five categories, the presence of which has been alleged at times to have the following interpretations: Malingering/secondary gain, hysteria, psychological distress, magnified presentation, abnormal illness behavior, abnormal pain behavior, and somatic amplification. At the present time, there is, therefore, significant confusion as to what these findings mean.	A computer and manual literature search produced 61 studies and case series reports relating to WSs. These references were reviewed in detail, sorted, and placed into tabular form according to the following subject areas: 1) Reliability (test-retest); 2) Reliability (inter-rater); 3) Reliability (factor analysis); 4) Validity, psychological distress; 5) Validity, correlation Minnesota Multiphasic Pain Inventory (MMPI); 6) Validity, correlation abnormal illness behavior; 7) Validity, other behaviors; 8) Validity, as a nonorganic phenomenon; 9) Validity, correlation pain drawing; 10) Validity, functional performance; 11) Validity, treatment outcome; 12) Validity, predicting surgical treatment outcome; 13) Validity, return to work outcome; 14) Validity, secondary gain correlation; and 15) Validity, pain correlation. Each study in each topic area was classified according to the type of study it represented according to the type of evidence guidelines developed by the Agency for Health Care Policy and Research (AHCPR). In addition, a list of 14 study quality criteria was used to measure the quality of each study. Each study was categorized for each criterion as positive, (criterion filled), negative (criterion not filled), or not applicable independently by two of the authors. A percent quality score was obtained for each study by counting the total number of positives obtained, dividing by 14 minus the total number of not applicables, and multiplying by 100. Only studies having a quality score of 75% or greater were used to formulate the conclusions of this review. The strength and consistency of the evidence represented by the remaining studies in each topic area (above) was then categorized according to the strength and consistency AHCPR guidelines. Conclusions of this review for each topic area are based on these results.	Of the 61 studies, four had quality scores below 75% and were not used to generate the results of this review. According to the AHCPR guidelines for strength and consistency of the reviewed data, the following results were obtained: 1) There was consistent evidence for WSs being associated with decreased functional performance, poor nonsurgical treatment outcome, and greater levels of pain; 2) There was generally consistent evidence for WSs not being associated with psychological distress, abnormal illness behavior, or secondary gain; 3) There was also generally consistent evidence that WSs are an organic phenomenon and that they cannot be used to discriminate organic from nonorganic problems; 4) There was inconsistent evidence that WSs do demonstrate inter-rater reliability, do not correlate with the neurotic triad of the MMPI, are associated with poorer surgical treatment outcome, and are associated with nonreturn to work; 5) There was little or no evidence that WSs demonstrate test-retest reliability, or reliable factors, and are associated with self-esteem problems, catastrophizing, or the nonorganic pain drawing.	Based on the above results, the following conclusions were made: 1) WSs do not correlate with psychological distress; 2) WSs do not discriminate organic from nonorganic problems; 3) WSs may represent an organic phenomenon; 4) WSs are associated with poorer treatment outcome; 5) WSs are associated with greater pain levels; 6) WSs are not associated with secondary gain; and 7) As a group, WS studies demonstrate some methodological problems.	
12884550	This study is a part of a larger project Nr. NJ 6139-3 funded by the Grant Agency of the Czech Ministry of Health. The aim of the paper was to analyse the response rate using standard statistical methods and the Geographical Information System (GIS); to indicate differences in the response by sex, age, education, and employment; to determine the breakpoint for the collection of questionnaires according to which we can estimate the total response rate; to indicate whether the study sample was representative enough to generalize the project results. The additional aim of the paper was to collect those background literary sources dealing with the response rate as a methodological paradigm. The statistical and GIS analysis were based on comparison of the total population data (Census 2001), the study sample and the sample of the completed questionnaires data in the 23 districts of the city of Ostrava. The information from the data collection was derived from the date of receipt for each questionnaire. The literature sources were obtained from the Internet--in total 228 papers from the period since 1986 to the present have been checked. The main results of this study are: the GIS analysis was confirmed in all stages by standard statistical methods--it can therefore be used as a valid tool for quick orientation in data and for the comparison of a study sample with the general population; we did not find significant differences in the course of the collection of the questionnaires between sex, age, education, and the employment of respondents; it can be seen that the breakpoint according to which we can estimate the total response rate, is the 10th day after the questionnaires are distributed by post (75% of the questionnaires collected); our sample is representative enough from the geographical point of view. More detailed information about the whole project and results already published or presented are available on the following web site: www.zuova.cz/projekty/ses/php.
12884549	The study of reliability was part of a project funded by the Grant Agency of the Czech Ministry of Health. The repeatability of answers, 180 questionnaires being sent again after a six week interval, was assessed by two methods: by the percentages of agreement and using the Kappa index. We evaluated 61 questions, which were divided into five sections (general questions, questions on employment, lifestyle, health, and personality). The agreement rate varied from 46% to 100% and the value of the Kappa index from -0.01 to 1. The agreement performed by the Kappa index was divided into 4 groups (< or = 0.4--poor; 0.41-0.6--average; 0.61-0.80--good; 0.81-1 almost perfect). The agreement across our questionnaire was poor in 6.6% of the questions, average--in 31.1%, good--in 45.9% and almost perfect--in 16.4% of the questions. Next we divided the questions by their content into two groups--the factual questions (group 1) and questions where answers contain an evaluative or motivational element (group 2). Significant differences (p < 0.001) were found between groups 1 and 2 in the agreement (86.8%; 72.1%) and the Kappa index (0.73; 0.48). In questions where agreement of answers is evaluated as average or even weak we used three types of solution: a) substitution by the analogous questions with a higher agreement, b) aggregation of the answers if possible, or c) the questions were not used for the analyses. These important results will be considered in further analyses of the data and in the interpretation of the study results. The detailed information about the whole project and the results has already been published or presented are available on the following web site: www.zuova.cz/projekty/ses.php.
12876883	The relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency were investigated. The purpose of the study reported here was to explore conceptual integration that could be useful in determining interventions that enhance self-care agency. The sample consisted of 379 adult subjects. The instrumentation scales included: Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practices, and Exercise of Self-Care Agency. A canonical correlation identified a significant variate with a correlation of .76 (p < .001) accounting for 58% of the variance explained. The loading variables included: spiritual growth, self-concept, initiative, and responsibility. Therefore, spiritual growth was more strongly related to self-care agency than self-efficacy.
12874926	Three wards of different sizes and with a mixture of full-time and part-time staff, qualified and unqualified, took part in a self-rostering trial lasting a total of six months. The results showed a high satisfaction rate among staff, with 82 per cent saying they were usually able to organise a work and home life balance compared to 38 per cent before the trial. In addition baseline sickness, and figures on the use of bank and agency staff, were taken for the preceding three months and repeated at six and 16 months after self-rostering was adopted. Two years later, staff on those wards are continuing with self-rostering and the concept has now been extended to other areas in the trust.
12869246	A case is made for the epistemological and ontological premises of social constructionism against arguments that it is subjectivist. From this, questions about the 'status' of the self, and its centrality (or not) to experience, emerge. Arguments for the de-centralization and centralization of the self are discussed, with particular attention to the embodied-embedded quality of the self, from which the spatiotemporal metaphors of 'positioning', 'narrative' and 'voicedness' have arisen. It is argued that communication is inherently evaluative and that the self is a 'special case' of evaluation (in terms of moral agency): the self and morality are, therefore, conceptually linked. The concept of a relational self-of-selves is one that, it is argued, emerges from dialogic processes--processes that draw upon these metaphors of embodiment and generate high orders of reflexivity. Thus, social constructionism yields a sophisticated account of self-hood, agency and responsibility.
12842033	There has been a recent and dramatic growth of interest in the psychological and neural mechanisms of multisensory integration between different sensory modalities. Much of this recent research has focused specifically on how multisensory representations of body parts and of the 'peripersonal' space immediately around them, are constructed. Research has also focused on how this may lead to multisensorially determined perceptions of body parts, to action execution, and even to attributions of agency and self-ownership for the body parts in question. Converging evidence from animal and human studies suggests that the primate brain constructs various body-part-centred representations of space, based on the integration of visual, tactile and proprioceptive information. These representations can plastically change following active tool-use that extends reachable space and also modifies the representation of peripersonal space. These new results indicate that a modern cognitive neuroscience approach to the classical concept of the 'body schema' may now be within reach.
12833554	This qualitative study examines the experience of haematological cancer as described by ten people who have been through leukaemia or lymphoma and a bone marrow transplant. The focus is on the interaction of these participants with this challenging experience and the meaning it had for them. The descriptions of their thoughts, feelings and actions as they negotiated the period from diagnosis to treatment and survival reveal that these people brought both the present values in their life, as well as a life-long pattern of dealing with adversity, into their confrontation of a life-threatening illness. Issues of personal meaning and agency (the capacity to act and control valued aspects of one's life) were found to be paramount. These results are then discussed with a view to their implications for patient care.
12822694	This article presents findings of the evaluation of the Experience Corps for Independent Living (ECIL) initiative. The ECIL initiative was a two-year demonstration program designed to test innovative ways to use the experience, time, and resources of volunteers over 55 to expand significantly the size and scope of volunteer efforts on behalf of independent living services for frail older people and their caregivers in specific communities. Six demonstration projects were selected to participate in this initiative. The intensive volunteers, the critical component of the program, were more highly skilled than typical volunteers from existing senior volunteer programs. ECIL volunteers collaborated with agency partners to develop new programs, supervise direct service activities, and enhance the performance of the agencies being served. Although the projects addressed many of the goals of the initiative, they did not fully accomplish all of their objectives. The ECIL initiative was particularly successful in providing independent living services to frail elders and their families in the communities served. It was less successful in developing and maintaining the team and corps concept, in attracting and retaining the anticipated numbers of volunteers during the study period, and in becoming self-sufficient by the end of Year Three.
12817547	It is widely known that people with schizophrenia have difficulty telling a coherent story of their lives and that this is linked to impoverished function. But what specifically has gone wrong in the narratives in schizophrenia? Is it the case that some elements of narrative remain intact in schizophrenia while others are uniquely affected? To address these questions, we qualitatively analyze the personal narratives of three persons with schizophrenia, which have emerged in psychotherapy. Based on this analysis we suggest that narratives in schizophrenia uniquely fail to situate agency within the narrator resulting in a story that is missing an agent-protagonist. While the narratives we present contain coherent accounts of how others are connected to one another, they fail to evolve into a story about the self as an agent that others could associate with the narrator. We speculate that this may reflect neuro-cognitively based difficulties maintaining the internal dialogue that propels agency as well as fears that any emergent subjectivity may be appropriated or objectified by others. Implications for psychotherapy are discussed.
12798261	Recognizing oneself as the owner of a body and the agent of actions requires specific mechanisms which have been elucidated only recently. One of these mechanisms is the monitoring of signals arising from bodily movements, i.e. the central signals which contribute to the generation of the movements and the sensory signals which arise from their execution. The congruence between these two sets of signals is a strong index for determining the experiences of ownership and agency, which are the main constituents of the experience of being an independent self. This mechanism, however, does not account from the frequent cases where an intention is generated but the corresponding action is not executed. In this paper, it is postulated that such covert actions are internally simulated by activating specific cortical networks or representations of the intended actions. This process of action simulation is also extended to the observation and the recognition of actions performed or intended by other agents. The problem of disentangling representations that pertain to self-intended actions from those that pertain to actions executed or intended by others, is a critical one for attributing actions to their respective agents. Failure to recognize one's own actions and misattribution of actions may result from pathological conditions which alter the readability of these representations.
12759934	This study assessed nurses' actual and perceived knowledge of diabetes. These nurses were employed in a community hospital and home healthcare agency. The Diabetes Basic Knowledge Test (DBKT) and the Diabetes Self-Report Tool (DSRT) were used to assess actual and perceived knowledge. Nurses actual and perceived knowledge were positively correlated (r = 0.402, p < 0.0001). A mean score of 72.2% was obtained on the DBKT. The study findings raise questions about how competent nurses are in caring for patients with diabetes.
12753111	Food Photographs and standard portion sizes have been used with adults to assess portion size when recording dietary intake. The effectiveness of these methods may be reduced when memory/recall is required and children may have problems using these techniques.Adults (47) and children (37) were recruited from amongst university personnel, their children and children's friends to assess portion sizes of nine self-served amounts of selected food items using food photographs and standard descriptions of portion sizes. Portion sizes were estimated directly after self-serving and three - 4 days later.	Substantial differences in the estimate of portion sizes were observed for most foods regardless of the method used or the age of the subjects, median difference range: -52-100%. For children there were greater errors using both methods than for adults. Significant differences were found between the two methods of estimating weight. The food atlas provided higher median estimated weights for the majority of the food items. There were very few differences in the estimation of portion sizes between the two testing periods.	The findings would suggest that either an alternative method or a modification of the methods used here for estimating portion sizes in young subjects, for example standard food portion sizes for children of different ages such as those that are being developed by the Food Standards Agency, would be more appropriate.	
12741700	My first objective in this paper is to synthesize, synoptically, the literature on oppression and liberation with the contributions to this special issue. To fulfil this aim I introduce a framework for understanding, resisting, and overcoming oppression. The framework consists of psychopolitical well-being; experiences, consequences, and sources of oppression; and actions toward liberation. Each of these components is subdivided into 3 domains of oppression and well-being: collective, relational, and personal. Experiences of suffering as well as resistance and agency are part of the framework. My second objective is to offer ways of closing the gap between research and action on oppression and liberation. To do so I suggest 2 types of psychopolitical validity: epistemic and transformative.
12723783	The Implicit Association Test (IAT) uses reaction times to measure implicit linkages among concepts or between concepts and attributes. The Palm IAT is a simplified version of the IAT that runs on Palm Pilot or Handspring Visor personal digital assistant devices. The Palm IAT is portable, provides precise measurement, and allows for efficient data collection inside or outside the laboratory. Three studies were conducted to asses its practical usefulness. Study 1 (N = 1 2) replicated a previous demonstration of more favorable implicit associations for flowers than for insects. Study 2 (N = 9) found individual differences in linking the self-concept to characteristics of agency and communion. Study 3 (N = 23) found individual differences in linking the self-concept to characteristics of boldness and friendliness. Reliability of the Palm IAT is similar to reliability of theoriginal desktop computer version. Using the Palm IAT, one can study hard-to-reach populations in unusual settings.
12703411	The author explores the technique of interviewing chronic illness patients to obtain narratives of their illness experiences. It is argued that the perspective that interview responses are accurate reflections of experience (the "fetishism of words") hampers the understanding of patient voice and agency. Discussions of chronic illness and narrative are followed by an examination of the interview based on the work of Charles L. Briggs. The author then uses the concepts of self-presentation and social support to examine what interviewers and interviewees contribute to the coconstructed discourse that is produced by the interview and addresses the question of how these concepts contribute to the beneficial outcomes of constructing narratives. The author offers specific suggestions for future research.
12683739	Guided by the theory of planned behavior, this 2-week longitudinal study examined health behaviors in a sample of 279 adolescents. Social norms and perceived behavioral control (PBC) were tested as predictors of self-reported intentions and behaviors in 2 domains, eating and physical activity. Differentiating, as opposed to aggregating, parent and peer norms provided unique information. For PBC, the authors distinguished global causality beliefs from self-related agency beliefs and intraself (effort, ability) from extraself (parents, teachers) means. Intraself agency beliefs strongly predicted healthy intentions, whereas intraself causality beliefs had a negative influence. Patterns differed somewhat across behaviors and gender. Results highlight theoretical issues and provide potential targets for research on health promotion programs for youth.
12683272	Improving the quality of clinical care in developing country settings is a difficult task, both in public sector settings where supervision is infrequent and in private sector settings where supervision and certification are non-existent. This study tested a low-cost method, self-assessment, for improving the quality of care that providers offer in a peri-urban area in Mali. The study was a cross-sectional, case-control study on the impact of self-assessment on compliance with the quality of care standards. The two indicators of interest were the compliance with fever care standards and the compliance with structural quality standards. Both standards were derived from the Ministry of Health of Mali's standards for health care delivery. The study examined 36 providers, 12 of whom were part of the intervention and 24 of whom were part of the control group over a 3 month period from May to July 2001. Overall, the research team found a significant difference between the intervention and control groups in terms of overall compliance (p < 0.001) and in terms of assessment of fever (p < 0.005). The total costs for the intervention for 36 providers was less than US$250, which translated to approximately $6 per provider. The data appear to suggest that self-assessment, when used in a regular fashion, can have a significant effect on compliance with standards. However, it is clear that self-assessment is not a resource-neutral intervention. All of the individuals from the intervention pool interviewed cited the extra work that they had to do to comply with the intervention protocol as a burden. In particular, study participants put an emphasis on the 'long duration' of the study that 'discouraged' the study participants. Future research on self-assessment should include a larger sample of providers and should examine the impact of self-assessment over time.
12677324	How does the brain distinguish actions that we perform from movements imposed on us? To study links between the representations of actions and their somatosensory consequences, we compared the perceived times of voluntary actions or involuntary movements and of a subsequent somatic effect (a TMS-induced twitch of the right index finger). Participants perceived voluntary actions as occurring later and their bodily effects as occurring earlier in the agency context, compared to single-event baseline conditions. When the voluntary action was replaced by a passive, involuntary movement this attraction effect reversed. In a second experiment, subjects rated the intensity of the same TMS-induced somatic effect, again following a voluntary action or a passive movement. When the somatic effect was caused by a voluntary action, it was perceived as significantly less intense than when it followed a passive movement. Our results suggest a binding mechanism integrating awareness of somatic consequences occurring in voluntary action. This 'intentional binding' mechanism might underlie the way in which the mind constructs a strong association between intentions, actions and consequences so as to generate the unique and private phenomenological experience of self-agency.
12659487	The subject of this article is moral agency in nursing, studied by the use of an applied philosophical method. It draws upon nurses' accounts of how they see intrinsic value in their work and believe that they make a difference to patients in terms that leave their patients feeling better. The analysis is based on the philosophy of Iris Murdoch to reveal how nurses' accounts demonstrated that they hold a view of themselves and their professional practice that is intrinsically linked to, and dependent upon, their capacity to see good in the work they do.
12630131	This study, carried out from the point of view of positive psychology, gave inner-city children an opportunity to express themselves. Through interviews, they shared their perceptions of psychological well-being in the context of their everyday life and the contribution of a community agency towards their well-being. The support of others appeared as a fundamental aspect of their perceptions of psychological well-being, while the enrichment provided by the agency also emerged from the data. However, children were shown to have relatively few personal strategies to improve their own well-being. The children also identified some obstacles to their well-being. A series of tailored reporting activities made it possible for the personnel and clients of the agency to appropriate the results of the study.
12595186	This study investigated agency, the feeling of being causally involved in an action. This is the feeling that leads us to attribute an action to ourselves rather than to another person. We were interested in the effects of experimentally modulating this experience on brain areas known to be involved in action recognition and self-recognition. We used a device that allowed us to modify the subject's degree of control of the movements of a virtual hand presented on a screen. Four main conditions were used: (1) a condition where the subject had a full control of the movements of the virtual hand, (2) a condition where the movements of the virtual hand appeared rotated by 25 degrees with respect to the movements made by the subject, (3) a condition where the movements of the virtual hand appeared rotated by 50 degrees, and (4) a condition where the movements of the virtual hand were produced by another person and did not correspond to the subject's movements. The activity of two main brain areas appeared to be modulated by the degree of discrepancy between the movement executed and the movement seen on the screen. In the inferior part of the parietal lobe, specifically on the right side, the less the subject felt in control of the movements of the virtual hand, the higher the level of activation. A reverse covariation was observed in the insula. These results demonstrate that the level of activity of specific brain areas maps onto the experience of causing or controlling an action. The implication of these results for understanding pathological conditions is discussed.
12554428	Self-care agency is necessary for psychiatric patients to maintain a level of health that will enable them to have a satisfying personal life as well as to participate in their communities. This article discusses some theoretical and operational dimensions of self-care agency in patients treated for psychiatric illness, with an emphasis on self-care agency in mood disorder. Tools for measuring self-care agency based on Orem's power components are available, but tools specific to psychiatric patients' strengths and deficits, such as in the area of medication adherence and symptom management, need to be developed.
12546165	Persons of low socioeconomic status generally experience worse health and shorter lives than their better off counterparts. They also suffer a greater incidence of adverse psychosocial characteristics, such as low self-esteem, self-efficacy, and self-mastery and increased cynicism and hostility. These population data suggest another category of harm to persons: diminished moral agency. Chronic socioeconomic deprivation can create environments that undermine the development of self and capacities constitutive to moral agency--i.e., the capacity for self-determination and crafting a life of one's own. The harm affects not only the choices a person makes, but the chooser herself. This moral harm is particularly salient in modern Western societies, especially in the United States, where success and failure is attributed to the individual, with little notice of the larger social and political realities that inform an individual's circumstances and choices.
12532364	A theoretical review provides a rationale for examining self-agency as a developmental foundation underlying processes of self-regulated change and a potential moderator of intervention effectiveness among participants in a nurse home-visitation program. Self-agency is defined as the conceptual understanding of self as an agent capable of shaping motives, behavior, and future possibilities (Damon & Hart, 1991). Availability of a sample of 186 mothers who received nurse home visitation provided an opportunity to test the relationship between participant self-agency and enactment of targeted health behaviors. Self-agency items from the Pearlin Mastery Scale (1978) were used to differentiate mothers who endorsed self-agency from those who did not. Consistent with the theoretical premise, mothers who endorsed self-agency at an established threshold were significantly more likely to enact health behaviors promoted during nurse visitation. Results provide support for the relationship between the development of self-agency and enactment of health behaviors targeted by a nurse home-visitation program.

26954836	This paper is based on ethnographic fieldwork in south Bristol, United Kingdom, and on the south Atlantic island of St Helena. It addresses the relationship between the experience of psychosocial distress, the language used to express such distress and the socio-cultural constraints on both language and experience. Accounts of emotional distress were obtained from interviews with 36 informants in south Bristol and with 40 informants on St Helena. Informants in both settings shared a Euro-American discourse on the self in which emotional distress is conceived as a breakdown in human agency. This discourse is linked to narrative as a way of depicting and re-affirming individual agency. A prototypical concept of narrative is used in this paper to interpret accounts of emotional distress. This interpretation demonstrates the usefulness of the idea of narrative for understanding such experiences. 
12490176	Psychologists have been studying identity processes at the intrapsychic level that resemble what sociologists have noted at the macro-societal level. Specifically, using the identity capital model introduced in previous issues of this journal (Côté, Journal of Adolescence, 19, 419-430; 20, 421-437), we explore a link between the psychologically oriented identity status paradigm, and the sociologically oriented individualization theory. The primary link between these two disciplinary approaches appears to be that the individualization process can be operationalized in terms of agency in identity formation. The relationship between agency and identity formation has been recognized by identity status researchers for some time, but primarily in terminology referring to the intrapsychic level; hence, in some respects, identity status researchers anticipated individualization theory. This link was empirically investigated in three studies of ethnically diverse samples. It was concluded, with a high degree of replication, that the identity statuses representing identity confusion (Diffusion) and identity synthesis (Achievement) appear to represent forms of default and developmental individualization, respectively. This comparison of similar elements between psychological and sociological perspectives may yield a richer understanding of identity formation processes, and help to pave the way for future interdisciplinary research..
12462385	Five community-designed pilot projects were undertaken to reduce the time to diagnosis following an abnormal mammogram. One thousand five hundred and seventy-eight women with abnormal mammograms completed a self-administered questionnaire (71% response) which inquired about experiences and satisfaction with time delay from screening to diagnosis, the information received and support given by health professionals, and measures of anxiety and stress during this time interval. Four of the five pilot project initiatives shortened the time interval from screening to diagnosis, the greatest improvement occurring with facilitated referral from screening to diagnostic breast imaging. There was little difference among the pilot projects and control for most measures of client satisfaction and anxiety. Differences were found between biopsied and nonbiopsied women for several of these measures. Shortening the time to diagnosis positively influenced the client's perception of unnecessary delay.
12445032	The new cyclooxygenase-2 (COX-2) selective inhibitors, celecoxib (Celebrex) and rofecoxib (Vioxx), have been widely prescribed since their launch. No reviews currently appear in the literature of prescribing patterns in Australia. This paper describes a self-audit of the clinical use of selective COX-2 inhibitor therapy undertaken with rural general practitioners (GPs) in Australia.A structured audit form was developed and distributed to interested GPs. The form was self-administered and focused on issues about COX-2 inhibitors and the types of patients who were receiving them, e.g. indications, patient demographics, risk factors and drug interactions.	A total of 627 patients were recruited (569 celecoxib and 58 rofecoxib). A range of doses was prescribed. Osteoarthritis was the most common indication (68.1%). Risk factors known for the nonselective nonsteroidal anti-inflammatory drugs were identified in 65.1% of patients, with the most common being advanced age, hypertension and previous peptic ulcer disease. Potential drug interactions were common. A variety of reasons for initiation of therapy was identified; these included perceived increased efficacy, safety and failure of other treatment.	These results show that COX-2 inhibitors are being prescribed for patients with multiple risk factors that may place the patient at increased risk of adverse drug reactions to a COX-2 inhibitor. The perception of improved safety and efficacy was common and is of concern. Limitations of the study include the reliance on self-reporting.	
12425449	This study investigated the factor structure of an instrument to measure social work students' perceptions of preparedness to enter managed care environments. Exploratory statistical procedures to reduce data through principle component analysis identified nine factors with eigenvalues greater than 1.0. These factors include: perceived understanding of agency financial agendas, managing personal risk and liability, perceived understanding of agency documentation requirements, awareness of ethical and value conflicts in documentation, classroom preparation for documentation, understanding the fit between client advocacy and managed care agendas, worrying about law suits in employment settings, perceived understanding of managed care gatekeeping and service authorization, and perceptions of field preparation for documentation. Recommendations are made for utilizing this brief self-report instrument in training students for managed care settings.
12375330	To assess the accuracy of self-reports of use of healthcare services by comparing patient reports to the patients' medical records kept by the health agency.The participants were 213 members of a large health maintenance organization (HMO) who were 60 years of age or older and had a diagnosis of osteoarthritis. Participants were asked to keep medical logs for 6 months; these data were collected after 3 and 6 months. Agency reported healthcare data were collected for the same 6 month period.	The average number of contacts reported by the HMO was 6.42, while the average number of self-reported contacts was 3.79. The mean absolute discrepancy score between self and agency reported contacts was 3.45. More salient contacts (i.e., days in hospital) were more accurately reported than routine doctor visits, but 70% of the participants underreported their total use of the medical care system.	Accurate and unbiased information is a fundamental necessity basis for making decisions about healthcare issues, and self-reports may not provide such information.	
12240518	Knowledge and self-efficacy concerning interactions of prescription medications with over-the-counter (OTC) agents were assessed in community health nurses. Three convenience samples of community nurses were recruited to complete the instruments. The first was a sample of 20 experienced nurses working for a local visiting nurse agency (VNARNs). The second was a sample of 20 bachelor of science in nursing (BSN) students (graduate nurses [GNs]) completing their final nursing rotation with the VNARNs. The third was a sample of 31 nurses enrolled in a graduate program training nurses for advanced practice (APRNs). There were no significant differences in overall mean self-efficacy scores among the groups of community health nurses. The mean scores indicated moderate self-efficacy about prescription-OTC interactions. Post-hoc analyses determined VNARNs had significantly greater knowledge scores than APRNs. Overall mean self-efficacy was not correlated with mean knowledge scores. Inspection of the knowledge item responses revealed nine general misconceptions about OTC medications held by many community nurses in the sample. The data can guide the development of continuing education programs about prescription-OTC interactions aimed at community health nurses.
12224121	Program teaches participants skills for addressing several different diseases. Patients save $400 to $500 over a two-year period by limiting visits. Course is taught by lay leaders in hospitals, churches, and community centers.
12198107	Estimates of group differences in functional disability may be biased if items exhibit differential item functioning (DIF). For a given item, DIF exists if persons in different groups do not have the same probability of responding, given their level of disability. This study examines the extent to which DIF affects estimates of age and gender group differences in disability severity among adults with some functional disability.Data came from the 1994/1995 National Health Interview Survey Disability Supplement. Analyses focused on 5,750 adult respondents who received help or supervision with at least one of 11 activities of daily living/instrumental activities of daily living tasks. We estimated gender and age group (18-39, 40-69, and 70+) differences in disability, using multiple-indicator/multiple-cause models, which treat functional disability as a latent trait.	Nine items manifested significant DIF by age or gender; DIF was especially large for "shopping" and "money management." Without adjusting for DIF, middle-aged persons were less disabled than elderly men, and women were less disabled than men among nonelderly persons. After adjusting for DIF, middle-aged persons did not differ from elderly persons, and gender differences within age groups were not significant.	Comparisons of disability across sociodemographic groups need to take DIF into account. Future research should examine the causes of DIF and develop alternative question wordings that reduce DIF effects.	
12169377	Emergency contraception (EC) refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure, or incorrect use. There is growing worldwide acceptance and promotion of EC as a measure to reduce the level of unwanted pregnancies and, hence, unsafe abortions. The potential effect of EC in this regard could be most evident in sub-Saharan Africa. In Ghana, the Ministry of Health has since 1996 included EC in its reproductive health service policy and standards. The Planned Parenthood Association of Ghana is the only agency involved in the promotion of EC in the country. Very little is known about societal perception of EC. We undertook a study to assess knowledge and attitude toward EC among a sample of students at the University of Ghana. We used a two-page, self-administered questionnaire in a cross-sectional study among students chosen by random sampling. The aspects of EC assessed included level of knowledge, extent of use, common traditional methods of emergency contraception, as well as socially and culturally acceptable ways to promote EC in Ghana. We also assessed how the availability of EC could influence the use of condoms among male respondents. Less than half (43.2%) of the 194 respondents (88 males and 106 females) had heard of modern emergency contraceptive methods. Postinor-2, a dedicated emergency contraceptive product, which was already on the Ghanaian market, was known to 1.5% of respondents. Only 11.3% of respondents indicated correctly the recommended time within which emergency contraceptive pills (ECPs) are to be taken after unprotected sex. Taking concentrated sugar solutions, having an enema, and douching were commonly used traditional methods of EC. More than half (55.0%) of the male respondents indicated that they would either "certainly" or "probably" reduce how often they used condoms once they knew that EC was available. Almost all (97.4%) the respondents wanted to learn more about EC. The indications from this study are that the promotion of EC in Ghana is desired and must be encouraged. The fact that EC does not offer protection against sexually transmitted infections should always be emphasized.
12144136	Based on the idea that risks are knowable, calculable and preventable, dominant social scientific and health promotion discourses foster an image of individual risk control and responsibility. The presentation of the self is a moral enterprise. Accounts of unprotected sex by HIV positive people who have the potential to transmit HIV to their sexual partners can be particularly morally charged. Drawing on 73 depth qualitative interviews with HIV positive people and their sexual partners, this paper explores how the interview accounts of unprotected sex can illuminate the way in which the self is presented within the context of situated norms of risk acceptability and moral responsibility. We identify two forms of account: stories of agency; and stories of acceptability. Stories of agency tend to deny agency and abdicate individual responsibility given the circumstances, and were also a key feature of accounts in which the sexual partners of HIV positive people were placed at risk of HIV transmission. Categories of appeal included the denial of agency as a consequence of: risk calculus and condom accidents; alcohol and drug effects; powerlessness and coercion; and forces of nature. By contrast, stories of acceptability tend to justify unprotected sex as acceptable. Categories of appeal included: HIV positive concordance; and commitment in relationships. Other forms of justification included: alter responsibility; and intentional HIV transmission. We conclude that accounts of risk management are risk managed. We call for greater attention by social scientists to the way in which accounts are constructed, and in particular, to 'anti-rational' forms of explanation within accounts.

12049166	Grounded in theories of global positive expectancies and social influences of behavior, this investigation posited a model in which global positive expectancies are related to substance use as mediated by attitudes, subjective norms, self-efficacy, and intentions. Using a cohort sample (n = 525), structural equation modeling was employed to test the hypothesized predictions of future substance use. The findings suggest that, relative to adolescents with lower global positive expectancies, adolescents with higher global positive expectancies use substances less frequently over time because of their protective attitudinal and control-oriented perceptions towards that behavior. Additionally, results from the current investigation also extend prior findings on the factor structure of global positive expectancies, suggesting these expectancies can be viewed as a second-order factor representing optimism and two components of hope-agency and pathways.
12009754	We discuss the studies reported in this special issue on the basis of a descriptive framework. We conclude that implicit assumptions-silent voices, as we call them-concerning the transactional influence between person and environment, and concerning the primacy of personal agency exist side by side. We find in the studies both a variable-centred and a person-centred approach, and show that the person-centred approach can complement the variable-centred approach in a fruitful manner. On the other hand, both approaches seem to lead to similar results in the studies reported in this special issue. As a rule, the approaches lead to characterization of categories of adolescents, and moreover they can both be seen as exemplifying transactional thinking in the psychology of adolescence. Personal agency and personality are systematically correlated with developmental outcomes, but there are no strong indications that personal agency and personality are important predictors of later developmental outcomes. Such indications are found to a greater extent as regards the influence of parenting and the quality of the parent-adolescent relationship. Finally, there is evidence that peers have their own specific significance in the exploration of developmental options.

11974440	Ketamine is an anaesthetic used in human medicine and veterinary practice, synthesised on 1962 and marketed on 1970 in France. Recreational uses were described during 1992 in the medical community and in 1996 in the dance settings. The chemical name of ketamine is 2--(2chlorophenyl)2-(methylamine)-cyclohexanone, an aryl cyclohexylamine, structurally related to phencyclidine. Ketamine is known under the following street names: Keta K, Kate, Special K, Vitamin K, la Golden, la Vétérinaire. Ketamine is used intranasally, orally and intramusculary in recreational use. Ketamine is manufactured by the chemical industry. Due to the complicated synthesis, it is sold illicitly for recreational use. Ketamine is a dissociative drug, and the user enters in a psychedelic dream with hallucinations, floating sensation, feeling of dissociation of the mind from the body. The dream is forgotten, the user full in reality with loss of self control, risk of acute intoxication. In long-term exposure, tolerance, dependence, withdrawal signs and flash back are described. Ketamine trademarks are subject to control in France through medicine legislation Ketamine and its salts are subject to control under the national legislation on narcotics and psychotropics substance. From September 2001, the theft of medical and veterinary trademarks have to be declared to police, care health authority Pharmacy control authority and French Health Products Safety Agency.
11893018	Findings from the Parent Mutual Aid Organizations (PMAOs) in the Child Welfare Demonstration Project are presented with particular emphasis on parents' motivation to join PMAOs and the benefits from their involvement. Members' perceptions from qualitative investigations are compared with a controlled outcome study. PMAO members show less loneliness, more enthusiasm about their lives, and improved self-esteem and confidence. PMAOs result in substantially less reliance on child protection professionals, fewer child placements, and cost savings for the host agency.
11887678	Little is known about the relationships among life change events, hope, and self-care agency in inner-city adolescentsAdolescents (N = 202) attending two inner-city high schools in Miami (M = 15.9 years; 85% African-Americans; 55% females). Measures used included the Adolescent Life Change Events Questionnaire, Miller Hope Scale, and Denyes Self-Care Agency Instrument.	A significant positive correlation was found between hope and self-care agency. No correlations were found between life change events and hope or life change events and self-care agency. Hope accounted for 20.8% of the variability in self-care agency.	Hope is a significant factor in self-care agency and may be a coping strategy for inner-city adolescents who experience multiple life change events.	
11882195	This article outlines a research methodology that embraces individual narratives, yet recognizes that individual narratives are nested within a backdrop of broader social and cultural understandings of who we are and how we come to understand our world. This dialectical move requires an epistemological shift, focusing on the utility of reconceptualizing the 'environment', not only as the social, political, or economic conditions in society, but also as language. Reconceptualizing the environment as language makes it epistemologically possible to construct a bridge between varying levels of analysis, namely, between individual accounts and life stories and the cultural, social, and historical worlds from which those accounts emerge.
11881177	Studies have considered the experiences of women in terminating abusive relationships. However, the personal strengths and internal resources women use to assist them in terminating have not been studied. The purpose of this naturalistic inquiry was to explore what personal strengths and inner resources contributed to (1) the actual making of women's decision to terminate the abusive relationship, and (2) their ability to successfully follow through with this decision. Themes of turning point, realization, reframing, agency, and self-efficacy emerged from the study. The results suggest a process, although the steps were not sequential and were repeated numerous times before the women were finally successful in leaving. Based on results of this study, implications for intervention include the promoting of cognitive approaches such as reframing and self-talk to facilitate the process of leaving.
11873355	According to Orem's self-care deficit theory of nursing, the structure of self-care consists of self-care agency balanced by therapeutic self-care demand. Different conditioning factors constitute these two constructs. The aim of this study was to investigate through secondary analysis the structure of self-care in a group of elderly. Data were originally collected from a total of 125 randomly chosen elderly individuals (65+ years of age) in Sweden by means of a mailed questionnaire. Confirmatory factor analysis was used to show that self-care agency was totally and significantly balanced against therapeutic self-care demand and explained by five conditioning factors.
11860593	Increasing numbers of persons over 65, decreased length of hospital stay, and need for chronic (custodial) health care have placed a strain on home health care agencies. The second largest group of persons providing care is home health aides (HHAs), who perform in-home, nonskilled, technical procedures with little or no on-site supervision. They are generally high school graduates or hold GEDs. The purpose of this study was to compare home health care administrators' (HHCAs) and HHAs' perceptions of risk involved in home visiting. Given HHAs' educational preparation and limited supervision, they are basically on their own for work performed. Although agencies provide orientation sessions for new workers, periodic in-services often relate to tasks and competency testing and little attention directed toward protecting the self-specifically, strategies to decrease personal risk. In order to determine to what extent HHCAs and HHAs perceive risk, the Home Health Care Perception of Risk Questionnaire, a self-report measure, was administered to a national random sample of 93 HHCAs and 227 HHAs. Findings suggest that these groups differ in perception of risk and level of agency support in making home visits. Suggestions for meeting the needs of this HHA provider group are offered.
11848702	The present study is aimed at identifying the neural correlates of two kinds of attribution: experiencing oneself as the cause of an action (the sense of agency) or experiencing another person as being the cause of that action. The experimental conditions were chosen so that they differed only in their requirement to attribute an action to another person or to oneself. The same motor task and the same visual stimuli were used in the experimental conditions. Subjects used a joystick to drive a circle along a T-shaped path. They were told that the circle would be driven either by themselves or by the experimenter. In the former case subjects were requested to drive the circle, to be aware that they drove the circle, and thus to mentally attribute the action seen on the screen to themselves. In the latter case they were also requested to perform the task, but they were aware that action seen on the screen was driven by the experimenter. In accord with previous studies, the results showed that being aware of causing an action was associated with activation in the anterior insula, whereas being aware of not causing the action and attributing it to another person was associated with activation in the inferior parietal cortex. These two regions are involved in the perception of complex representations of the self and of its interactions with the external world. We suggest that the anterior insula is concerned with the integration of all the concordant multimodal sensory signals associated with voluntary movements. The inferior parietal cortex, in contrast, represents movements in an allocentric coding system that can be applied to the actions of others as well as the self.
11847654	Based on results of a concept synthesis and concept derivation, an argument is made that self-esteem is a human foundational disposition within the self-care deficit theory of nursing and, as such, is a component of an individual's self-care agency. Guided by research literature, the basic conditioning factors of age, gender, developmental state, family systems, sociocultural orientation, health state, and environmental factors are discussed in regard to their influence on the adolescent's developing self-esteem and emerging self-care agency.
11847639	Couples' collaborative care systems wherein work of self-care is shared are described from the perspective of Orem's nursing theory. Couples (N = 108) completed two forms of the Self-As-Carer Inventory: their perception of their own and of their partner's self-care agency. Each completed the Couple Form of the Family Adaptability and Cohesion Evaluation Scales and self-reports of health at this moment and of health in general. The person identified by the couple as having more caregiving responsibilities completed the Caregiver Reciprocity Scale. Stepwise multiple regression yielded a three-variable model (cohesion, dyad gender, and health now), which explained 27% of the variance of collaborative care system score. A collaborative care system model is proposed.
11846187	Cultural and personal traits will become important as the number of short-duration spaceflights of international crews supporting the International Space Station (ISS) increases and more people begin staying aboard ISS for longer durations. This project investigated the interpersonal and personal changes of Japanese subjects during a 1-wk stay in the Japanese Experiment Module. The Giebetaen Test (GT) was used to determine if the cultural background and personality traits of the subjects become more explicit and stronger during isolation.Six males and two females aged 22-28 yr participated in the study. They stayed 7 d in the isolation chamber at the National Space Development Agency of Japan (NASDA). The GT was chosen as an individual and group diagnostic instrument; it was administrated four times during, and one time after, isolation.	According to the GT-self-picture, subjects exhibited a change toward negative social resonance and social withdrawal. Subgroups formed but caused no isolation or tension. The GT-foreign-pictures showed that the judgment of other subjects changed toward hedonic and permeability directions. The common interpersonal relationships of the Japanese subjects influenced the group dynamics. These relationships tend to be integrative and tend to support the network and value systems, emphasizing connectedness and minimizing differences.	The cultural background became more explicit and stronger during isolation. Based on this, isolation studies with international crews and intercultural training will be necessary for international crews performing both short- and long-duration missions.	
11844027	Previous studies have reported on dentine sensitivity (DS) prevalence in hospital and general practice populations. Results from these studies indicate that perception and prevalence of DS vary depending on the population. The study aimed to determine any major differences in the perception and prevalence of DS in subjects in a military training establishment. Questionnaires from 228 subjects [188 completed by males, 39 completed by females, with one person not indicating their gender of mean age 24.0 years (s.d. 7.16)] were collected and analysed using the Statistical Package for the Social Sciences (SPSS). Fifty percent of the subjects (n=114) claimed to have DS. Yet approximately 30% of the subjects (29.8%, n=68) perceived the condition as a slight problem and approximately 40% of the subjects (40.8%, n=93) claimed it was an occasional problem and approximately 50% (49.1%, n=112) did not seek treatment. Seventeen subjects (7.5%) used a desensitizing paste during periods of discomfort. No clear pattern emerged with regard to seasonal variation in DS although 5.7% (n=13) subjects considered DS to be more of a problem in winter. Only 7.9% (n=18) reported any previous periodontal surgery, consistent with previous studies (12.6 and 15.5%). Of those who received regular scaling (27.2%, n=62), only 23 (10.1%) reported any discomfort following treatment, which did not last >or=5 days. The results indicate that self-reporting of DS was similar to previous reports, although it is of fundamental importance that such studies should be supplemented with a thorough clinical examination to determine more reliable prevalence data.
11787510	This study examines how age patterns in health control, self-efficacy, and self-esteem are influenced by age-correlated social status, health, personality, and social integration variables.Ordinary least squares regression documents age patterns in data from a 1985 community sample of 1,549 physically disabled and nondisabled individuals from southwestern Ontario, Canada.	Older respondents report lower health control, self-efficacy, and self-esteem. Less education, more physical impairment, poorer global health, less empathy, and less introspectiveness explain about 43% of age's negative association with health control and more than half of its negative association with self-esteem. In addition, age is associated more negatively with self-efficacy among the disabled. Social status variables conceal the strength of the age-by-disability interaction coefficient, while health accounts for almost an equal amount.	The findings describe how age-correlated personal and social factors contribute to, or statistically conceal, older adults' sense of health control, self-efficacy, and self-esteem.	
11763250	Individuals with inflammatory bowel disease (IBD) often exhibit anxiety and depression, pain and reduced energy but may not adequately develop self-care agency (SCA) to manage IBD. The purpose of this study was to examine whether SCA is related to quality of life in adults diagnosed with IBD. The sample of 34 individuals for this descriptive, correlational study completed three questionnaires including the Appraisal of self-care agency scale (A.S.A.-A Scale), the Inflammatory bowel disease questionnaire and a Demographic data questionnaire. Results indicated SCA was unrelated to indicators of quality of life among IBD individuals. This finding may be attributed to the high level of functioning of the sample. However, IBD quality of life (emotional functioning, social functioning, and bowel and systemic symptoms) was negatively correlated with the number of medications individuals took and positively correlated with the number of diagnosed chronic illnesses.
11729535	Listed are 117 propositions, generated as beginning notes for development of theoretical understanding of agency and communion in human mentation.
11658132	Western philosophy has been powerfully influenced by a paradigm of personal agency that is linked to an individualistic conception of autonomy. This essay contrasts this conception with an alternative understanding that recognizes a social component built into the very meaning of autonomy. After reviewing feminist critiques of the dominant conception of autonomy, I develop the broad outlines of a relational view and apply this reconceptualization to a concrete situation in order to show how this altered view reconfigures understanding of the participants' relationships and each of their personal perspectives. The situation chosen, physician-assisted suicide, is intended principally to illustrate one respect in which a relational conception of autonomy reframes a controversial moral issue and reveals perspectives toward it that are likely to be obscured when autonomy is viewed through the lens of the dominant individualistic conception. My principal aim is to show that when autonomy is understood relationally, respecting others' autonomy is likely to be a far more complex issue than is apparent within the standard conception, both for those with professional responsibilities and often for personal intimates as well.

11595266	It is known that the adult visual memory system is fractionable into functionally independent cognitive subsystems, selectively susceptible to brain damage. In addition, there have been hints from studies with individuals with autism that these cognitive subsystems can fractionate developmentally. However, there has been a paucity of systematic investigations. The present study involves the analysis of visual memory of a population of individuals with autism and age- and VIQ-matched comparison individuals. The individuals with autism presented selective impairments in face recognition in comparison to both the age- and VIQ-matched comparison populations. In addition, they were impaired relative to the age-matched comparison group on recognition memory for potential agents (i.e. objects capable of self-propelled motion) whether they were living (cats and horses) or non-living (motorbikes). In contrast, they were selectively superior relative to the VIQ-matched comparison group on recognition memory for such objects as topographical stimuli (buildings) and leaves that clearly do not have agency. The data is interpreted in terms of reduced sensitivity to agency cues in individuals with autism and general information processing capacity.
11560724	Much confusion still surrounds the concept of empowerment and how it is to be translated into practice within the context of community care for service users and carers. A major limitation has been the tendency to treat empowerment as synonymous with participation in decision-making with little attention given to the 'ecological' model of empowerment where linkages have been found between community participation and measures of psychological empowerment. Training has been suggested as a means through which carers might become empowered, yet to date little empirical evidence has appeared within the literature to support this proposition. This study investigated whether attendance on a training programme to empower carers resulted in improvements in carers' levels of perceived control, self-efficacy and self-esteem as partial measures of psychological empowerment. The findings demonstrated that whereas carers' knowledge of services and participation increased as a result of the programme, no changes were found in measures of carer empowerment. The failure to consider how training needs to be designed in order to achieve changes in individual competence and self-agency are suggested as the most likely explanation for the lack of change observed in carers' psychological empowerment. It is suggested that community care agencies should focus greater energies in determining how the policy objectives of empowerment are to be achieved through training, and in so doing make far more explicit the supposed linkages between training content, design, and its posited impact on individual behaviour or self-agency.
11549326	This paper presents the results of an exploratory analysis, description, and comparison of the self-concept and motivational patterns of academically resilient, non-resilient students, advantaged achievers, and advantaged low-achievers. Resilient students are defined as coming from an impoverished and stressful environment, yet achieving a 2.75 or greater grade point average (GPA). Non-resilient students come from the same background, yet do not have the requisite GPA. There are 17 resilient students and there are 19 non-resilient students. The advantaged achievers come from a low-stress, high-SES background and have a 2.75 or greater GPA. The advantaged low-achievers come from a low-stress, high-SES background, but their GPA falls below 2.75. There are 19 advantaged achievers and nine advantaged low-achievers. Goals, self-concept, and environmental support beliefs are measured by the Assessment of Personal Agency Beliefs and the High School Assessment of Academic Self-Concept. The results show significant results in the cognitive beliefs subscale, social beliefs subscale, general extra-curricular beliefs subscale, and the personal trust subscale.
11495360	This article describes a psychodynamically oriented psychotherapy group for older adults conducted in an agency setting, highlighting the problems specific to such groups. The literature on such groups for older adults is reviewed. The issues discussed are the psychology of late life, diagnostic considerations, medical illness and dementia as complicating factors, the issue of caretaking, and the centrality of shame. A systems-oriented approach to understanding the group's success is suggested.
11467248	Using two waves of panel data from Americans' Changing Lives (House 1995) (N = 2,681), we examine the relationships between volunteer work in the community and six aspects of personal well-being: happiness, life satisfaction, self-esteem, sense of control over life, physical health, and depression. Prior research has more often examined the effects of voluntary memberships than of volunteer work, has used cross-sectional rather than longitudinal data, and, when longitudinal, has emphasized social causation over selection effects. Focusing only on the consequences of volunteer work overlooks the antecedents of human agency. People with greater personality resources and better physical and mental health should be more likely to seek (or to be sought for) community service. Hence, we examine both selection and social causation effects. Results show that volunteer work indeed enhances all six aspects of well-being and, conversely, people who have greater well-being invest more hours in volunteer service. Given this, further understanding of self- versus social-selection processes seems an important next step. Do positive, healthy people actively seek out volunteer opportunities, or do organizations actively recruit individuals of these types (or both)? Explaining how positive consequences flow from volunteer service may offer a useful counterpoint to stress theory, which has focused primarily on negative life experiences and their sequelae.
11407634	It is widely accepted within the field of community service that reflection is an important factor in promoting personal and sociomoral development. The purpose of this research was to determine if a particular form of reflection--decision making with an emphasis on the ethical nature of community service--has special value in achieving service-learning goals. Three dimensions of adolescent identity development served as dependent variables: agency, social relatedness, and moral-political awareness. Four hundred seventy-six high school students were assessed on the dependent variables before and after experiencing one of three conditions: community service with an ethical reasoning component; community service with reflection, but without an ethical reasoning component; and no community service (control). After one semester, it was found that students in the first condition (ethical decision making curriculum integrated into the community service program) made greater advances on all three dimensions of identity formation when compared with students in the other two conditions. Specifically, it was found that they became more systematic in their ethical reasoning and more likely to consider situations and issues from an ethical point of view.
11386395	To develop a scale to measure self-efficacy in neurologically impaired patients with multiple sclerosis and to assess the scale's psychometric properties.Cross-sectional questionnaire study in a clinical setting, the retest questionnaire returned by mail after completion at home.	Regional multiple sclerosis (MS) outpatient clinic or the Clinical Trials Unit (CTU) at a large neuroscience centre in the UK.	One hundred persons with MS attending the Walton Centre for Neurology and Neurosurgery and Clatterbridge Hospital, Wirral, as outpatients.	Cognitively impaired patients were excluded at an initial clinic assessment. Patients were asked to provide demographic data and complete the self-efficacy scale along with the following validated scales: Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, Impact, Stigma and Mastery and Rankin Scales. The Rankin Scale and Barthel Index were also assessed by the physician.	A new 11-item self-efficacy scale was constructed consisting of two domains of control and personal agency. The validity of the scale was confirmed using Cronbach's alpha analysis of internal consistency (alpha = 0.81). The test-retest reliability of the scale over two weeks was acceptable with an intraclass correlation coefficient of 0.79. Construct validity was investigated using Pearson's product moment correlation coefficient resulting in significant correlations with depression (r= -0.52) anxiety (r =-0.50) and mastery (r= 0.73). Multiple regression analysis demonstrated that these factors accounted for 70% of the variance of scores on the self-efficacy scale, with scores on mastery, anxiety and perceived disability being independently significant.	Assessment of the psychometric properties of this new self-efficacy scale suggest that it possesses good validity and reliability in patients with multiple sclerosis.	
11365651	Recent cases involving persons willfully and deliberately infecting others with HIV have highlighted the need for public health departments to develop action plans to address these issues. The case of LaShawn Williams in New York demonstrated the need for cohesive, cross-agency plans to deal with cluster infections. The Williams case was notable for its level of publicity and for its involvement with other agencies besides public health agencies, such as the news media and the law enforcement community. A coordinated publicized action plan will help all concerned agencies act effectively and quickly if other cases of deliberate infection occur.
11359622	The purposes of this study were to: (1) examine the relations among age, marital status, social class, perceived health, self-care agency, health-promoting lifestyle, and well-being in two groups of rural elderly Taiwanese women and (2) validate and compare two models using the two age groups of rural elderly Taiwanese women. Based on the conceptualizations of the major study variables in Orem's self-care model (1995), Pender's health promotion model (1987), and other scholars' ideas (Hartweg, 1990; Simmons, 1990), a theoretical model of health-promoting lifestyle was proposed for this study. A survey-interview method was used for data collection. Two groups of elderly women were recruited for data analysis: 168 in the younger group and 116 in the older group. The mean age was 64.66 in the younger group and 75.59 in the older group. Two models of health-promoting lifestyle were tested with a path analysis, using the Linear Structural Relations 8 (LISREL 8) program. The resultant models yielded chi2 of 13.69 with 9 degrees of freedom (p = 0.13) in the younger group and chi2 of 15.76 with 10 degrees of freedom (p = 0.11) in the older group. Other fit indices also indicate the two models fit the data well. Community nurses can assess, identify, and use effective interventions for rural elderly women on a basis of the resulting models.
11353460	A predictive model of well-being and self-care was tested with 284 women aged 60-88 living in rural communities in Taiwan. The variables studied were age, marital status, social class, social support, perceived health, self-care agency, self-care behavior, and perceived well-being. The model was tested by path analysis. The parameters of the model were estimated with the maximum likelihood method. In the refined model, chi2 (12, N = 284) = 15.18, p =.23), 33% of the total variance in well-being was explained by self-care behavior, social support, and perceived health; 66% of the total variance in self-care behavior was explained by self-care agency and social support; 49% of the total variance in self-care agency was explained by social support, perceived health, social class, and age; 14% of the total variance in social support was explained by marital status, social class, and age; and 8% of the total variance in perceived health was explained by social support. The goodness-of-fit index was.99, indicating that the refined model fit the data well. The findings of this study contribute to a greater understanding of this predictive model for application with older women in rural Taiwan.
11330031	This self-assessment instrument was developed by Mike Carter, regional manager at the Office of Civil Rights (OCR) in New York City, and a variety of health care professionals and organizations. It is not a policy guide or enforcement document from the OCR, but a road map for your agency or facility.
11327193	A pilot study assessed the utility of the Timeline Followback (TLFB) method to collect information on help seeking.Using the TLFB method, 34 clients (26 men) who had attended at least one session of an outpatient alcohol treatment program reported on treatment contacts, including any supplemental services (e.g., psychiatric care). TLFB reports of help seeking at that agency were compared with agency records of treatment contacts.	Clients reported on their help-seeking behavior for a period of approximately 8 months after they had completed an initial assessment for the outpatient treatment. With regard to the number of outpatient sessions they attended, intraclass correlations and equivalence testing showed that the TLFB data were comparable to the agency records of treatment contacts. Analysis of week-to-week correspondence of the presence or absence of help-seeking episodes showed good agreement between TLFB and the agency records for most participants, although there was substantial variation. Degree of correspondence was not associated with the length of the recall period or individual differences (e.g., drinking pattern). Older participants, however, tended to have lower week-to-week concordance than did younger participants.	These data provide preliminary support for the utility of a help-seeking TLFB instrument to assess addiction- and mental health-related contacts. This instrument may be especially useful in research in which collecting temporal patterns of help seeking is of interest (e.g., in studies examining factors influencing the delay in help seeking after relapse).	
11294126	This research was designed to compare data obtained from agency records at three treatment programs for juvenile male sex offenders with information available from clinicians once youth and their families had been in treatment for at least 6 months. Results revealed that over the course of treatment, youth and their families disclosed information about additional victims and offenses, physical and sexual abuse of the offenders, and several aspects of a violent and sexualized family environment. Over half the boys reported additional victims or additional offenses or both. There were significant increases in the number of reports of physical abuse, witnessing of domestic violence, living in a sexual environment, maternal sexual victimization, maternal victimization of domestic violence, and fathers being perpetrators of domestic violence. These data clearly support the hypotheses of the study and have important implications for both clinical practice and future research in this area.
11214811	The aims were twofold: 1) to determine whether maltreated and nonmaltreated children differed in the accuracy of their self-assessments of academic achievement; and 2) to determine whether discrepancies between perceived and actual academic competence were related to perceptions of social support from mothers, teachers, and peers.A sample of 195 maltreated children known to a state protective service agency was compared to a control group of 179 nonmaltreated children. The groups were matched on child's gender, age, ethnicity, and birth order; socioeconomic ranking of neighborhood; and family structure.	Although maltreated children had significantly lower achievement scores than did nonmal-treated children, the two groups did not differ on perceived academic competence. With regard to discrepancies between perceived and actual competence, maltreated children were more likely than nonmaltreated children to overestimate their level of competence, particularly for reading and arithmetic. Overall, children who reported low maternal support were more likely to overestimate reading competence than were those who reported average or high maternal support. When maltreatment status was considered, maltreated children with low support seemed likely to overestimate abilities, whereas nonmaltreated children with low support seemed likely to underestimate competence.	Maltreated children may overestimate their academic abilities in order to compensate for self-perceptions of low self-worth. Efforts to improve academic performance in maltreated children should focus not only on increasing academic skills but also on enhancing self-esteem.	
11204685	The purpose of this investigation was to study the adjustment and learning characteristics of children with different types of clefts. The hypotheses were that there may be different relationships among cleft variables (speech and appearance) according to the cleft types.The study compared three cleft groups on behavior rating, anxiety scales, depression scales, and self-perception (analyses of variance) and examined the influence of facial and speech ratings on self-perception (multiple regression analyses).	All patients were treated at a university hospital cleft palate clinic.	Sixty-five children aged 8 years to 17 years were selected based on nonsyndromic cleft (unilateral cleft lip and palate [ULP], bilateral cleft lip and palate [BLP], and cleft palate only [CPO]) and no significant neurological condition or hearing loss.	The findings indicated children with CPO showed greater problems with parent- and teacher-reported depression, anxiety, and learning related to speech than children with ULP or BLP. The later two groups showed fewer problems and a greater relationship of problem to facial appearance. The children with ULP self-reported lower levels of depression than the other two groups.	Children with cleft show relatively good overall adjustment, but some problems appear related to speech and facial appearance. Subgroups may need to be studied separately.	
11200026	The healing and preventive powers of people's health resources and self-assessed knowledge have so far been grossly underestimated in medicine. In this article, we call attention to ethical and epistemological dilemmas related to knowledge, values, communication, and autonomy embedded in the prevailing risk-oriented epidemiology, and suggest a patient-centred salutogenetic approach to promote a better balance between resources and risks in medicine. Identification and intervention upon risk factors can provide hypotheses about origins of disease and predict and sometimes prevent disease at a group level. However, there are several pitfalls related to this perspective concerning causal factors, group level based possibilities, adequate end points for intervention, informed consent, and medicalization, especially in the individualized context of the clinical encounter. By introducing a salutogenic perspective, we urge to shift the attention toward resources, agency and strength, which may counteract risk of disease and empower the patient. Talk can mediate oppression as well as empowerment. A communicative key question approach, and self-assessed health resources identified through this strategy, are briefly presented as examples of empowerment through dialogue.
11153782	This study evaluated the effects of a group learning program on patients with chronic musculoskeletal pain and high absenteeism and investigates what characterizes those patients who may benefit from such a program. The learning program was based on personal construct theory. The theory included the following: (1) participation in an educational program is related to a favorable outcome across the outcome measures (pain, pain coping, management of daily life, absenteeism, and use of health care), (2) patients with high agency orientation (i.e., inner-directed) cope with their pain and manage daily life in a better manner than do patients with low agency orientation (i.e., outer-directed), and (3) patients with high personal control, measured in terms of agency orientation, in terms of health locus of control, or in both terms, will benefit more from the educational program than will patients with low personal control.The study was a randomized controlled study.	One hundred and sixteen patients with chronic musculoskeletal pain and high absenteeism answered a questionnaire before and after the intervention program. The intervention group (n = 61) consisted of nine subgroups geographically spread through the eastern part of Norway and met for four hours every 2 weeks from February 1997 to October 1997. A total of 12 meetings were held.	The intervention group reported a significantly higher score for the variable "management of everyday life" (p <0.005) and for the variable "health care consumption" (p <0.001) than did the control group. Patients with high agency orientation benefited more from the program with regard to pain reduction and improved pain coping than did those patients with low agency orientation (p <0.05). Patients with high agency orientation also reported less absenteeism than did those patients with low agency orientation (p <0.05).	
11148297	The capacity to exercise control over the nature and quality of one's life is the essence of humanness. Human agency is characterized by a number of core features that operate through phenomenal and functional consciousness. These include the temporal extension of agency through intentionality and forethought, self-regulation by self-reactive influence, and self-reflectiveness about one's capabilities, quality of functioning, and the meaning and purpose of one's life pursuits. Personal agency operates within a broad network of sociostructural influences. In these agentic transactions, people are producers as well as products of social systems. Social cognitive theory distinguishes among three modes of agency: direct personal agency, proxy agency that relies on others to act on one's behest to secure desired outcomes, and collective agency exercised through socially coordinative and interdependent effort. Growing transnational embeddedness and interdependence are placing a premium on collective efficacy to exercise control over personal destinies and national life.
11130731	Agency and communion are broad dimensions of personality that reflect a focus on the self and a focus on others, respectively. In this article, we distinguish unmitigated agency, a focus on the self to the exclusion of others, flom agency, and we distinguish unmitigated communion, a focus on others to the exclusion of self, from communion. We argue that it is unmitigated agency and unmitigated communion that are linked to domains of problem behavior, in particular relationship difficulties and poor health behavior. Unmitigated agency and unmitigated communion are associated with a lack of support from others, a reluctance to ask others for help, and a range of poor health behaviors. The reasons for these links differ. The links to problem behavior for unmitigated communion individuals stem from their tendency to subjugate their own needs to the needs of others and their dependence on others for esteem. The links to problem behavior for unmitigated agency individuals stem from their unwillingness to attend to relationships and their negative view of others.
11079235	People typically underestimate their capacity to generate satisfaction with future outcomes. When people experience such self-generated satisfaction, they may mistakenly conclude that it was caused by an influential, insightful, and benevolent external agent. In three laboratory experiments, participants who were allowed to generate satisfaction with their outcomes were especially likely to conclude that an external agent had subliminally influenced their choice of partners (Study 1), had insight into their musical preferences (Study 2), and had benevolent intentions when giving them a stuffed animal (Study 3). These results suggest that belief in omniscient, omnipotent, and benevolent external agents, such as God, may derive in part from people's failure to recognize that they have generated their own satisfaction.
11012994	The Zuluaga-Raysmith (Z-R) model is a conceptual framework that incorporates accepted concepts of universal basic human needs developed by Maslow, yet removes the hierarchical nature of these. The Z-R model recognizes the existence of a health-illness continuum and accepts that an entity (individual, family, aggregate, or community) may move freely in the direction of greater health and self-actualization or towards illness and premature death. The Z-R model identifies 10 basic needs and recognizes that a perceived deficit in any one of these needs can adversely affect the level of wellness of the entity being considered. This exploratory and descriptive study used 11 nurses as interviewers. Subjects consisted of a convenience sample of homebound clients of a home health agency in a metropolitan city, and selected caregivers (n = 27). A modified functional wellness inventory (developed in 1993 by Louvenia Carter) was used with several open-ended questions, which together related to the 10 needs of the Z-R model. Reliability coefficient of the instrument was 0.84. Descriptive statistics were used to analyze the data, using means, percentages, and frequencies. Open-ended questions were grouped according to content and ranked in order of frequency. The five most pressing needs of this small sample were income; physical health; opportunity to make a contribution; mobility; and mental, emotional, social, and spiritual health (MESSH). Nurses unanimously reported that use of the instrument and the Z-R model helped them to focus on the total person, identify strengths in their clients, identify perceived needs deficits, and therefore, with the client, facilitate the preparation of a timely and cost-effective interdisciplinary plan of care to help the entity to move to a higher level of wellness despite the presence of chronic disease, disability, or impending death. These findings suggested that further research is warranted to explore the use of the Z-R model. A replication study is in progress.
11012160	The last 10 years have seen the development of a quantitative assay that is specific for transplantable totipotent murine hematopoietic cells with durable in vivo blood-forming ability. Recently, this assay has been successfully adapted to allow the detection and enumeration of an analogous population of human hematopoietic stem cells using myelosuppressed immunodeficient (nonobese diabetic/severe-combined immunodeficiency) mice as recipients. Characterization of the cells detected by this assay indicates their close relationship in both mice and humans with cells detected in vitro as long-term culture-initiating cells (LTC-IC). Culture conditions have now been identified that support a significant net expansion of these cells from both species. More detailed analyses of the cytokine requirements for this response indicate that the viability, mitogenesis and maintenance of LTC-IC function by human CD34+ CD38- cells can be independently regulated by exogenous factors. Superimposed on this uncoupling of hematopoietic stem cell "self-renewal" and proliferation control is a change during ontogeny in the particular cytokines that regulate their responses. These findings unite stochastic and deterministic models of hematopoietic stem cell control through the concept of a molecular mechanism that actively blocks stem cell differentiation and must be maintained when these cells are stimulated to divide by exposure to certain types and concentrations of cytokines.
11009260	When people think counterfactually about how a situation could have turned out differently, they mentally undo events in regular ways (e.g., they focus on actions not failures to act). Four experiments examine the recent discovery that the focus on actions in the short term switches to inactions in the long term. The experiments show that this temporal switch occurs only for particular sorts of situations. Experiment 1 showed no temporal pattern to the agency effect when 112 participants judged emotional impact and frequency of "if-only" thoughts from both short- and long-term perspectives for an investment scenario. Experiment 2 showed no temporal pattern when 190 participants considered a college choice scenario with a good outcome. Experiment 3 showed no temporal pattern when 131 participants considered an investment scenario even when the situation for the actor and nonactor was bad from the outset. Experiment 4, with 113 participants, showed a focus on actions even when the investment loss was equal for both the actor and nonactor. The implications of the results are discussed in terms of what is explicitly available in the mental representation of actions and inactions.
10994684	When families cannot serve as full-time caregivers for severely, mentally ill family members, agency-supported caregivers provide an alternative to chronic hospitalization. Caregivers who provide 24 hour per day care experience caregiver burden; they also find rewards and meaning in their work. The purpose of this study is to observe positive experiences of paid caregivers for seriously, mentally ill individuals, especially the meaning or purpose it gives their lives and the self-fulfillment or self-actualization that caregiving provides. The caregivers in this study possessed a high purpose in life suggesting that caregiving may give meaning to life. Also, the caregivers of these individuals with severe, mental illness tend to be highly other-oriented (altruistic), an external focus that may decrease their own self-awareness. Thus, caregivers who provide continuous residential care may benefit from therapeutic interventions designed to reinforce self-care skills.
10993669	The human self model suggests that the construct of self involves functions such as agency, body-centered spatial perspectivity, and long-term unity. Vogeley, Kurthen, Falkai, and Maieret (1999) suggest that agency is subserved by the prefrontal cortex and other association areas of the cortex, spatial perspectivity by the prefrontal cortex and the parietal lobes, and long-term unity by the prefrontal cortex and the temporal lobes and that all of these functions are impaired in schizophrenia. Exploring the connections between the prefrontal cortex and the construct of self, the present article extends the application of the self model to autism. It suggests that in contrast to schizophrenia, agency and spatial perspectivity are probably preserved in autism, but that, similarly to schizophrenia, long-term unity is probably impaired. This hypothesis is compatible with a model of neuropsychological dysfunction in autism in a neural network including parts of the prefrontal cortex, the temporal lobes, and the cerebellum.
10927967	This paper discusses some of the anthropological and philosophical features of the use of self-management plans by patients with a chronic disease, focusing on patients with asthma. Characteristics of this technologically mediated form of self-care are contrasted with the work of Mauss and Foucault on body techniques and techniques of self. The similarities and differences between self-management of asthma and Foucault's technologies of self highlight some of the ways in which self-management contributes to modifications in the definitions of patients and physicians. Patients, in measuring their lung function, first come to rely on measurements more than on felt disturbances, but next, felt disturbances become modified by previous measurements. Physicians, one the other hand, see their role changed from expert to being a participant in a joint treatment. It is argued that the concept of agency is more appropriate for describing the advantage of self-management for patients than autonomy.
10826304	Case management has become increasingly popular as a means to alleviate the difficulties associated with accessing health care and social services. However, little information exists regarding models of case management specifically intended for work with HIV-positive women. This article explores the practices currently in use at an HIV/AIDS service agency to further define empowering practices employed by case managers working with HIV-positive women. Although a client's active participation in service plan development and delivery is widely regarded as the pathway to empowerment, findings indicate that "active participation" is not so readily defined; empowerment exists on a dynamic continuum with increasing levels of client participation. A model is presented that demonstrates the relationship of particular behaviors to client self-empowerment. Because the needs of clients with HIV/AIDS are continually fluctuating, and because case managers' behaviors will need to adapt accordingly, this model also incorporates the concept of balance as it pertains to HIV/AIDS case management.

10716094	Using its own resources, a follow-up outcome study of 83 out of 119 (70%) graduates from four therapeutic community programs at two inner-city sites was conducted using the Tennessee Self Concept Scale:2 (TSCS:2) and the Post-Treatment Follow-Up Survey (PTFUS). The TSCS:2 and the PTFUS were completed anonymously by the respondent graduates and collected by research staff independently of program administrative staff and clinical staff. On average, the graduates had completed all formal agency required treatment and had been living independently in the community for nearly 12 months at the time of follow-up. Graduates who participated in the study were separated into one of three TSCS:2 profile groupings: Valid TSCS Profile, Invalid Faking Good (FG), and Invalid Inconsistency, to provide a more meaningful analysis of their outcomes data. All three TSCS:2 groups had favorable outcomes; however, to the extent that PTFUS questions were less specific than more specific, the Invalid FG group self-reported more positive outcomes. Where the PTFUS questions were very specific and concrete, the Valid TSCS Profile group generally had the most favorable outcomes. Implications of these findings are discussed.
10711648	Nominated representatives from the various stakeholder interests, i.e. social services, health, education, voluntary organizations, parent groups and self-advocacy groups, involved in the implementation of the All Wales Strategy for the development of services for people with intellectual disability were interviewed 2 years after the end of the initial 10-year phase. Interviewees were asked to reflect on the strengths and weaknesses of policy implementation, including: changing priorities, planning arrangements, agency roles, central guidance and financial mechanisms, consumer participation, and the impact of more recent policy or structural developments. Despite recognition of the leadership of the Welsh Office, the shift in thinking achieved, the developments made in joint agency collaboration and in consumer participation in planning, and an increasing competence to plan effectively over time, the overriding perception was that more could have been made of the opportunity afforded by the clearest and best resourced central government policy within the UK in this area. At the heart of this judgement lay concerns about pragmatic rather than strategic planning, a failure to link annual service developments to a final comprehensive end point and a related failure to integrate planning to meet community needs with hospital resettlement Factors which may have contributed to these weaknesses are discussed, as are lessons for subsequent community care policy.
10661287	Self-care agency is the practice of health-related activities that individuals deliberately initiate and perform in order to maintain life, health and well-being (OREM, 1987). A tool measuring self-care agency is useful to nurses for identifying patients lacking knowledge, motivation, and for those with limited self-care agency. KEARNEY and FLEISCHER (1979) have developed the Exercise of Self-care Agency (ESCA) scale to asses the extent to which individuals take action toward their health care. Several studies suggest that the ESCA scale possesses adequate psychometric properties (KEARNEY & FLEISCHER, 1979; LUCAS, MORRIS & ALEXANDER, 1988; MCBRIDE, 1987; RIESCH & HAUCK, 1988). The lack of a validated tool measuring self-care agency among french speaking populations, led us to translate the ESCA scale and to examine its psychometric properties in a sample of French Canadian individuals who have survived a recent non-complicated myocardial infarction (MI). At 8 and 14 weeks after their MI, 83 subjects aged 52 +/- 10 years with a 1,857 +/- 1,605 U/L MI and an ejection fraction of 51 +/- 10% completed the french-ESCA scale. Mean scores were 112.6 +/- 13.3 at 8 weeks and 117.9 +/- 14.0 at 14 weeks post-MI. Internal consistency coefficients of the french-ESCA scale (at 8 and 14 weeks post-MI) are acceptable (0.84 and 0.88, respectively). Internal consistency coefficients are similar to those obtained in previous studies whereas mean scores on the ESCA scale are somewhat higher (RIESCH & HAUCK, 1988). Cronbach alphas for the french-ESCA scale's sub-scales are generally lower: Self-concept (0.57 and 0.69), Initiative/responsibility (0.72 and 0.80), Knowledge/information seeking (0.80 and 0.79), and Taking actions (0.49 and 0.62). The french-ESCA scale appears stable within the 6 weeks period (r = 0.77, p < 0.001). We recommend to further assess the french-ESCA scale's psychometric properties using larger samples of subjects with or without various health problems.
10660017	To assess the incidence and nature of concerns about sexual abuse, with particular reference to erroneous concerns of sexual abuse made by children.A review of case notes of all child sexual abuse reports to the Denver Department of Social Services over 12 months. Cases were put into four groups: substantiated, not sexual abuse, inconclusive and erroneous accounts by children.	551 cases were reviewed. Forty-three percent were substantiated, 21% were inconclusive and 34% were not considered to be abuse cases. There were 14 (2.5%) erroneous concerns emanating from children. They comprised three cases of allegations made in collusion with a parent, three cases where an innocent event was misinterpreted as sexual abuse and eight cases (1.5%) of false allegations of sexual abuse.	Erroneous concern of sexual abuse from children are uncommon. The four categories of concern in this study, in contrast to the simple classification of substantiated and unsubstantiated, provide a means of encouraging open minded assessments of the typical concerns which a child protection agency receives.	
10637618	Several recently developed philosophical approaches to the self promise to enhance the exchange of ideas between the philosophy of the mind and the other cognitive sciences. This review examines two important concepts of self: the 'minimal self', a self devoid of temporal extension, and the 'narrative self', which involves personal identity and continuity across time. The notion of a minimal self is first clarified by drawing a distinction between the sense of self-agency and the sense of self-ownership for actions. This distinction is then explored within the neurological domain with specific reference to schizophrenia, in which the sense of self-agency may be disrupted. The convergence between the philosophical debate and empirical study is extended in a discussion of more primitive aspects of self and how these relate to neonatal experience and robotics. The second concept of self, the narrative self, is discussed in the light of Gazzaniga's left-hemisphere 'interpreter' and episodic memory. Extensions of the idea of a narrative self that are consistent with neurological models are then considered. The review illustrates how the philosophical approach can inform cognitive science and suggests that a two-way collaboration may lead to a more fully developed account of the self.
10609429	This study investigated A. T. Beck's (1970) negative cognitive triad as a model of depressive thinking. A mixed clinical sample (N = 126) completed the Sentence Completion Test for Depression (SCD) and self-report measures of depression and anxiety. Two reference patterns were tested: agency roles, people who are the source of thoughts, feelings, and actions (self and others); and object roles, points of reference location (self, other, world, future, and past). Cognitive effects were highly specific to depression. With self in agent role, significant correlations were observed with negative self, world, and future references but not with other people or the past. With others in agent role, only negative self references were correlated with depression (e.g., "Some people would not ... put me out if I was on fire"), suggesting an interpersonal extension to the negative cognitive triad.
10604402	Sweden has now around 38,000 individuals who have been adopted from other countries. Most often they are transracially adopted and have a different appearance from their new parents--"visible" adoptions. This study was made to explore the mental health of a teenager/young adult group that arrived with their families in the southernmost county of Sweden between 1970 and 1977. They were placed through the largest Swedish adoption agency at that time. One hundred and forty-seven families and their 211 adopted children, who were 13 years of age or older at the time of the investigation, were interviewed in their homes. CBCL, SCL-90, a self-esteem questionnaire, and two family relations inventories were also completed. Compared to nonadopted Swedish young persons of the same ages, who had been investigated with the same inventories in earlier epidemiological studies, the adoptees had as good mental health. The adoptees also reported good self-esteem. The pre-adoption conditions were more important than the age of arrival in itself for the risk of later maladaptation. Family relations, various aspects of identity, and peer relations explained much of the variance of mental health and self-esteem. Those who were most engaged in questions about their identity and felt mostly non-Swedish had more behaviour problems. The association, however, between the factor "Identity" and the mental health variables approached zero for the older subjects (18-27 years of age). The majority (about 90%) of the adoptees felt mostly Swedish. Seventy per cent didn't feel any connection to their country of origin.
10576115	Empirical support for Orem's Self-Care Deficit Theory of Nursing [Orem, D.E., 1995. Nursing: Concepts of practice, 5th. ed. Mosby, Toronto] is accumulating. However, little is known about the relative usefulness of the theory with well and chronically ill adults. This research examined multiple relationships deduced from Orem's Theory in 109 well adults and 141 adults with end stage renal disease (ESRD). Relations among personality traits, gender, age, socioeconomic status, self-care agency, and self-care were examined. Qualitative and quantitative differences were evident for the two samples. For example, self-care agency was a stronger predictor of self-care in well adults. Implications for development of disease-specific, mid-range theory are explored.
10538477	Responses to simple questions that predict subsequent health care utilization are of interest to both capitated health plans and the payer.To determine how responses to a single question about general health status predict subsequent health care expenditures.	Participants in the 1992 Medicare Current Beneficiary Survey were asked the following question: "In general, compared to other people your age, would you say your health is: excellent, very good, good, fair or poor?" To obtain each participant's total Medicare expenditures and number of hospitalizations in the ensuing year, we linked the responses to this question with data from the 1993 Medicare Continuous History Survey.	Nationally representative sample of 8775 noninstitutionalized Medicare beneficiaries 65 years of age and older.	Annual age- and sex-adjusted Medicare expenditures and hospitalization rates.	Eighteen percent of the beneficiaries rated their health as excellent, 56% rated it as very good or good, 17% rated it as fair, and 7% rated it as poor. Medicare expenditures had a marked inverse relation to self-assessed health ratings. In the year after assessment, age- and sex-adjusted annual expenditures varied fivefold, from $8743 for beneficiaries rating their health as poor to $1656 for beneficiaries rating their health as excellent. Hospitalization rates followed the same pattern: Respondents who rated their health as poor had 675 hospitalizations per 1000 beneficiaries per year compared with 136 per 1000 for those rating their health as excellent.	The response to a single question about general health status strongly predicts subsequent health care utilization. Self-reports of fair or poor health identify a group of high-risk patients who may benefit from targeted interventions. Because the current Medicare capitation formula does not account for health status, health plans can maximize profits by disproportionately enrolling beneficiaries who judge their health to be good. However, they are at a competitive disadvantage if they enroll beneficiaries who view themselves as sick.	
10532146	Evolutionary accounts of vulnerability to depression have focussed either on the attachment system (Bowlby, 1980) or the social rank system (Gilbert, 1992; Price, 1972). According to a two-factor evolutionary model, depression-prone dependent and self-critical individuals suffer from insecurities regarding both attachment and social rank, but they differ in their strategies for dealing with those insecurities. Event-contingent recording was used to assess agentic (dominant-submissive) and communal (agreeable-quarrelsome) interpersonal behaviour as well as affect in 119 employed adults over 20 days. Participants also completed questionnaire measures of agency and communion. Self-criticism predicted low levels of agency and low levels of communion. In the sample as a whole, agentic and communal behaviours were associated with pleasant affect, but highly self-critical participants experienced relatively less pleasant affect when they acted communally or agentically. Individuals with high levels of immature dependency (neediness) were low in agency, whereas those with high levels of mature dependency (connectedness) were high in communion. Implications for evolutionary theories of vulnerability to depression were discussed, and interpersonal processes that may contribute to vulnerability were identified.
10519924	The proper domain of naive psychological reasoning is human action and human mental states but such reasoning is frequently applied to non-human phenomena as well. The studies reported in this paper test the validity of the currently widespread belief that this tendency is rooted in the fact that naive psychological reasoning is initially restricted to, and triggered by, the perception of self-initiated movement of agents. We report three habituation experiments which examine the necessary conditions under which infants invoke a psychological principle, namely the principle of rational action, to interpret behaviour as goal directed action. Experiment 1 revealed that the principle of rational action already operates at 9 (but not yet at 6) months of age. Experiment 2 demonstrated that perceptual cues indicating agency, such as self-propulsion, are not necessary prerequisites for interpreting behaviour in terms of the principle of rational action. Experiment 3 confirmed that this effect cannot be attributed to generalisation of agentive properties from one object to another. These results suggest that the domain of naive psychology is initially defined only by the applicability of its core principles and its ontology is not restricted to (featurally identified) object kinds such as persons, animates, or agents. We argue that in its initial state naive psychological reasoning is not a cue-based but a principle-based theory.
10515171	The low correlations between memory performance and subjective memory may be attributable to disparities between tasks in neuropsychological tests and cognitive experiences of day-to-day living. This study evaluated the relationship between everyday memory performance, perceived cognitive functioning, and mood among patients with epilepsy.From three epilepsy centers in the USA, 138 patients were recruited. Everyday memory performance was measured using the Rivermead Behavioural Memory Test (RBMT). Questionnaires assessed perceived cognitive function (cognitive domain, Quality of Life in Epilepsy Inventory, QOLIE-89) and mood (Profile of Mood States, POMS).	Memory performance scores were weakly correlated with perceived cognitive functioning (r =0.22, P < 0.01). Perceived cognitive functioning was strongly correlated with mood (r = - 0.75, P < 0.0001). Multiple regression analysis indicated memory performance (RBMT) and mood (POMS) were independent predictors of perceived cognitive functioning (P < 0.02); however, the explained variance for RBMT and POMS combined (R2 = 0.58) is only slightly higher than the predictive value for the POMS score alone (R2 = 0.56).	Memory performance tests provide qualitatively different information than patients' self-reported cognitive difficulties, thus it is important to assess memory performance, perceived cognitive function, and mood separately because the constructs are related but not redundant.	
10507103	A study is carried out to examine a demonstration project for partial hospitalization rehabilitation of patients of the pension insurance scheme of Rhineland-Palatinate (LVA Rheinland-Pfalz) using a parallel design. In four centers for the rehabilitation of musculoskeletal diseases the patients are assessed at the beginning and at the end of rehabilitation as well as six and twelve months post using the IRES questionnaire, a phycisians' questionnaire for the documentation of medical parameters, an instrument for client satisfaction and additional questionnaires. In addition the treatment and the costs on the side of the pension insurance agency are examined. Partial hospitalization rehabilitation clients are compared to inpatient ones from three rehabilitation hospitals. Preliminary analyses of patient self-report data show a strong similarity of inpatient and partial hospitalization clients as far as admission parameters, rehabilitation treatment, perception of rehabilitation and its effects are concerned. These results indicate that the pension insurance schemes' concept of interdisciplinary rehabilitation can be realized in partial hospitalization rehabilitation centers as well, achieving an outcome very similar to inpatient rehabilitation.

10441919	To introduce a new model of female adolescent sexual health based on feminist principles and to investigate the extent to which adolescent girl's beliefs about femininity are associated with three specific elements of their sexual health.148 eighth-grade adolescent girls completed a survey with questions about sexual self-concept, sexual agency, attitudes toward romance conventions, femininity ideology, and demographic background. Correlational and regression analyses were conducted. An illustrative case study is drawn from a subsample of 46 girls interviewed in depth about gender and relationships.	A statistically significant association was found between early adolescent girls' espousal of more conventional beliefs about femininity and diminished positive sexual health. To illustrate the ways in which a girl's femininity ideology interplays with her sexual health, selections from an interview with a 13-year-old Latina girl are presented as a case illustration.	
10404002	This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author's concern for the generally poor health status of Pakistani women. Orem's nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self-care agency (specifically, perception of power as a foundational capability of self-care agency and the enabling capabilities of self-care agency), self-care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self-care agency and self-care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self-care agency, will be directly and positively related to enabling capabilities of self-care agency; (3) perception of power as a foundational capability and enabling capabilities of self-care agency will have a direct and positive relationship with self-care; and (4) self-care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self-care agency, self-care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self-care.
10397629	Battered women receiving either shelter (n = 30) or nonshelter services (n = 30) from a domestic violence agency were interviewed regarding psychological abuse and its aftermath. Four types of abuse were derived from factor analysis: ridiculing of traits, criticizing behavior, ignoring, and jealous control. Sheltered women experienced ridicule and jealous/control more often than nonsheltered women. For the entire sample, ridiculing of traits was rated as the most severe form. Ignoring was the strongest predictor of low self-esteem. Both psychological abuse and physical abuse contributed independently to depression and low self-esteem. However, fear of being abused was uniquely predicted by psychological abuse. Implications for practice and research are discussed.
10222970	Developing partnerships between service and education is one strategy to enhance student learning. A pre-test-post-test design was used to compare changes in perceptions of self-efficacy expectations in the supervision of a team of four senior nursing students. A convenience sample of eight community practitioners completed the Community Advisor Self-Efficacy (CASE) questionnaire prior to and following a 13 week community health practicum. Following the community practicum, the preceptors were also invited to attend a focus group to discuss their experience. No significant differences were found between the pre- and post-self-efficacy scores. Community practitioners felt reasonably confident in assuming the preceptor role. They felt most efficacious in encouraging students to use agency personnel and in providing student feedback, but somewhat less confident in areas such as selecting learning experience congruent with course objectives, and trusting the students' readiness to work with communities. All strategies to assist the preceptors in assuming their role were considered helpful. Evidence of the preceptors and faculty advisors working in partnerships with the students was not clearly evident. Findings are being used to refine strategies for preparing and supporting agency personnel for their role in working with students.
10214234	Self-care agency, a multidimensional concept in Orem's self-care deficit nursing theory, includes motivation, decision-making, energy, and knowledge necessary to perform self-care actions. Basic conditioning factors affect individuals' development and exercise of self-care agency. Secondary analysis of Appraisal of Self-Care Agency (ASA) scores in two groups of pregnant women, (1) a childbirth education group (n = 119) and (2) a clinic group (n = 127) was completed. Group 2 had significantly higher ASA scores. Several basic conditioning factors influenced ASA scores. Results offer implications for Orem's theory and maternity nursing practice.
10214175	Self-neglect is a familiar concept to all community nurses. Nevertheless there have been few empirical studies undertaken in this area over the last 30 years. The study of self-neglect has been hampered by inadequate conceptualization and a lack of theoretical frameworks. This article reports a study of patients who did and did not self-neglect, drawn from district nursing caseloads. Patients with self-neglect had lower levels of operable self-care agency than patients in a comparison group. Only self-neglecting patients had the nursing diagnoses 'ineffective management of therapy' and 'non-compliance'.
10028783	Self-care agency (SCA) is a phenomenon of great interest. Nevertheless, difficulty comes when attempting to compare results of studies. This difficulty is caused by the multiple conceptual definitions and instruments used across disciplines. Based on the literature, a historical view of the conceptual development of SCA, a description of the extant instruments, and a discussion of the fit between these definitions and instruments are presented. Researchers need to determine if they plan to measure personal abilities for self-care or the actions taken by an individual for self-care and choose their instruments appropriately.
9818516	The author proposes that psychotherapy in a collectivistic culture tends to view therapeutic change as dissolving the self by merging with the environment (communion), whereas psychotherapy in an individualistic culture tends to view therapeutic change as enhancing the self by experiencing control over one's self and the environment (agency). By using D. Bakan's (1966) concepts of agency and communion, the author critically investigates the differences in how therapeutic change is viewed as well as how these differences are reflected in the therapeutic procedures of the various forms of psychotherapy between two different cultures (i.e., North America and Japan). It is suggested that psychotherapy in individualistic cultures may benefit from adding more focus to dissolving the self and merging with the environment and that psychotherapy in collectivistic cultures may benefit from adding more focus to enhancing the self by controlling the environment.
9787056	This paper offers a framework for consciousness of internal reality. Recent PET experiments are reviewed, showing partial overlap of cortical activation during self-produced actions and actions observed from other people. This overlap suggests that representations for actions may be shared by several individuals, a situation which creates a potential problem for correctly attributing an action to its agent. The neural conditions for correct agency judgments are thus assigned a key role in self/other distinction and self-consciousness. A series of behavioral experiments that demonstrate, in normal subjects, the poor monitoring of action-related signals and the difficulty in recognizing self-produced actions are described. In patients presenting delusions, this difficulty dramatically increases and actions become systematically misattributed. These results point to schizophrenia and related disorders as a paradigmatic alteration of a "Who?" system for self-consciousness.
9755523	In this paper, I introduce the philosophical notion of strong emergence and argue that it is almost exclusively applied to properties related to (conscious) subjective experience. Contrary to the still common attitude of refraining anxiously from these topics, I argue that we have a promising scientific approach to them: the cognitive neurosciences. I list a spectrum of interesting, potentially strongly emergent properties already investigated, and discuss the example of volition in more detail. Psychiatric disorders, like antisocial personality disorder, schizophrenia, and obsessive compulsive disorder, open new ways for understanding aspects of volition such as willed action, decision making, and agency. I conclude that the notion of strong emergence is only a preliminary label which, however, might be understood as a challenge for empirical scientists to explain and understand phenomena related to subjectivity and consciousness.
9742314	In an early paper, the authors presented the findings of a qualitative research study which applied the self-psychological and object relations theories to the social and interpersonal dynamics surrounding adolescent sexual offending. One of the findings of the study was that informal and formal social responses to detected offenders encouraged the rapid foreclosure of deviant, bad and dangerous social, interpersonal and sexual identity and therefore militated against therapeutic personality reconstruction. The current paper widens the scope of such observations to include the victim, as well as the offender, and examines the role of the therapist in mediating between intrapsychic and interpersonal priorities carried within the offense dynamics and socially and legally defined exigencies surrounding child abuse. The authors suggest that appropriate devolution of therapeutic agency can be devolved to patients through the concept of the twinship transference while at the same time attending to necessary psychiatric, medical, social and legal processes.
9709534	Hope is defined as a cognitive set which consists of level of goal-directed determination (agency) and propensity to plan ways to achieve goals (pathways). This study investigated whether hope was related to anxiety about statistics. Participants were 109 graduate students from a variety of disciplinary backgrounds enrolled in courses on statistics and educational research methods. A canonical correlation analysis was interpreted as indicating that students who had the poorest sense of successful determination in relation to their goals and who had the least positive appraisals of their ability to generate ways to overcome goal-related with worth of statistics, interpretation, tests and class, computational self-concept, fear of asking for help, and fear of the instructor. Based on these findings, it is recommended that researchers investigate whether interventions aimed at agency and pathways help to reduce such anxiety.
9699685	This article delineates the main psychological interventions used by American asylum superintendents practicing moral treatment between 1815 and 1875. Further, it explores the impact of Protestant religious ideas on specific aspects of moral treatment's theory and practice.Asylum annual reports written by superintendents (physicians dedicated to the treatment of the mentally ill) were studied along with volumes of the American Journal of Insanity from its premier issue in 1844 through the 1890s. The writings of two laymen, Thomas Gallaudet and Horace Mann, both committed advocates of moral treatment, were also examined.	The superintendents espoused complex theories about individual psychology and the nature of the self based on their observations. Protestant religious thought was a major influence, helping to catalyze original psychological propositions. Interesting resonances can be found between the superintendents' concept of a central agency, a governing "I" accounting for individual behavior, and ego psychologists' concepts of the organizing functions of the ego.	Moral treatment did not produce a comprehensive psychotherapeutic system. Nonetheless, the superintendents voiced surprisingly modern psychotherapeutic insights. Religious worship as well as religious notions about the inviolability of the soul greatly influenced their views of patients. Rather than being an impediment to formulating psychological ideas, religious concepts proved to be a rich framework for evolving theories about aspects of patients' internal psychological functioning.	
9679079	Research on the self-regulatory implications of psychological control suggests that overestimations of one's capabilities may be associated with enhanced performance. We examined this hypothesis in a two-year (three-occasion) longitudinal study of 381 German school children (8-11 years of age). Controlling for gender, grade in school, prior academic achievement, and level of intelligence, we used path analysis to examine the longitudinal relations between overestimations of one's personal agency and subsequent school performance. We expected overestimations of one's agency to facilitate subsequent school performance. Furthermore, we expected that this relationship would be strongest for those with moderate overestimations of their agency. Supporting our first hypothesis, overestimations of one's capabilities were consistently associated with improvements in subsequent school performance. However, our second hypothesis was not supported. The results suggest that overestimating personal agency is one possible mechanism through which one maintains and improves performance.
9611542	The purpose of this study was to determine whether abused and nonabused pregnant, low-socioeconomic adolescents differ in regard to perceived self-care capabilities.The sample (N = 36) consisted of 18 abused/neglected and 18 nonabused/non-neglected adolescents.	The adolescents' responses on the Denyes Self-Care Agency Instrument were analyzed to determine significant differences between the two groups regarding self-care agency.	Significant differences were found between the two groups in regard to perceived relative valuing of health and perceived attention to health.	Although abused adolescents had a higher level of relative valuing of health and lower attention to health than their nonabused counterparts, findings show that both groups are capable of performing self-care and should be encouraged to do so.	
9601300	The health effects of everyday occurrences of unwanted sexual attention (such as looks, whistles, and comments) were explored in semistructured interviews with 8 women in Seattle, WA. Participants described the strategies they used for avoiding and dealing with unwanted sexual attention, as well as the effects the attention had on their health and sense of self. Grounded theory techniques were used to code the data and identify themes. The women in this study were affected both physically and emotionally by their experiences and their perceived ineffectiveness in dealing with them. On a phenomenological level, these experiences contributed to a "diminishing of self," which included feeling dehumanized and lacking agency. This project begins to describe the complexities of this seemingly simple everyday occurrence and relates the experience to social science and psychological theory.
9574499	Examined the effectiveness of an HIV intervention program among 151 adolescents ages 13 to 24 years who were randomly assigned to (a) seven sessions of 1.5 hr each (10.5 hr); (b) three sessions of 3.5 hr each (10.5 hr); or (c) a no-intervention condition. Using cognitive-behavioral intervention strategies, social skills and HIV-related beliefs, perceptions, and norms were targeted in both the three- and seven-session, small-group intervention conditions. Regression analysis indicated that over 3 months, the number of unprotected risk acts and the number of sexual partners were lower in the seven-session condition compared to the other conditions. Factors mediating risk acts changed in a complex manner. For example, perceived vulnerability increased for those with initially lower vulnerability scores among youths in the seven-session condition compared to others. Self-approval of condom use was also higher for those with initially low scores in the seven-session compared to the three-session condition. Self-efficacy for risk avoidance and condom use was significantly higher in the three-session condition for those with initially low scores compared to other groups. On the role-play measure, those with higher baseline scores in the low-pressure situation improved significantly only in the three-session intervention; in the high-pressure situation, the participants reported significantly higher scores in the seven-session intervention, and those with higher scores improved the most. Results suggest the importance of multisession HIV intervention programs to be delivered with fidelity in community settings.The effectiveness of a small-group HIV/AIDS prevention intervention was assessed in 151 US adolescents 13-24 years of age who were randomly assigned to seven 1.5-hour sessions, three 3.5-hour sessions, or no intervention.  The study participants were recruited from a community-based agency in New York, New York, that serves high-risk Black and Hispanic youth from neighborhoods with high HIV seroprevalence rates.  The cognitive-behavioral intervention emphasized role-playing for social skills development and HIV-related beliefs, perceptions, and norms.  Regression analysis indicated that over the 3-month study period, the numbers of sexual partners and sex acts unprotected by condoms were significantly lower in the 7-session group than in the other 2 groups.  Compared with youths in the 7-session group, those in the control condition reported an average of 7.9 more risk acts and those in the 3-session group had an average of 7.2 more risk acts.  The factors mediating risk reduction behavior changed in a complex manner.  For example, perceived vulnerability increased more among those with initially lower vulnerability scores among youth in the 7-session group and self-approval of condom use was higher for those with initially low scores in the 7-session compared to the 3-session regimen.  Self-efficacy for both risk avoidance and condom use was significantly higher in the 3-session condition for those with initially low scores, however.  On the role-play measure, those with higher baseline scores in the low-pressure situation improved significantly only in the 3-session intervention; in the high-pressure situation, adolescents reported significantly higher scores in the 7-session condition and those with higher scores improved the most.  These findings support an HIV/AIDS intervention strategy of shorter educational sessions spread over a brief span of time.	
9504535	WHO's activities at country level have earned the organisation both criticism and praise. The organisation's technical publications are esteemed as authoritative guidelines for disease control. Successful disease-control programmes and contributions to health research have heightened WHO's reputation. The organisation has also provided the focus for evolution of important ideas, such as primary health care and the relevance of equity and other ethical issues. But WHO has been criticised for not adapting rapidly and logically to changes in the health field. With increasing national capacity in the more advanced developing countries, and with the involvement of new participants in the health sphere, the organisation needs to reassess its role at country level. My recommendation is that WHO improves its analytical capacity so that its programmes take into consideration the health needs of the country, its national capacity, and the contributions from other external agencies.This article offers a critical appraisal of the World Health Organization's (WHO) disease control (DC) efforts and development of health services at the country level.  The WHO has had a considerable influence on health services over the past 50 years: in training of health personnel, development of national programs, building and strengthening national institutions, and directing involvement in the operation of health programs.  WHO has been criticized recently for the quality of its leadership, the effectiveness of its programs, and reliance on traditional ways of DC.  WHO achieved recognition as an effective agency for its success in treating endemic disease with modern medicine.  WHO is now criticized because the target diseases selected by global and regional agencies are not necessarily compatible with national priorities.  Specific DC programs are difficult to integrate into the general health services, and limited national resources may be diverted to fund new and changing initiatives of international donors.  WHO has achieved a positive reputation for research and development of new products and its "state of the art" technical papers and manuals for DC.  WHO is noteworthy for its innovative practical approaches to DC and problems involving intercountry interventions.  WHO advocated the development of basic health facilities that reached most of the population at the community level.  In the past 20 years, national capacity has increased.  WHO must modify its country programs.  A 1997 study proposed that WHO's presence should be necessary and sufficient to achieve desired goals of capacity strengthening and self-reliance.  Implementation of this concept requires stronger analytical capacity and greater care in program design based on country needs and resources.  External agencies must design complementary programs, collaborate with other agencies, and continue global cooperation.	
9504206	To be effective, presentation of health messages for development of self-care agency must be age and developmentally appropriate. Blending cognitive development theories with selected foundational capabilities and dispositions from Self-Care Deficit Nursing Theory (SCDNT) has resulted in five concrete factors for successfully designing and delivering health messages for optimal learning in children. The capacity to learn requires perception, attention, play, communication, and memory. Actual evidence of learning about healthy choices by elementary school-aged children is illustrated. Indications of successes and deficiencies in design and delivery of health promotion messages during a school health fair are presented.
9455171	The abilities to attribute an action to its proper agent and to understand its meaning when it is produced by someone else are basic aspects of human social communication. Several psychiatric syndromes, such as schizophrenia, seem to lead to a dysfunction of the awareness of one's own action as well as of recognition of actions performed by others. Such syndromes offer a framework for studying the determinants of agency, the ability to correctly attribute actions to their veridical source. Thirty normal subjects and 30 schizophrenic patients with and without hallucinations and/or delusional experiences were required to execute simple finger and wrist movements, without direct visual control of their hand. The image of either their own hand or an alien hand executing the same or a different movement was presented on a TV-screen in real time. The task for the subjects was to discriminate whether the hand presented on the screen was their own or not. Hallucinating and deluded schizophrenic patients were more impaired in discriminating their own hand from the alien one than the non-hallucinating ones, and tended to misattribute the alien hand to themselves. Results are discussed according to a model of action control. A tentative description of the mechanisms leading to action consciousness is proposed.
9418279	Hope is the sum of goal thoughts as tapped by pathways and agency. Pathways reflect the perceived capability to produce goal routes; agency reflects the perception that one can initiate action along these pathways. Using trait and state hope scales, studies explored hope in college student athletes. In Study 1, male and female athletes were higher in trait hope than nonathletes; moreover, hope significantly predicted semester grade averages beyond cumulative grade point average and overall self-worth. In Study 2, with female cross-country athletes, trait hope predicted athletic outcomes; further, weekly state hope tended to predict athletic outcomes beyond dispositional hope, training, and self-esteem, confidence, and mood. In Study 3, with female track athletes, dispositional hope significantly predicted athletic outcomes beyond variance related to athletic abilities and affectivity; moreover, athletes had higher hope than nonathletes.
10177211	To determine whether recipients of clinical laboratory science (CLS) advanced degrees (MS) perceive greater career enhancement value related to earning an advanced degree than is perceived by their baccalaureate level (BS) colleagues.Two questionnaires were used-one for certified or licensed CLS professionals who had earned MS CLS degrees; the other for matched BS CLS colleagues.	Five academic programs that conduct both National Accrediting Agency for Clinical Laboratory Sciences accredited CLS education and CLS MS degree programs participated.	The number of survey respondents was 220 (117-MS; 103-BS level controls). The groups were matched for gender, residence region, and years of experience.	The primary outcome measurements were the perceived benefits of having a CLS MS degree, the reasons for and against obtaining a CLS MS degree, and the overall evaluation of CLS degree programs at both levels.	The highest perceived benefit of having a CLS MS degree was the same in both groups, "enhanced self esteem and confidence". The highest priority motivation of MS degree recipients for obtaining a CLS advanced degree was "personal satisfaction". The highest priority reason of the BS group for not obtaining a CLS advanced degree was "family obligation". In both levels of degree programs the subject most commonly cited as needing modification was laboratory management.	The results indicate that CLS professionals who have CLS MS degrees perceive a greater career enhancement value of advanced CLS degrees than their BS level colleagues.	
9366877	The purpose of this article is to review the evidence linking variations in care delivery system with achievement of appropriate self-care.This synthetic review of the research literature used the Outcomes Model for Health Care Research. The concept of self-care was reviewed from several theoretical perspectives, as was the quality of instruments used to measure aspects of self-care. Finally, studies examining the linkage between care delivery system and self-care were critically analyzed.	Reliable and valid instruments exist to measure self-care agency and self-care performance, and these data elements are collected routinely in many care settings. Only a few studies, however, have examined the relation between achievement of self-care and variations in delivery systems.	Achievement of appropriate self-care may be an outcome measure better suited to nonacute care settings or across the continuum of care. Additionally, work is needed in applying risk-adjustment strategies to the measurement of achievement of appropriate self-care.	
9364759	The first part of the study confirmed an additive effect of the newly proposed construct of relationship harmony to self-esteem in predicting life satisfaction across student samples from the United States and Hong Kong. As predicted from the dynamics of cultural collectivism, the relative importance of relationship harmony to self-esteem was greater in Hong Kong than in the United States. In the second part of the study, the independent and interdependent self-construals (H. R. Markus & S. Kitayama, 1991) and the 5 factors of personality (P. T. Costa & R. R. McCrae, 1992) were advanced to be the culture-general determinants of life satisfaction, acting through the mediating variables of self-esteem and relationship harmony. Both self-construals and the 5 factors of personality were shown to influence life satisfaction through the mediating agency of self-esteem and relationship harmony in equivalent ways across these 2 cultural groups.
9348764	This chapter summarizes a part of the case that can be made that the individual construction of a personal domain of choice and privacy generalizes across cultures and is not restricted to persons who live within Western or so-called modern societies. The research findings reported here are consistent with the view that persons seek to establish such areas of control in order to maintain a differentiated personal identity and a sense of personal agency. Children, adolescents, and adults from the United States and traditional cultures have been found to identify a class of behaviors and issues as being outside the legitimate sphere of social or moral regulation. Mothers from Western and traditional cultural settings recognize and foster their children's claims to areas of personal choice and privacy. Across cultures, as children mature and move toward adulthood, they lay claim to a broader range of issues and actions as personal matters. Research on adolescent-parent conflict with U.S. and Chinese samples has indicated that these shifts associated with adolescent claims to freedom are the source of most family conflicts. Anthropological accounts of adolescent-parent conflicts in 160 cultures have provided evidence that such conflicts are widespread (Schlegel and Barry, 1991). Finally, we are beginning to obtain evidence that parental overcontrol of personal issues is associated with symptoms of psychological problems in their adolescent children. These research findings are consistent with the proposal (Nucci, 1996) that establishment of a personal domain is an intrinsic feature of normal human development, resulting from the inevitable attempt by individuals to account for and differentiate between their own motives, values, and experiences and those of others. The evidence also points to the fact that such personal issues are coexistent with concerns for interpersonal harmony and social integration. Thus, it is not surprising that the work summarized here also suggests considerable social-class and cultural variation in how the personal is expressed. Such variation is consistent with the assumption that the personal is constructed out of social interactions (Nucci, 1996) that entail reciprocal interchange between individual and societal structures (Turiel, 1996). In Spiro's analysis (1984), the results of such reciprocal structural interaction cannot be accounted for by reducing the analysis of psychological structures in terms of cultural structures and vice versa. Thus, any accurate interpretation of the impact of culture on psychological development must be constrained by features that are peculiar to psychological systems. Extending this to the cross-cultural study of the personal domain, a case can be made for the need to explore such issues at the level of the individual, rather than at the level of the cultural shared-symbol system. On the other hand, this nonreductionist approach and the available evidence rule out the reification of the personal as a culturally empty set of psychological issues. As illustrated in studies of the distribution of rights in relation to gender and social hierarchy among Druze Arabs (Wainryb and Turiel, 1994), the interplay between the personal and the cultural system of roles and obligations provides a rich and contradictory portrait that can be understood only by shifting perspective from the social to the individual and back again without favor.
9234025	The aim of the study was to investigate the reproducibility of a food frequency questionnaire (FFQ) used in a cohort of 14,290 women enrolled in the NYU Women's Health Study.A subset of 474 cohort subjects who completed the dietary questionnaire at baseline (FFQ-1) were approached again on the occasion of a second visit to the mammography study centre and asked to complete the questionnaire a second time (FFQ-2) two to four years after FFQ-1. Two to three months later the questionnaire was mailed to the subjects, and they were asked to complete it a third time (FFQ-3).	A breast cancer screening clinic.	Of the 474 subjects selected, 100% completed the second questionnaire while only 56% completed and mailed back FFQ-3. This made it possible to compare the long-term reproducibility of dietary intake measurements and baseline dietary habits between the two groups of subjects 'respondents', who agreed to complete the questionnaire a third time, and 'non-respondents', who did not.	Among respondents (56% of study subjects), energy-adjusted correlation coefficients for short-term reproducibility between FFQ-2 and FFQ-3 ranged from 0.50-0.64 for nutrients, and from 0.44-0.67 for foods. The long-term reproducibility was lower, ranging from 0.36-0.53 for nutrients, and from 0.31-0.48 for specific food groups. Among those who did not respond to FFQ-3, crude correlations for long-term reproducibility, unadjusted for energy intake, were generally lower than among respondents. Nevertheless, after adjustment for energy intake, correlations for long-term reproducibility (FFQ-2 to FFQ-1) were of similar magnitude in both groups. In addition, 'non-respondents' reported lower intake of fruit and vegetables and higher intake of meat.	The results of this study suggest that subjects who volunteer to participate in substudies on the validity or reproducibility of dietary questionnaire measurements may tend to provide more accurate responses to the questionnaire. The phenomenon seems related more to accuracy of reporting of absolute intake levels than of the relative composition of diet, self-selection may be associated with differences in dietary habits.	
9179326	This study examined the relationship among (1) two aspects of college students' self-concept--the degree to which they reported an agentic or communion orientation, (2) two views of intelligence they might hold--entity and incremental, and (3) students' tendencies to report adopting attitudes and behaviors consistent with a mastery or learned-helpless orientation. Results from a survey of a sample of 306 Introductory Psychology students indicate that: (1) an incremental view of intelligence was associated with the adoption of mastery-oriented achievement attitudes and behaviors, while an entity view of intelligence was associated with the adoption of learned-helpless attitudes and behaviors; (2) both agentic and communion orientations were associated with a mastery orientation; (3) an agentic orientation was also associated with lower levels of learned-helpless attitudes and behaviors while a communion orientation was associated with higher levels of learned-helpless attitudes and behaviors; and (4) patterns in the correlation between agency and communion, on the one hand, and several indices of students' self-confidence in academic arenas, on the other, further supported this asymmetry in the role agency and communion orientations appear to play in determining college students' adjustment to academic challenges.
9212556	Assuming that children are goal-oriented, it is suggested that their thoughts are related to two components--agency and pathways. Agency thoughts reflect the perception that children can initiate and sustain action toward a desired goal; pathways thoughts reflect the children's perceived capability to produce routes to those goals. Hope reflects the combination of agentic and pathways thinking toward goals. A six-item dispositional self-report index called the Children's Hope Scale is introduced and validated for use with children ages 8-16. Results suggest that the scale evidence internal consistency, and is relatively stable over retesting. Additionally, the scale exhibits convergent, discriminant, and incremental validity. Limitations and uses of the scale are discussed.
9141162	In the United States, contradictions related to medicine use abound in a social environment in which the pursuit of health has become a cultural project. In a marketplace where over half a million health products are available, choices at once seem to foster agency and encourage dependency on medical fixes. The aggressive marketing of medicines as indispensable commodities co-exits with rising concerns among the lay population about what is safe in the short- and long-term. In this paper we broadly consider medication-related practice in the United States as it is affected by social, cultural, and political-economic factors. We direct attention to changes in medicine use related to product proliferation, lowered thresholds of discomfort, the economics of health care, and a revival of the self-help ethic. We also consider the manner in which the demand for and use of medications reflect deeply embedded cultural ideals and emergent perceptions of need. We juxtapose two trends in American thinking about medicines: (1) the perception that "more is better," associated with cultural impatience with illness; and (2) a growing doubt about medicine necessity, safety, and efficacy.
9161109	A revision of the Quality of Life Questionnaire (QLQ-C30) of the European Organization for Research and Treatment of Cancer (EORTC) was undertaken to improve low internal consistency estimates (Cronbach's alpha) and content validity for the role functioning scale and a conceptual difficulty (undue emphasis on physical functioning) in the global quality of life (QOL) scale. The role functioning items were reworded and a four-category response format was substituted for the previous dichotomous format. A new item asking about 'overall health' was substituted for the 'overall physical condition' item in the global QOL domain. The original and new versions were tested at three time points in a total of 1,181 patients with cancer in Canada (n = 696) and the Netherlands (n = 485). In both samples there was a marked improvement in internal consistency for the role functioning scale (Cronbach's alpha s ranging from 0.78-0.88) in the new version. In the global QOL scale, the substitution of the new item for the previous one did not alter internal consistency (Cronbach's alpha's ranging from 0.81-0.92). The revised versions of the role functioning and global QOL domains have been incorporated into the QLQ-C30 (version 2.0).
9028944	The results of previous studies have shown that the development of hematopoiesis during fetal life can occur in the absence of Steel factor (SF) signaling. On the other hand, impairment of this mechanism can severely compromise the ability of cells from adult bone marrow to regenerate hematopoiesis on their transplantation into myeloablated recipients. This apparent paradox could result from changes during ontogeny in the responsiveness of hematopoietic stem cells to regulators that may substitute for SF as well as from differences in the availability of such factors during embryogenesis and in the myeloablated adult. To investigate these possibilities, we studied the effect of W41 and W42 mutations on the numbers, phenotype, and posttransplant self-renewal behavior of primitive hematopoietic cells present in the fetal liver (FL) of 14.5-day-old mouse embryos. In W41/ W41 FL, day-12 spleen colony-forming units and long-term culture-initiating cells appeared both quantitatively and qualitatively similar to their counterparts in the FL of +/+ embryos. W41/W41 FL also contained near normal numbers (approximately 50% of controls) of transplantable lymphomyeloid stem cells with competitive reconstituting ability in myeloablated adult +/+ recipients (as assessed for up to at least 16 weeks posttransplant). Moreover, both the original phenotype of these W41/W41 competitive repopulating units (CRUs) and their clonal posttransplant output of mature progeny were normal. Similarly, when myeloablated adult +/+ mice were cotransplanted with 5 x 10(4) +/+ FL cells and a sevenfold to 70-fold excess of W41/W41 FL CRUs, the contribution of the +/+ FL CRUs to the circulating white blood cell count present 5 weeks later was markedly reduced as compared with that of mice that received only +/+ FL cells. However, over the next 3 months, the proportion of mature white blood cells that were derived from +/+ precursors increased significantly (P < .002) in all groups (to > or = 30%), indicating that the ability to sustain hematopoiesis beyond 5 weeks is more SF-dependent than the ability to initially reconstitute both lymphoid and myeloid compartments. Cells from individual FL of W42/+ matings also showed an initial ability (at 7 to 8 weeks posttransplant) to competitively repopulate both lymphoid and myeloid compartments of myeloablated +/+ adult recipients. However, in contrast to recipients of normal or W41/W41 FL cells, the repopulation obtained with the W42 mutant stem cells was transient. Secondary transplants confirmed the inability of the W42 mutant cells to regenerate or even maintain a population of transplantable stem cells. Taken together with previous results from studies of CRUs in adult W mice, these findings support the concept of changes in the way hematopoietic stem cells at different stages of development respond to the stimulatory conditions evoked in the myeloablated recipient. In addition, they provide the first definitive evidence that SF is a limiting physiological regulator of sustained hematopoietic stem cell self-renewal in vivo.
9084126	The complexity of toddlers' self-development was examined in the context of knowing others. Two studies were designed to test whether toddlers' self-knowledge was different from their knowledge of others (e.g., mother and inanimate object) or whether toddlers' knowledge of persons (e.g., self and mother) was different from their knowledge of objects. Knowledge of self, mother, and inanimate object was observed in developmentally sequenced tasks assessing agency and featural knowledge. When the inanimate object was perceptually different from humans, 12-month-old toddlers responded differently to all 3 versions. When the inanimate object was perceptually similar to humans, 24-month-olds distinguished self from other and did not distinguish between the 2 versions of "other:" mother and inanimate object. We concluded that 12-month-old infants were more sensitive to perceptual features of objects than were older toddlers. Data were interpreted according to Neisser's distinction between the ecological self and the interpersonal self.
9076608	Dietary ingestion may be a significant pathway of human exposure to many potentially toxic chemicals. The U.S. Environmental Protection Agency-National Human Exposure Laboratory has made the development of methods for measuring personal dietary exposures a high priority for its dietary exposure research program. Of particular interest was the testing of methods that could be applied in the general population as one component of multipathway exposure measurement studies. This paper describes a controlled pilot study that was conducted to evaluate procedures for collecting and processing duplicate diet samples. Nine adult and three child participants volunteered to provide dietary information for 28 days, and duplicate portions of all foods consumed daily for seven consecutive days. Sample collection procedures were evaluated for participant collection and segregation of solid and liquid foods, and for identification and separation of high-fat and low-fat foods. Methods for compositing and homogenizing mixed diet samples were tested. Food records and questionnaires were tested to document the collected food and to evaluate procedures for assessing dietary changes and collection bias. Participant time and monetary needs were evaluated along with the approach for training and providing support to study participants. Participants were able to collect 96% of the meals they consumed, even with 33% of the meals consumed away from home. Food consumed in social settings was the most difficult to collect, and participants were unable or unwilling to collect foods in some social settings. Noncollection of meals and food items increased after the third day of collection. Mixed diet samples were successfully homogenized, with 1%-11% mean relative standard deviations for moisture, fat, protein, and ash analysis in replicate sample aliquots. The laboratory-measured caloric content of collected foods was an average of 12% (range: -24% to 36%) lower than estimates of energy intake using a food diary and 16% lower than estimated energy expenditure values.
9111803	The home health care industry has grown significantly over the past 15 years, primarily as the result of an increasing percentage of elderly needing services. Although personal risk has always been a contextual factor of home visiting, an additional challenge facing home health care administrators today is ensuring field worker safety, because visits are now made 24 hr a day, 7 days a week. The purpose of this study was to compare home health care administrators' with field workers' perceptions of risk involved in making home visits. The Home Health Care Perception of Risk Questionnaire (HHCPRQ), a self-report measure, was administered to a national random sample of 93 home health care administrators and 705 field workers to determine perception of risk within the context of making home visits. Findings indicate significant differences between home health care administrators' and field workers' perceptions of risk in making home visits. Suggestions for enhancing communication among all agency personnel and developing in-service education programs that are specifically for field workers are identified.
8936570	A significant percentage of the U.S. population has multiple poor health behaviors. Understanding the relationship among these behavioral risk factors is important for designing effective multiple risk factor interventions. While there is some evidence suggesting that participation in physical exercise may have a positive impact on smoking cessation, there is much to be learned about the relationships between cognitive-behavioral (self-efficacy, decisional-balance) and motivational mechanisms (stage of change) which have been shown to mediate changes in both exercise and smoking behavior.The sample comprised 332 smokers employed at two workplaces-a government agency and a medical center-recruited as part of a larger worksite health promotion project and who completed questionnaires on their smoking and exercise behaviors.	The results revealed significant relationships between smoking variables and exercise variables. Smokers who rated as important the positive benefits of smoking also rated as important the costs associated with increased physical activity. Similarly, the negative consequences of smoking were significantly associated with the positive benefits of physical activity. Self-efficacy for one behavior was significantly associated with self-efficacy for the other. Significant differences by exercise and smoking stage of change were found on the cross-behavior sets of variables (self-efficacy, pros, cons). Smokers who were contemplating a more active lifestyle reported the negative consequences of smoking to be significantly more important to them than smokers who were not considering adoption of a more active lifestyle. Smokers who were exercising regularly reported significantly more confidence in their ability to refrain from smoking than smokers not exercising regularly. Finally, smokers preparing for quitting reported less confidence in their ability to exercise than smokers who had already taken action to change their smoking behavior.	The cognitive mechanisms associated with changes in smoking behavior are related to the cognitive variables which have been shown to predict changes in exercise behavior. Significant relationships in mediating mechanisms including decisional balance and self-efficacy between smoking and exercise provide preliminary information on how change in one risk behavior may relate to change in another. These associations have implications for future intervention research and for methods research on multiple risk factors interactions.	
8828392	Previous findings suggest that a move towards internality in control beliefs is positively associated with academic success. The present study set out to explore the extent to which the use of self-assessment techniques by Portuguese primary school children is positively associated with increased internality, and to establish whether the presence of these techniques together with enhanced internality correlate with improved academic (mathematical) performance. A sample of Portuguese primary school teachers was coached in how to teach self-assessment techniques to their children, and these children were then monitored by the researchers over an eight-month period. Results on the Control, Agency and Means-End Interview Questionnaire (Skinner, Chapman & Baltes, 1988a, 1988b) indicated that at the end of the experimental period the children showed significantly less dependence upon external sources of control (perceived externality), and upon luck and unknown control as explanations for school academic events when compared to a matched control group of children who were not using pupil self-assessment. In addition, the children regularly using self-assessment strategies significantly increased their relative internality over the period concerned, and showed significant improvements in academic performance (as measured by mathematics scores) relative to the control group.
8776881	Personality researchers and theorists are approaching consensus on the basic structure and constructs of personality. Despite the apparent consensus on the emergent five-factor model (Goldberg, 1992, 1993), less is known about external correlates of separate factors. This research examined the relations between Conscientiousness, one dimension of the model, and driving accident involvement. Using multiple measures in independent samples drawn from college students (N = 227) and a temporary employment agency (N = 250), the results generally demonstrate a significant inverse relation between Conscientiousness and driving accident involvement; individuals who rate themselves as more self-disciplined, responsible, reliable, and dependable are less likely to be involved in driving accidents than those who rate themselves lower on these attributes. The findings are consistent with other research demonstrating the relations among Conscientiousness and other tasks and job performance. Suggestions for future research are discussed.

8712249	Basic to occupational engagement is a person's personal power to author choices. Impairment in functioning moves some clients from an agentic identity of self to a victimic identity. The change in identity causes previously self-directed clients to adopt a passive and acquiescent stance toward their lives. The recovery of occupational functioning includes the restoration of the person's sense of agency. Recent developments in self theory emphasize the self as a process rather than a substance or thing. Narrative is the discourse mode most able to express identity as a process. Victimic identity is manifest in a self-story in which protagonists have lost power to affect change in their lives; agentic identity is manifest in self-stories of active agency. A study of clients' rehabilitation by Cochran and Laub found that clients' change from victimic to agentic identity moves through four phases: incompleteness, positioning, actualizing, and completion.
8656318	How does personality type moderate personality change in middle age? Answers to this question were sought with three observer-based measures of self-directedness (autonomy, hypersensitivity, and willfulness) scored from the California Q-set when the participants in the Mills longitudinal study were age 43. From their early 40s to early 50s, high scorers on autonomy (healthy self-directedness) increased on California Psychological Inventory measures of impulse control and agency, and continued their involvement in high-status occupational careers. Despite increases in impulse control, the hypersensitive women had not increased in agency and expressed boredom in major social roles. In their early 50s, high scorers on willfulness increased in agency but not impulse control. In social roles, they perceived themselves as stimulating and creative.
8610826	The status of patients and research subjects is usually considered in terms of self-reported symptoms. Measures seldom include disturbances in a conscious sense of the self. An additional brief measure of the sense of current self-regard is desirable, since a conscious lapse in an integrated self-concept may occur under stressful circumstances. The authors constructed and tested such a measure.Clinical interviews had indicated five common experiences that occurred more frequently as complaints during stress-induced regressions in the sense of the self as a functioning mind-body agency. An anchored five-item scale, the Self-Regard Questionnaire, was constructed and tested with 79 subjects who were in the midst of grief from the death of a spouse. Data analyses included checks on the internal coherence of questionnaire scale scores and their association with symptom, personality, and social desirability measures.	The five-item Self-Regard Questionnaire was completed quickly, in less than a minute, and led to internally consistent and unique data. Low levels of overall self-regard were correlated with higher levels of distress and predicted prolonged distress.	These results suggest that the questionnaire is a useful, quick, and easy-to-score self-report tool for assessing, and reassessing over time, current experiences of the self. The five questions may also be useful to clinicians who evaluate patients in contexts other than research.	
8636885	Defining hope as a cognitive set comprising agency (belief in one's capacity to initiate and sustain actions) and pathways (belief in one's capacity to generate routes) to reach goals, the Hope Scale was developed and validated previously as a dispositional self-report measure of hope (Snyder et al., 1991). The present 4 studies were designed to develop and validate a measure of state hope. The 6-item State Hope Scale is internally consistent and reflects the theorized agency and pathways components. The relationships of the State Hope Scale to other measures demonstrate concurrent and discriminant validity; moreover, the scale is responsive to events in the lives of people as evidenced by data gathered through both correlational and causal designs. The State Hope Scale offers a brief, internally consistent, and valid self-report measure of ongoing goal-directed thinking that may be useful to researchers and applied professionals.
8970660	The impact a Big Brother has on a Little Brother's self-concept and behavior was examined for 45 boys ages 7 to 15. The Big Brothers/Big Sisters of America is a United Way agency dedicated to supplying children from single-parent homes with an adult volunteer of the same sex. The adult serves as a friend and role model for the child. Boys who were matched (n = 23) with a Big Brother were compared to boys who were unmatched (n = 22) but were on a waiting list to receive a Big Brother. All boys completed a self-concept measure, and their mothers completed a checklist regarding the behavior of her child. Results indicated that boys who had a Big Brother reported significantly higher self-concepts than did those who were unmatched. Scores on the behavioral instrument did not yield significant differences between groups. Implications of the findings and suggestions for future research are discussed.
7487431	To determine whether a finite population, with severe physical disability, had better perceived quality of life, health status, and lower cost depending on whether they used agencies for their caregivers or hired, trained, and reimbursed their caregivers, independently.A survey, including demographics and portions of the Rand-36, LSI-A, PASI, PIP and CHART. The interviews were completed by telephone, by the leading author.	Seventy-one persons who had sustained spinal cord lesions between C1 and C4. All were at least 1 year postinjury and had received rehabilitation at a local hospital in Englewood, Colorado. Ten additional persons came from the leading author's case management caseload or from a Boston rehabilitation center. They were interviewed in person for pretesting.	Chi square, t tests, and multiple regression analysis, which controlled for potentially confounding group differences. Individuals were placed in two cohorts. Twenty-nine persons received primarily agency provided care and 42 individuals used personal care attendants.	The self-managed group showed significantly better health outcomes, with fewer rehospitalizations and diminished preventable complications. They also experienced greater life satisfaction and significantly lower costs. Those in the self-managed care group had significantly higher composite scores on Rand-36, indicating higher perception of recent health status. Significant differences in mean PIP scores indicated that members of the self-managed care cohort perceived greater control over day-to-day lives. PASI scores showed that persons in this cohort had greater satisfaction with their caregivers and costs. Cost benefit analysis showed appreciable lowering of costs in the self-managed care group.	The self-managed care group had many more hours of paid attendant care, whereas the agency provider group had almost equal amounts of care from paid and unpaid providers. Persons using self-managed care reported having fewer medical problems, fewer hospitalizations and better perception of health. Participants declared greater satisfaction in having a choice of caregivers. Persons who were self-managing their care spent less money and used more hours of paid care. The financial burden borne both by the individual and society and the emotional burden borne by families and friends were diminished by the persons managing their care individually.	
8576407	Arguments about the possibility that cognitive variables may play a causal role in human behavior are unlikely to be resolved in favor of one side or the other, because they set against each other two incommensurable views of human agency. Contemporary cognitive models of psychology are based on an implicitly dualist view of human behavior, assuming the existence of a nonmaterial mental realm which has the capacity to act on the material world. Critics, by comparison, frequently argue from an epiphenomenalist position. While there may be sound scientific reasons for rejecting self-efficacy theory, and particularly for rejecting the utility of the concept that behavior is caused by efficacy expectations, this paper argues that epistemic criteria are frequently less important than a sense that a theory is compatible with a particular world view. I argue that cognitive theories are accepted by the psychological mainstream because their dualist basis accords with deeply held cultureal beliefs about the relationship between the person and the world. However, the social and political consequences of such models are rarely articulated, and there is a need for psychologists to develop a more explicit understanding of the relationship between psychological theories and their broader implications.
8576402	The debate over the contribution of cognitive processes in understanding human endeavor rages on in psychology despite decades of conceptual and empirical scrutiny from researchers. Recently, the construct of self efficacy has stimulated a renewal of this debate. We discuss the significance of this cognitive construct from the perspective of cross-cultural behavior. We examine the empirical evidence from a number of cross-cultural studies, and we argue that the etic quality of this construct provides strong evidence for its significance in understanding universal aspects of behavior.
11541314	For the European manned space activities an EVA space suit system was being developed in the frame of the Hermes Space Vehicle Programme of the European Space Agency (ESA). The space suit was to serve the needs for all relevant extravehicular activities for the Hermes Columbus operations planned to begin in 2004. For the present Russian manned space programme the relevant EVAs are performed by the Orlan-DMA semi-rigid space suit. The origin of its development reaches back to the 1970s and has since been adapted to cover the needs for extravehicular activities on Salyut and MIR until today. The latest modification of the space suit, which guaranteed its completely self-contained operation, was made in 1988. However, Russian specialists considered it necessary to start developing an EVA space suit of a new generation, which would have improved performance and would cover the needs by the turn of the century and into the beginning of the next century. Potentially these two suit developments could have a lot in common based on similarities in present concepts. As future manned space activities become more and more an international effort, a safe and reliable interoperability of the different space suit systems is required. Based on the results of the Munich Minister Conference in 1991, the European Space Agency and the Russian Space Agency agreed to initiate a requirements analysis and conceptual design study to determine the feasibility of a joint space suit development, EVA 2000. The design philosophy for the EVA 2000 study was oriented on a space suit system design of: space suit commonality and interoperability; increased crew productivity and safety; increase in useful life and reduced maintainability; reduced development and production cost. The EVA 2000 feasibility study was performed in 1992, and with the positive conclusions for EVA 2000, this approach became the new joint European Russian EVA Suit 2000 Development Programme. This paper gives an overview of the results of the feasibility study and presents the joint requirements and the proposed design concept of a jointly developed European Russian space suit.
24254573	This study examines the effectiveness of a primary drug prevention/early intervention counseling program for elementary school children. The program, sponsored by a community drug treatment and prevention agency, assists children in acquiring social skills, reducing behavioral problems, and increasing academic success. The program is currently implemented in targeted public schools in Northeast Florida. It is a model which demonstrates the effectiveness of a community and school alliance in positively impacting social skills and behavioral correlates leading to adolescent drug experimentation. Results of the study indicate that the counseling program significantly impacted behavioral problems such as Acting Out, Immaturity, and Distractibility as measured by the Walker Problem Behavior Checklist. Some improvements were also noted in the children's self-concept, particularly in perceptions of peer acceptance, as measured by the Piers-Harris Self-Concept Scale. 
7729174	This article is based upon a two-year research project in a government child welfare agency in British Columbia involving frontline child welfare workers and women who are single parents. Based upon previous research with public child welfare workers, the authors developed several principles that emphasized the importance of female clients and frontline workers having the power to shape practice according to their joint plans. The article reports on the achievements of women who are single parents and of workers once they are given the freedom to redevelop services. The underlying concept--empowerment--is reviewed and a comprehensive definition of the term, based upon client and worker empowerment, is proposed.
7694909	This longitudinal study examined predictors of patterns of change in HIV sexual risk acts among homosexual and bisexual adolescent males.A consecutive series of 136 homosexual and bisexual males aged 14-19 years were recruited into the study. Subjects were predominantly Hispanic (51%) and African American (31%) and seeking services at a homosexual-identified community-based agency in New York City. All subjects participated in an intensive HIV intervention program. Patterns of change in HIV sexual risk acts were based on assessments at four points (intake and 3, 6, and 12 months later) and were used to classify youths as demonstrating one of five patterns of anal and oral sexual acts: protected (anal: 45%, oral: 25%), improved (32% and 28%, respectively), relapse (5% and 8%), variable (8% and 15%), and unprotected (10% and 24%). Components of the health belief, self-efficacy, peer influence, coping, and distress models were assessed as predictors of these patterns.	Protected and improved patterns of sexual risk acts were associated with low levels of anxiety, depression, and substance use and high self-esteem.	These data suggest that HIV interventions must address non-HIV-related issues confronting youths in difficult life circumstances, particularly emotional distress and the role of peer networks for homosexual and bisexual youths.	
7779768	The cultural contribution to psychopathology may become more salient in situations of social change, but it remains difficult to distinguish individual agency among wider social and economic transitions, such as 'modernization' or simply 'culture change', which carry the potential for recourse to new patterns. Eating disorders, a biosocial pattern once identified exclusively with European societies, do occur among South Asian women including those living in the West. This seems not just a simple appropriation of contemporary Western ideals of female morphology--the 'fear of fatness'-but a reassertion of an instrumental strategy of self-renunciation in situations of experienced constraint.
7759344	Perceptions of power in women living in rural villages in Pakistan were explored. The Lee-Hezekiah Power Perception Scale was developed by the authors to measure women's perception of their power. The instrument was administered in interviews conducted by a group of Lady Health Visitors who were participating in a project funded by the Canadian International Development Agency. Sixty-nine women ranging in age from 20 to 65 were interviewed. One-way analysis of variance revealed that the oldest group perceived themselves to have more power than the youngest group perceived themselves to have. Stepwise multiple regression indicated that the number of male children a woman had was predictive of the amount of power she perceived herself to have. The results are discussed in relation to existing literature on women and power in developing countries. Implications for further research on women's perceptions of power and health are discussed.The study aim was to identify women's perceptions of their own power in patriarchal Pakistani society. The theoretical framework was based on French and Raven's bases of power. 69 Muslim rural women, 20-65 years old, were selected randomly from 6 rural health centers in Sindh province in December 1990. Perceptions of power were measured by the Lee-Hezekiah Power Perception Scale. The respondents had a mean age of 34 years; 41% were Sindhi, 41.5% Balouchi, and 17% other. All were married or widowed. The maximum possible score on the perception test was 95; the mean score was 47, and scores ranged from 25 to 85. Analysis of variance results showed that women 46 years and older felt significantly more powerful. The 5 literate women had a mean score of 59. Multiple regression analysis indicated that only the number of male children was a significant predictor of women's power scores. Number of male children explained 9% of the variance. Age, marital status, education, and number of female children were insignificant. The French and Raven framework suggests that legitimate power is based on cultural values and acceptance of the social structure. In Pakistan men have power in the family, but this study found that women's perception of power was more related to age, literacy, and the number of sons. The small sample size of literate women made difficult a definitive interpretation of the impact of education, but the findings suggest that education could have a powerful influence.	
9447027	The concept of self-care was conceptualized as having three major components: enabling perceptual elements (motivation, values, responsibility, and decision making); domains for enactment (cognitive/ perceptual, psychosocial/affective, and physical functioning); and self-care enactment factors (capacity), which included self-care action and knowledge adequate for self-care. A new tool, The Self-Care Agency Inventory, was designed to discriminate between those who will enact self-care and those who will not because of either a lack of knowledge or a lack of motivation. Content validity was demonstrated (.77 or greater from each scale) and concurrent validity documented. Alpha reliability for the new scale and principal components factor analysis of the scale items did not achieve desired levels, although a pilot sample demonstrated test-retest reliability of .82. The conceptual model is presented.
7706100	To describe and test a model of recovery in the elderly after coronary artery bypass surgery derived from Self-Care and Self-Efficacy Theory.Prospective, longitudinal, repeated measures.	Two large urban teaching hospitals on the East Coast.	One hundred thirty-three adults over the age of 65 years who had coronary artery bypass surgery on hospital admission. There were 32 women and 101 men with an age range of 65 to 87 years (M = 71.8 years +/- 4.8 years) in whom 77.5% were in a New York Heart Association class of 3 or 4, indicating significant functional limitations.	Self-care agency, self-efficacy expectations, and the performance of self-care/recovery behaviors at discharge, 6, and 12 weeks after coronary artery bypass surgery.	The exercise of self-care agency was measured with the Exercise of Self-Care Agency Scale, self-efficacy expectation, and the performance of self-care/recovery behavior by the Jenkins Self-Efficacy Expectation Scales and Activity Checklists. Data were collected at discharge, 6 weeks, and 12 weeks after surgery for the specific behaviors of walking, climbing stairs, resuming general activities, and the performance of roles.	Repeated measures analysis of variance revealed significant changes in self-care agency, the self-efficacy expectations for all behaviors, and the performance of the behaviors for walking, resuming general activities, and performance of roles over the recovery period (p < 0.01).	In support of the model, self-efficacy expectations mediated between self-care agency and all self-care/recovery behaviors at selected times. Comparison of the performance of self-care/recovery behaviors with other samples from the literature found recovery in the elderly to be protracted. Nurses can be pivotal in providing the elderly with accurate projections of recovery and an environment to support the initial mastery of self-care/recovery behaviors to promote optimal health in this vulnerable population.	
7988275	As an addition to the growing literature on school of social work/child welfare agency collaborations, this article describes a clinical group supervision arrangement between Children and Youth Services of Delaware County, Pennsylvania, and the master of social work program at Widener University's Center for Social Work Education in Chester, Pennsylvania. Six students who were also employees of the department received clinical group supervision every other week by a faculty member of the center. The process of initiating the group, the supervision issues that emerged, the articulation and application of a model of child-centered family treatment, and preliminary results from the use of a Skill-Level Self-Rating scale are presented and discussed.
7934083	Kentucky has the fourth highest percentage of infants born to teenage mothers in the US. Risk factors for adolescent pregnancy are poor academic performance, family history of adolescent pregnancy, absence of one or both biological parents in the home, troubled family relationships, family violence, history of substance abuse, and poor self-concept. Pregnancy adds new developmental requirements to the continual developmental crisis of adolescence. Some of these developmental requirements are dealing with pregnancy and birth of a child and peer and family reactions and relationships. Pregnant teens are at high risk for anemia, preeclampsia, preterm delivery, and low birth weight infants. The health care team must assess the abilities, needs, practices, and priorities of teens. Nurses should promote health and positive health practices in teens. They should focus on prevention of adolescent pregnancy and on meeting the needs of pregnant teens. Adolescent pregnancy interventions include education and adolescent-centered special programs. Peer groups, role playing, videos, and computer games are individualized and effective education techniques for teens. Formal adolescent pregnancy prevention programs are abstinence education, knowledge-based programs, and clinic-focused or school-based programs. A combination of approaches is more effective than using just one approach. Adolescent pregnancy prevention interventions should promote the value of education, discourage substance abuse, and provide counseling for victims of child abuse. Pregnant teens should receive prenatal care as soon as possible. One health care agency should combine physical care, psychosocial support, and education for teens. Kentucky schools help pregnant teens continue their education and help them obtain information and support for care for themselves and their babies. Nurses can be effective at reducing the number of unwanted teen pregnancies.

8310316	This article examines the creation of a gay affirmative group model that focuses on the unique social, developmental, and psychoeducational needs of lesbian and gay clients who attend psychiatric day treatment. The author discusses how these clients' psychosocial potential can be maximized in a group that addresses issues related to their sexual orientation, including their double stigmatization as both mental patients and homosexuals. The following modifications of traditional group interventions are illustrated: (1) the tolerance of primitive interpersonal styles; (2) the encouragement of differentiation; and (3) the need for a structured, nonconfrontational approach. These principles, which lead to enhanced group safety and cohesion, are contrasted with those of a more traditional "coming-out" group. Overcoming resistance and homophobia among staff and other clients is outlined, as is establishing the group as an integral component of a gay-sensitive treatment structure in a mental health agency.
8167612	The changes in psychic structure attributed to the effects of interpretation when they transpire during psychoanalysis occur spontaneously in the course of normal development. The parental behaviors associated with the changing structure of the normally developing personality are similar to various specific and nonspecific features called "supportive" in psychotherapy. These features include interventions that promote a "learning" state by optimizing anxiety, foster a sense of self and of agency, encourage mature relationships, and strengthen adaptive defenses.
8042606	In order to more precisely investigate the nature of control and self-control issues for adult children of alcoholics (ACA), a group of ACAs was compared to a group of sex and age matched healthy normals and a sex matched group of college students on the Shapiro Control Inventory (SCI). The SCI provides a profile that is both general domain (positive sense of control, desire/efforts for control, agency of control, and mode of control) and domain specific (body, mind, interpersonal, self, career, environment). Analysis of variance and subsequent planned comparisons on the SCI showed significant differences between the ACA and the two comparison groups in general domain sense of control, in three of the four general domain mode quadrants, and in the domain specific areas of body, mind, interpersonal, and career. Individual areas where ACA subjects felt most out of control were weight, significant other, and family of origin; 89.5% felt concern with self-concept, stress, and relationship with significant other. Although a small subset of ACAs had a strikingly high "in control" profile, most did not. Finally, the sense of control profile of ACAs is compared with two clinical populations--borderline and depression--and is shown to fall midway between the clinical and normative groups. Guidelines and suggestions for further research are offered.
8256142	During the past 15 years, there has been tremendous growth in the number of self-help groups and agencies for mental health clients. This article examines the self-help perspective in relation to problems with traditional mental health services and the need for client-run services. Self-help agencies see their goal as empowerment on an individual, organizational, and societal level. They strive to accomplish this by helping members obtain needed resources and develop coping skills; providing means of enhancing members' self-concept and lessening the stigma of perceived mental disability; giving members control in the agencies' governance, administration, and service delivery; and furthering member involvement in social policy-making. The goal of this article is not to endorse the self-help perspective but to use it as the basis for raising research questions that will further the mental health practitioner's understanding of this service modality.
12156362	Logistic regressions were used to analyze consistency in decision making about adoption and parenting among 162 pregnant adolescents aged 12-23 years in a Crittenton Services facility.  Eight hypotheses were generated about the determinants of adoption or parenting.  For instance, external locus of control and lower self-esteem were expected to lower the odds of being consistent in planning for adoptions.  Significant others' influence in support of adoption increases the odds of consistency.  Residents have the opportunity to participate in small group educational efforts which emphasize adoption as a viable alternative and receive general counseling help in planning a realistic postpartum plan for parenting.  Age, ethnicity, education, and reproductive history were considered background variables.  Nowicki and Strickland's Control Scale for Children, Coopersmith's Self-Esteem Inventory, and McMaster's Family Assessment Device were used to measure social psychological variables.  Social influence measures pertained to communication with and preference of the mother and the birth father.  The dependent measures were the initial adoption plan and consistency with or switching of the initial adoption plan.  The results reveal that equal numbers initially planned to adopt and to parent.  Each group had similar background characteristics, with the exception that most adoption acceptors lived at home, and those who chose parenting were in the custody of a public agency.  About 20% switched decisions over time.  One teenager switched from parenting to adoption, and 32 (19.8%) switched from adoption to parenting.  Of the 16 predictors, only social influence variables had clear significant effects.  Mother's preference for adoption was the strongest influence on decision making.  Only the birth father's preference strongly influenced the plan to adopt, by tripling the odds of consistency of adoption.  Agreement between the mother and the birth father on adoption increased the odds of a consistent adoption plans.  In the multivariate models, only birth father's influence remained adequately significant.
8332923	Existing theoretical explanations of the mental health consequences of unemployment are outlined, critically reviewed and an alternative theory proposed. Theories reviewed include the rehabilitation approach, the stages model, Jahoda's functional model, Warr's vitamin model and Fryer's agency critique. A discussion of the effects of moderating variables--including the quality of work, work commitment and age--is used to assess the usefulness of these theoretical explanations. Most theories are found to deal inadequately with the temporal aspects of unemployment, the relationship between subjective experience and objective location and the complexity of the effects of moderating variables. In response to these inadequacies and in contrast to the predominant empiricist, psychological orientation, a middle range theory is proposed informed by a sociological perspective. The proposed theory conceptualises unemployment as a type of status passage and suggests an explanation of changes in mental health derived from identity theory.
8326940	The ethical demands of professional nursing practice are considered, and the concept of Agency is offered as a potentially useful part of the nurses conceptual equipment for such practice. The pressures of working in large organisations are suggested to be inimical to a sense of Agency, and it is also suggested that some of the academic disciplines involved in nurse education are offering an ambiguous view of the issue of Agency. The discipline of Ethics, while also ambiguous on this issue, is presented as offering useful ways of exploring that ambiguity. Several theories of Ethics are considered in relation to human freedom and responsibility, and the issue between determinism and free will is likewise considered. It is suggested that these offer ways of helping the individual to explore and develop their own stance on freedom and responsibility, and thereby on the issue of Agency. This discussion is related to the United Kingdom Central Council (UKCC) Code of Professional Conduct, and the paradox of choice is acknowledged.
8229218	Limited documentation is found on dental hygienists' attitudes toward acquired immunodeficiency syndrome (AIDS) patients and their knowledge and practice of clinical infection control to prevent disease transmission to themselves and their patients. The purpose of this paper was to survey practicing Pennsylvania dental hygienists to document 1) their infection control practices; 2) their attitudes towards AIDS patients; and 3) their knowledge of clinical infection control practices.A self-administered survey questionnaire, with fixed-alternative responses, was mailed in January 1991 to a random sample (N = 300) of licensed, practicing Pennsylvania dental hygienists. The questionnaire comprised eight multiple-choice questions for demographic purposes and 89 Likert-type questions eliciting information in five areas: AIDS-related knowledge, attitudes toward AIDS patients, knowledge of recommended Centers for Disease Control and Prevention (CDC) infection control measures, individual infection control measures, and individual laboratory infection control measures. Means and modes for individual questions and for specific categories were determined and analyzed utilizing Spearman rho correlation coefficients (p < .05). Mean scores were also tabulated for actual operator/laboratory infection control practices for both a routine patient and an AIDS patient. Those scores were analyzed utilizing the Wilcoxen signed-ranks test.	Two hundred twenty questionnaires were returned for a 73.3% initial response rate. One hundred fifty-four of those returned were usable, for a 64% response rate. Results indicated that 94.2% of surveyed dental hygienists had comprehensive knowledge about AIDS and 92% had comprehensive knowledge of CDC-recommended infection control procedures. Eighty-five percent of respondents possessed a moderate or high feeling of worry concerning treatment of AIDS patients. The majority of surveyed dental hygienists routinely practiced the use of glasses, masks, and gloves; the use of disposable items; and surface disinfection of light handles, instrument bracket trays, and patient chair switches. Knowledge of recommended infection control procedures for dentistry was found to be associated (r = .22) with adherence to recommended infection control practices. Accurate knowledge about AIDS showed a weak (r = -.088) and nonsignificant relationship with dental hygienists' attitudes toward AIDS patients. Use of recommended infection control practices was found to be associated (r = -.20) with less fear concerning the treatment of AIDS patients. In addition, dental hygienists' infection control practices varied according to their perception of patient HIV status.	Since Pennsylvania dental hygienists, within the limitations of this study, appear not to follow CDC guidelines on proper and responsible operatory/laboratory aseptic techniques stringently, and to differentiate infection control procedures based on perceived patient HIV status, recommendations are that 1) the Commonwealth of Pennsylvania should mandate that all Pennsylvania-licensed dental hygienists take at least one state-approved course on operatory/laboratory infection control every two years to qualify for relicensure; 2) all dental and dental hygiene education institutions and professional organizations should place more emphasis on strict adherence to the various agency recommended clinical guidelines for infection control; and 3) all dental hygienists should continually strive to update their own knowledge of current infection control practices.	
8454809	Weight-related attitudes and practices of women who attended health department clinics or who worked for a health and human services agency were assessed by means of an anonymous, self-administered questionnaire. Black women who were 25 to 64 years old and were not pregnant or had not given birth within the past year were included in this analysis (n = 500). The overweight women perceived themselves as being overweight. They were less likely to be satisfied with their weight and more likely to have dieted and to be currently dieting than nonoverweight women. Awareness of obesity-related health risks was high, but the perceived psychosocial consequences of being overweight were somewhat limited. Approximately 40% of moderately and severely overweight women considered their figures to be attractive or very attractive, which indicates a relatively positive body image. The overweight women were less likely to exercise, less likely to skip meals, and more likely to eat between meals than the nonoverweight women. Among the subset who had ever attempted to lose weight (n = 368), the overweight women were significantly more likely to have regained all or more of the weight lost during their most recent attempt. The findings of this exploratory survey suggest that although overweight black women are weight conscious, the absence of strong negative social pressure combined with a relatively positive body image may limit the extent to which weight loss efforts are sustained. Findings about eating and exercise patterns suggest some specific factors that may interfere with the effectiveness of weight control among black women.
8494807	The aim of this paper is to report an extension to the computationally efficient Self Similar Stack model (Burton et al. Biol., Cybernet. 53, 397-403, 1986) to include the effects of local gain control in the retina. The method employed to do this has been to fit a family of difference-of-Gaussian functions to the human contrast sensitivity function curves of van Nes and Bouman (J. Opt. Soc. Am. 57, 401-406, 1967). The centre frequencies of the DoGs within each family are octave-related, in a simplified manifestation of the DoG channels found by Wilson et al. (Vision Res. 23, 873-882, 1983). The sensitivity of each level, or channel, that formed the original Stack model is modulated individually according to the fitted values, as the local illumination varies within an image. The model was tested against psychometric data obtained by Haig and Burton (Appl. Optics 26, 492-500, 1987) during experiments on visual discrimination. The consistency of the results indicates the validity of the approximations and the robustness of the model, either for machine vision purposes or for predicting human visual performance. A simple algorithm, developed for use with a machine vision application of this model, provides a means by which a TV camera may be focused automatically. The success of this algorithm, using the newly computed channel sensitivities, suggests that human focal accommodation may be regulated by a similar form of mechanism.
8481269	A sample of San Francisco gay/bisexual men in substance-abuse treatment (N = 314) was compared to the San Francisco Men's Health Study (SFMHS) cohort to compare levels of sexual behaviors that are high-risk for HIV transmission. Quantitative data were supplemented by analysis of transcripts of focus group discussions with gay men in treatment at the same agency. Sexual risk for HIV infection was significantly higher for gay/bisexual men in substance-abuse treatment than among the community-based (SFMHS) sample of gay/bisexual men. Among those entering outpatient alcohol/drug treatment, 21% reported unprotected insertive and sex, 23% reported unprotected receptive anal sex, and 32% reported unprotected insertive and/or receptive anal sex during the previous 3 months. In comparison, in the SFMHS cohort, 17% reported unprotected insertive and sex, 15% reported unprotected receptive anal sex, and 22% reported unprotected insertive and/or receptive anal sex during the previous 6 months. Substance abusers in focus groups identified a number of factors that made it difficult to reduce their sexual risk behavior, including the perceived disinhibiting effects of alcohol and other drugs, learned patterns of association between substance use and sex (especially methamphetamine use and anal sex), low self-esteem, lack of assertiveness and negotiating skills, and perceived powerlessness.
8452399	A mixture of paraquat and water was applied, by helicopter, to agricultural fields near a residential community and near an associated commercial complex. Drift from the application passed directly over the community, which resulted in resident complaints to the local county agricultural department. A community survey was undertaken to determine what health consequences, if any, resulted from the drift. A comparison of 2-wk self-reported symptom rates between the exposed community and three historical control communities indicated that 10 symptoms were elevated significantly at p < .05: cough, diarrhea, eye irritation, headache, nausea, rhinitis, throat irritation, trouble breathing, unusual tiredness, and wheezing. An internal comparison, which predicted symptom rates by an index of paraquat exposure (smelling an unusual odor in the prior 2-wk period), indicated fever (relative risk [RR] = 11.97) and nausea (RR = 3.75) to have elevated relative risks. Odor perception also predicted the report of a greater than the average number of symptoms. Based upon these findings, it was concluded that these residents probably did experience an increase in health symptoms from the drift. It is recommended that paraquat not be sprayed near residential communities.

10120033	This article has described the importance of increasing staff feelings of self-worth, of promoting feelings of personal power, involving staff actively in practice issues, of increasing staff knowledge of the health care and agency system, and of setting limits on negative discussion in a group. When nurses feel power in the health care system, it not only has the benefit of increasing job satisfaction but increases positive responses on the job. On the other hand, nursing staff who are unable to conquer the feeling of powerlessness may respond to assignments with statements signifying the subjective state experienced: "We can't do it!" Such staff are unlikely to experience personal and professional rewards and may ultimately leave the health care field. This negative process may be blocked by the manager who assists staff to develop feelings of worth, professional autonomy, and control and who can appropriately handle negative feelings expressed in a group.
1518669	This study tested the efficacy and effectiveness of systematically planned parenting enhancement program aimed toward breaking the cycle of high-risk mothers producing high-risk babies in Egypt. The assumption is that self-esteem and self-care are requisites to effective parenting, which can be enhanced or impeded by human and environmental forces. Given that parenting is a learned behavior, it can be repatterned by modifying human-environmental processes.This evaluation study tested the effectiveness of the parenting enhancement program (PEP) among a convenience sample of 56 Egyptian mothers (28 PEP and 30 non-PEP).  The aim of PEP was to halt the process of high-risk parents producing high-risk children.  PEP provided health education and parenting competency training and enhanced opportunities for self-direction.  The hypotheses were that PEP mothers would improve in self-esteem, self care, and perceive their infants more positively than non-PEP mothers.  A brief theoretical discussion is directed to the relationship between parenthood and self-esteem, self-esteem and self-care, and the maternal perception of the infant (MPI).   Mothers were selected based on a list of infants registered with a well-baby clinic, which was part of a large teaching hospital in Alexandria, Egypt. Infants were selected at 6 weeks of age and followed for about 10 months.  Parenting groups received 5 parenting classes of 1-2 hours duration.  Data was collected at 3, 6, and 12 months postpartum.  The following questionnaires were used to assess mother's perception, self-esteem, and self-care: the Broussard and Hartner Neonatal Perception Inventory (NPI and NPI II), a background information questionnaire, Rosenberg's Self-Esteem Scale, and Kearney and Fleisher's Self-care Agency Scale.  Translations were made to Arabic by a master's level pediatric nurse and reviewed by several nurse professionals.   A pilot study was conducted to test the feasibility of the study.   The study findings revealed that both mothers' groups had low self-esteem, low self-care at baseline, and negative scores on MPI, and were comparable in age, number of years married, and number of pregnancies.  Differences were observed in family income, living arrangements, and length of stay at home address; non-PEP mothers had a slightly higher socioeconomic status.  The non-PEP mothers had better scores on self-esteem and self-care at 3 months postpartum, even though PEP mothers' scores improved.  MPI was low for both mothers' groups at 3 months.  PEP mothers' scores increased at 6 months, but both mothers' scores decreased at 12 months. Differences in socioeconomic status (SES) and low SES are attributed to the results.  The implication is that sustaining support is needed after a sustained intervention.	
1550330	The purpose of this study was to further explicate the Dreyfus Model of Skill Acquisition in the practice of critical care nursing. For this analysis data were used from a sample of 105 nurses practicing in the adult, pediatric, and newborn intensive care units of eight hospitals in three metropolitan areas. The data were composed of group interviews in which nurses gave narrative accounts of exemplars from their practice and close observations and intensive personal history interviews of a subsample of nurses. Two interrelated aspects were found to distinguish four levels of practice, from advanced beginner through expert. First, practitioners at different levels of skill literally live in different clinical worlds, noticing and responding to different directives for action. Second, a sense of agency is determined by one's clinical world and shows up as an expression of responsibility for what happens with the patient.
12287095	Barry Konikov, a hypnotherapist, of Potentials Unlimited Inc., a Michigan-based company which produces approximately 160 Subliminal Persuasion/Self Hypnosis tapes, promises his listeners miracles.  The tapes on premenstrual syndrome, abortion, and sexual abuse were analyzed.  The self-hypnosis message by Konikov is dangerous for women, because his antifeminism, misogyny, and patriarchism are couched insidiously within New Age neofeminism.  Under therapeutic guidance the woman listener can direct her own transformation to complete mental, physical, and spiritual well-being, and her new and improved self is so empowered as to accept total and complete responsibility to overcome the hurt about menstruation, abortion, or sexual abuse.  Growth therapies such as Gestalt, guided fantasies, and bioenergetics undermine women with false promises of power.  If women are so powerful, then it is their fault if they got raped, or battered, or if they have not received love, money, and inner peace.  While seemingly empowering women to develop a strong sense of personal agency, Konikov ignores the patriarchal structures which intersect his women listeners' experience of menstrual discomfort, abortion, and sexual abuse.  Konikov's New Age, neofeminist stance contains 4 stages of healing:  responsibility, absolution, forgiveness, and resolution.  Accepting responsibility for the wound next leads to absolution, and particularly absolution for men. As an example of absolution, Konikov's woman client-ex-plantation slave accepted her past-life relationship to her husband, absolved him of guild, and decided upon a divorce.  The issue of absolution widens into forgiveness in the healing process, whereby Konikov wants women to hypnotize themselves therapy should be to help a woman see how her own power as an individual is inextricably bound to the collective power of women as a group.  There is no doubt that the New Age neofeminist stance taken by Konikov on the tapes leaves women profoundly disempowered.

1548569	This study compared the behaviors of autonomy, coping, and self-care agency among 22 adolescents with spina bifida with those of healthy adolescents matched for age, gender, grade in school, and socioeconomic status. Responses on the Adjective Checklist (Autonomy scale), the Ways of Coping Check List (Problem-Focused Coping scale), and the Denyes Self-Care Agency Instrument were analyzed. Adolescents with spina bifida demonstrated significantly lower scores on autonomy when compared with healthy controls. The absence of differences in coping and self-care agency suggests that similar therapeutic approaches may be appropriate for adolescents with and without spina bifida.
1621573	This study examined differences between high school students who were at risk for school failure and a control group of peers. Statistically significant differences were found with respect to locus of control, self-concept, and personal styles of learning. Implications focused upon approaches and suggestions regarding the use of such knowledge in facilitating improved adjustment and achievement in at-risk students.

1835735	The utility of different reality negotiation strategies among 57 persons who had traumatically acquired severe physical disabilities was examined. It was predicted that a sense of goal-directed determination ("agency"; Snyder, 1989) would predict lower depression and psychosocial impairment scores soon after injury. To meet the demands of rehabilitation and social integration, however, it was hypothesized that a sense of ability to find ways to meet goals ("pathways") would predict lower depression and psychosocial impairment among persons who had been disabled for a longer period. The expected interaction was significant in the prediction of psychosocial impairment but not of depression. The sense of pathways was predictive of impairment and depression regardless of the time since injury. Results suggest that in the reality negotiation process the different components of hope as defined by Snyder have salient effects on perceptions of ability to function in social capacities.
2057336	In this paper, I have maintained a distinction between person and self in order to describe and analyze contexts of caring in nursing encounters. As the nursed person's perspectives are examined in light of the nurse's capacity to engage his or her own experience, four contextual categories emerge: comprehension, consideration, concern, and communion. Such concepts can help us describe and analyze many situations in clinical nursing and in nursing education. The following paragraphs describe several of the possibilities for future research. It is important to study in which contexts in nursing personhood and selfhood are enhanced and when they are diminished. Diminishment of personhood leads to depersonalization which describes a condition of loss of agency and helplessness in a world where others are in control. This can happen to the nursed person and to the nursing person. When nurses are placed in contexts where they experience lack of agency and authority in their practice settings (even when they attempt to engage others with concern and compassion), they can start to feel and become depersonalized. Diminishment of self leads to dehumanization, which describes a loss of contact with one's own experience. Rules and relationships are oppressive or inflexible and the participants experience meaninglessness. For example, how long can nurses be in daily situations of administering painful procedures to patients without experiencing dehumanization? The same question can be asked of nurses at all levels in hierarchies, and in all relationships, for example, nursing instructors with students, nurse administrators with staff nurses, faculty in academic institutions, and staff nurses with each other. Depersonalization and dehumanization eventually lead to one another. Another significant question to explore could be this: In which of the four contexts defined above does the nurse experience most satisfaction, most dissatisfaction, and the condition we call burnout? We live in a world, a society, and a profession where depersonalization and dehumanization are the plight of many. How can personhood and selfhood be enhanced or even restored in our hospitals, clinics, classrooms, and academic institutions? I propose that investigations of the contexts of caring can help us explore, discover, describe, and analyze these questions.
2047615	This study was designed to test reliability aspects of a scale that was developed to measure the theoretical concept of self-care agency (Orem 1985). Equivalence and internal consistency of the scale were studied with populations of elderly patients and their nurses in The Netherlands, Norway and Denmark. Data was provided by 120 patients and 233 nurses. Not all criteria for reliability could be met for the Danish and the Norwegian versions of the scale. Nevertheless it is concluded that the results are indications for the reliability of the Dutch, as well as the Danish and Norwegian versions of the scale.
1987549	A number of instruments are used to measure Orem's (1985) concept of self-care agency. Their use reflects basic assumptions that both the instrument and the underlying tenets of the theory are valid. The purpose of this study was to examine the latent traits associated with three instruments designed to measure self-care agency. These included Denyes' (1980) Self-Care Agency, Kearney and Fleischer's (1979) Exercise of Self-Care Agency, and Hanson and Bickel's (1985) Perception of Self-Care Agency. The convenience sample consisted of 513 adult, nonhospitalized subjects who completed the three instruments. Common factor analysis and canonical correlation were used to identify latent traits and their relationships. The findings support the multidimensionality of Orem's (1985) concept of self-care agency. However, the use of one instrument does not adequately reflect this multidimensionality.
1812396	The aim of this study was to examine the relationship between self-care and an individual's ability to cope with cancer. The self-care an individual practised was measured using a researcher-developed Self-care Agency Assessment. Coping with cancer was assessed by measuring four outcomes: anxiety, depression, self-esteem and sense of control, as well as a general personal perception of coping. Analysis of the data using the correlation technique showed a strong relationship between self-care and how an individual coped with cancer (0.81).
2285510	Mind transforms the continuance of physical space-time into moments (the absolute Now) and blends these moments into an apparent continuity through an overlapping of unfolding capsules. The flow of psychological time is an illusion based on the rapid replacement of these capsules. Each mind computes the measure of time passing and duration from the decay of the surface present in relation to a core of past events. As each new surface is generated, that surface, the rim of the immediate past, recedes in the wake of rising contents. This recession, an uncovering of phases latent in the original traversal, exposes layers in the past forming the content of the immediate past moment. The surge of the microgeny to a surface that dissolves the instant it appears, the priority of the Self in the unfolding sequence, the feeling of agency, create a Self in a state of becoming, a Self that travels in time like the crest of a wave, always in pursuit of a future just beyond the grasp of the present.
2263723	Recent developments with the Rorschach invite research concerning cognitive and coping styles of learning disabled students. This study, based on an N of 25 (12 learning disabled and 13 controls), was designed to assess group differences in perceptual accuracy, self-concept, and reactivity. Analysis showed that learning disabled students represent a diverse population for which highly individualized understanding is required if appropriate schooling strategies are to be devised. Such students, compared with controls, were more inclined to have lower self-confidence, to be more reactive, to avoid emotionally-laden stimuli, to manifest a higher proportion of responses involving perceptual inaccuracies, and to be less spontaneous and less inclined to take risks. Some curricular implications of the findings are discussed.
2246605	This article documents a descriptive study of 80 adults considered to have learning disabilities. The study was initiated by the Language and Learning Disabled Adults Task Force in London, Ontario, for the purpose of developing a profile of the self-perceived characteristics and needs of the adult population with learning disabilities in Southwestern Ontario. The study also served as a vehicle for implementation of the Intake Questionnaire, an instrument with potential as a screening device for service agencies working with adults with learning disabilities. A self-referred and agency-referred sample of 80 adults completed the Intake Questionnaire. Data were collected in the areas of demography, education, employment, health, and psychosocial characteristics, aspirations, and cooperation with further testing. Results describe people with ongoing specific problems in education, employment, and psychosocial functioning who aspire to learn more about themselves and their learning disabilities.
2236653	The relationship between environmental and personal factors on self-appraised self-care agency of nursing home residents was examined. Data were collected from 83 nursing home residents in relation to self-care abilities, environmental constraints, and selected demographic factors. Race and previous occupation were related to self-care agency with residents who were black or previously self-employed evidencing higher scores. In addition, residents who viewed the home as overly restrictive or fostering dependence had lower perceptions of their self-care abilities. The results are discussed in terms of Orem's theory of self-care, social learning theory, and implications for restructuring care within nursing homes.
2229706	Congruence of client and nurse perceptions is vital to mutual goal-setting as a means of achieving self-care in the elderly. The purpose of this descriptive, correlational study was to explore the relationship between nurse and elderly client perceptions of the clients' self-care agency. A sample of 40 elderly client subjects and registered nurses' selected from two community health agencies, completed a questionnaire consisting of three instruments: (a) a demographic sheet; (b) the appraisal of Self-Care Agency Scale; and (c) the Perceived Health Status. Pearson product moment correlation coefficients were significant for the relationships between: (a) client and nurse perceptions of clients' self-care agency (r = 0.42, P less than 0.01); (b) client and nurse perceptions of clients' health status (r = 0.38, P less than 0.01; and (c) nurse perceptions of clients' self-care agency and nurse perceptions of clients' health status (r = 0.44, P less than 0.01). With increasing emphasis on health promotion of the elderly in the community, identified relationships may have potential implications for gerontological and community nursing practice.
2209186	Cooperation in peer interaction emerges during the second half of the second year. A consideration of the skills and knowledge entailed in these early forms of cooperation suggests that young children's emerging ability to differentiate self from other as causal agents may relate to their ability to coordinate behavior with age mates toward a common goal. Children at 12, 18, 24, and 30 months were observed in same-age, same-sex dyads (8 dyads per age) while attempting to solve a simple cooperation problem. They were also individually administered an elicited imitation task used to index decentration, or self-other differentiation. No 12-month-old dyad could cooperate, 18-month-olds did so infrequently and apparently accidentally, whereas 24- and 30-month-olds were able to coordinate behavior with one another quickly and effectively. Children who were better able to accommodate their behavior to one another during cooperation also represented the agency of others at a more advanced, decentered level.
2338682	This research examined whether blood pressure measurement relates to an individual Self-Care Agency's (SCA) capabilities (self-concept, knowledge, and initiative) to exercise self-care. A sample of 110 hypertensive high-risk urban black Americans (61 males and 49 females) with a mean age of 46 years (range 18-75), was administered the 43 item 'Exercise of Self-Care Agency' scale and a demographic/health questionnaire. The blood pressure (BP) of each participant was measured at the time of the survey. A large number of subjects (72%) had normal BP and 80% low SCA capability scores. Twenty-eight percent had abnormal BP and 21% had high SCA scores. Blood pressure did not relate to self-care agency. The SCA subconstruct, 'Initiative' was significantly related to normal BP (r = 0.3354, P = 0.006). Self-care agency was inversely associated with obesity, cigarette smoking and excessive salt use. These findings suggest a deficit relationship between SCA and therapeutic self-care demand among urban black Americans who are at high risk for hypertension.
12317633	The Luker model specifies that failure to contracept might be deliberate.  The determinants of contraceptive behavior are the assignment of advantages and disadvantages to contraceptive use and pregnancy.  A subjective probability is given to the likelihood of getting pregnant and to reversing any pregnancy that might occur. Successful risk taking leads to a lower probability of pregnancy and thus more risk taking.  Stressful life events or interpersonal situations may change the probabilities.  The advantage of this model is its proximity to the actual coital event.  The goal is to identify factors related to risk taking.  Examination of the model involved a sample of 425 sexually active women aged 13-19 years from a multiservice center for youth in New York City in 1981 who visited the agency at least 1 month prior to the interview.  The sample was 36% black, 36% white, 24% Hispanic, and 4% Oriental or other.  77% were enrolled in school and 55% were from intact homes.  38% had professionally employed parents and 14% received welfare.  Questions were directed to the likelihood of pregnancy and contraception and the advantages and disadvantages, the likelihood of abortion if pregnancy occurred, and background variables (social and psychological characteristics; situational factors at last intercourse; sexual, contraceptive and pregnancy histories; degree of support from partners, peers, parents; ego development; and knowledge of pregnancy risk and contraception). Reliability of each scale was assessed.  The results showed that 26% of women at last coitus had taken a pregnancy risk.  These risk takers considered birth control as more disadvantageous and pregnancy more advantageous.  The probability of pregnancy at last coitus was considered by risk takers to be lower than non-risk takers.  Risk and non-risk takers were at the same risk of pregnancy regardless of subjective perception.  50% thought about pregnancy or contraception at last coitus.  48% reported thinking about the good or bad things about getting pregnant, and 38% actually thought about being pregnant.  9 of 43 variables were related to risk taking.  The multivariate models revealed that significant variables were knowledge of welfare history, previous risk taking, ego development, and 5 variables from the Luker model.  Adding the scale for stressful life events did not affect the results.  The Luker model and developmental reasons for pregnancy risk are supported.  There was moderate support for Luker's feedback mechanism, but good longitudinal data are necessary for accurate cost accounting.  The assumption that motivation to attend a clinic will affect all future coital acts is deceptive.
2364178	This study explored the relationship between dominance-achievement motivation and psychological adjustment of 53 patients after their first myocardial infarction. These two motivations are perceived as expressions of general tendency to "agency," or assertiveness. The following findings were observed: (1) High-agency subjects reported less depressive moods than low-agency subjects; there was no time effect on this difference between groups nor within each group separately. (2) the self-esteem of high-agency patients was high and stable, whereas that of low-agency subjects was lower and got lower with time. It may be concluded that patients with a high-agency level might be more efficiently equipped to cope with stressful events.
2274799	This paper critically analyses the historical embeddedness and ideological functions of the concept of community as it is used in South Africa by representatives of the state and its opponents. The analysis shows that 'community' is a key concept in the ideology of separatism through which an apartheid psychology and society is reproduced. This has implications for progressive psychologists who aim to empower oppressed ordinary people through interventions based upon theoretical models of community. Some of these are explored by examining the interplay between political and theoretical images of community and ordinary people's ideas about social ills. This suggests that whilst community psychology can revitalise a sense of community amongst the oppressed, it may also reinforce existing social inequalities by deflecting experts and ordinary people from the reconstruction of individual agency upon which liberating social transformation depends. It is concluded that a central task for South African psychologists is to engage in critical self-reflection with the aim of identifying and eliminating oppressive forms of social and psychological discourse, thereby empowering themselves and contributing to the construction of a coherent counterideology.
2625837	The aim of this investigation was to delineate concepts contributing to the Exercise of Self-Care Agency (E.S.C.A.) Scale developed by Kearney & Fleischer (1979) and to test its construct validity and its predictors. The results are summarized as follows: 1. By means of principal factor analysis and maximal likelihood factor analysis upon data generated from 280 undergraduate students, the factors of Concern about Health Knowledge, Self-Concept, Information-Seeking Behavior, Decision-making and Responsibility, Self-esteem, and Passivity emerged. The total percent of variance explained by the 6 factors was 75.1%. 2. To assess factor independence and instrument homogeneity, correlations among the 6 factors were computed. The correlations ranged from .24 to .46 indicating that the factors and the items were not too similar or redundant. 3. Test-retest reliability of the total scale is r = .70. Cronbach's alpha coefficient for internal consistency of the total scale is .86 and that of the factors ranged from .750 to .661 (only factor 6 .497). 4. In additional analysis of the Exercise of Self-Care Agency Scale in relationship to Multiple Health Locus of Control, Family Environmental Scale, and Cornell Medical Index using stepwise multiple regression, the Internal Health Locus of Control Score predicted 21.8%(F = 53.34, P = .0001), Family Environmental Score 8.3%(F = 22.59, P = .0001), Modified Cornell Medical Index Score 5.4%(F = 15.74, P = .0001) of the score of the E.S.C.A.
2584543	This cross-cultural study attempted to replicate the nursing phenomena of self-care and self-concept using two self-reporting instruments. Both instruments were translated from English into Swedish and administered on a convenience basis to 187 Swedish subjects, 117 women and 70 men, ages 19-66, compulsory to university educated, and residing in the southern districts of Sweden. Swedish mean self-care scores were lower (112.5) than the United States normative group of university nursing and psychology students, but the mean was comparable to East German (113.6) reported from an earlier study. Self-concept scores were similar to Nebraska teachers and East Germans. Alpha coefficients were used to assess reliability, ANOVA for differences, and item correlation of self-care agency were organized by factor analysis with four subfactors identified. The derived subscales appeared to identify potentially useful factors to aid in unravelling the complexity of the self-care agency construct. Study limitations were addressed. Cross-cultural directives for international nursing are discussed.
2506797	This article traces the interactive process between theory and research as it has been used to clarify the concept of self-care agency, a key concept in Orem's model of nursing. Theoretical constructions of self-care agency that have emerged in the work of Orem and the Nursing Development Conference Group are reviewed. Operational measures of self-care agency are described, particularly with regard to their underlying theoretical formulations. Factorial structures for some self-care agency instruments are related to the components of self-care agency in Orem's most recent conceptualization. Dimensions of self-care agency that are consistently supported by research studies of this phenomenon are identified.

2756503	After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals.
2911507	Two theoretical models, grief and learned helplessness, were compared for relative explanatory applicability for responses of women to battering. Ninety-seven battered women were compared with 96 nonbattered women who were also having serious problems in an intimate relationship with a man. The two groups were similar on the majority of model variables, including self-esteem (TSCS), self-care agency (DSCAI), self-blame, depression (BDI), and control in the relationship. Both groups scored significantly below normative groups in self-esteem. The battered women had more frequent and severe physical symptoms of stress and grief and had thought of or tried more solutions to the relationship problems. Both models had significant explanatory power, especially for battered women, and were equally applicable for formulating theory and nursing care interventions.A pilot study was conducted, using in-depth interviews with 97 battered and 96 nonbattered women, to compare the two theoretical models, grief, and learned helplessness for the relative explanatory applicability to women's response to battering.  Demographic and five model variables, including the Tennessee Self-Concept Scale (TSCS), Beck Depression Inventory (BDI), Denyes Self-Care Agency Instrument (DSCAI), Blame Operationalization, and Conflict Tactics Scale were analyzed using the t-test and chi-square.  Findings revealed that the two groups (battered and nonbattered) were similar on the majority of model variables, including self-esteem for TSCS, self-care agency for DSCAI, self-blame, depression for BDI, and control in the relationship.  Both groups scored significantly below the established norms for the TSCS.  The battered women had more frequent and severe physical symptoms of stress and grief and had thought of or tried more solutions to the relationship problems.  Models, grief, and learned helplessness had a significant explanatory power, especially for battered women, and were equally applicable for formulating theory and nursing care interventions.	
2744971	The aim of this paper is to explore the concept of referral as it emerged from an in-depth qualitative study of health visiting practice. The study was conducted using a grounded theory approach to data collection and analysis (Glaser and Strauss, 1967). Forty-five experienced health visitors were interviewed using a semi-structured interview guide. The interviews were tape recorded and later transcribed. A detailed analysis is presented of the processes involved in referring. This includes working up the client for referral, working up the agency, third party referrals, and issues of control in the referral process. The outcome of referral in terms of the effect on the client is also discussed. This paper makes a contribution to our understanding of the microprocesses in everyday health visiting practice.
3406464	The aim of this investigation was to delineate the concepts contributing to the Exercise of Self-Care Agency (ESCA) scale developed by Kearney and Fleischer (1979) and to test its construct and discriminant validity. Using factor analytic techniques upon data generated by 506 subjects, the concepts of Self-Concept, Initiative and Responsibility, Knowledge and Information Seeking, and Passivity emerged. These findings are congruent with the theoretical work of the Nursing Conference Development Group (1973) and Kearney and Fleischer. The factors were found to discriminate these concepts among 3 different samples. Recommendations are made for revision, further research, and use of the instrument in practice.
3417926	Although a mother's perception of her competence in problem-solving issues of infant care may affect her sensitivity to her infant's cues, little is known about factors that contribute to this perception. This study explored the type of information on which maternal confidence is based and examined its relationship to perceived competence in problem-solving issues of infant care. The 49 mothers of healthy newborns who participated in this study were interviewed 30 and 90 days after the infant's birth to learn about sources of confidence or uncertainty. The interview protocol also included scaled items to assess perceived problem-solving competence. The infant's mood was most frequently reported as either a source of confidence or uncertainty at both 30 and 90 days. The infant's response to care as a source of confidence or uncertainty was positively related to perceived competence, suggesting that strengthening mothers' attention to this source of information about their performance may be clinically useful. Direct study of the type of information used to evaluate competence in problem-solving is recommended, since it may differ from the type of information on which mothers base their confidence in caring for their infants.
3398037	Twelve people with a mild mental handicap, their mothers and members of staff of Adult Training Centres were interviewed to explore their views on the subjects of stigma and handicap, and to establish the facts about the social life and autonomy of people with a mental handicap. It was found that all participants with a mental handicap were aware of the stigma attached to them. A minority of three conceived of themselves as 'essentially different' from non-handicapped people, while the majority of nine conceived of themselves as 'essentially the same'. In contrast, the majority of mothers viewed their sons and daughters as 'essentially different' from non-handicapped people. These findings do not support the claim of the social constructionist theory of the self that people's self-concepts are primarily determined by the ways in which they are treated by the significant others. Rather, people with a mental handicap are aware of their own agency and clearly express their socio-emotional needs.
3215721	Dreams are defined as a religion of the mind in the sense that they can re-ligare--i.e. unite in a complex relationship--the components involved in the construction of the mind and its representation. The paper discusses the processes of splitting and projective identification which are manifested in dreams and appear to be essential for the transformation of emotional experiences, the acquisition of knowledge and mental growth. On the basis of clinical findings, a revision of Freud's theory of dreams is proposed: the concept of an internal world dominated by good and bad parent figures suggests a theological function for dreams connected with a state of necessity. Dreams represent a real experience which, in analysis, becomes a representation of the internal organization in its immediate present. For this reason, work on dreams makes it possible to acquire knowledge of one's internal objects and of their relationship with the Self. The work on the internal world offered by dreams is made possible by the recovery of memory, the agency responsible for a fusion between current reality and that of infancy as reactivated in the transference. Finally, some aspects of the processes active in dreams are discussed, which make them similar to poetic texts.
3671128	The psychometric properties of Bickel and Hanson's Perceived Self-Care Agency Questionnaire (PSCAQ) (Hanson, 1981) were examined using a LISREL confirmatory factor analysis approach. Questionnaires were distributed to a convenience sample of 575 noninstitutionalized adults in northwestern Ohio; 462 questionnaires (80%) were returned. Findings indicated that the factor structure of the PSCAQ is significantly different from that described by Bickel (1982) and does not appear to conform to the expected self-care power component structure. These findings call into question the construct validity of the PSCAQ as a measure of self-care agency in non-institutionalized adults. It should be used only with extreme caution, if at all, for testing the self-care deficit theory.
3646268	The purpose of this empirical investigation was replication for comparing self-care phenomena in a cross-cultural setting. Two self-reporting inventories were employed to measure perceptual dimensions of self-care agency and self-concept. Both inventories were translated into German and administered to a convenience sample of 17 adults living in an agricultural collective in East Germany. One research concern was the usability of American-constructed nursing assessment tools in another culture. Other research questions for cross-cultural comparisons of means were formulated. Self-care and self-concept were related in the East German sample. Self-care agency means for the East German sample were lower than for an American student sample. Study limitations are identified and cross-cultural implications of the findings for nursing are discussed.
3649524	The purpose of this study was to determine whether there is a relationship between autonomy and either self-care agency or locus of control in a sample of school-age children. It was hypothesized that there would be a positive relationship between autonomy and both self-care agency and internal locus of control, and that increases in autonomy would be accompanied by increases in the other two variables. A sample of 92 fifth grade subjects was pretested and randomly assigned to one of four groups. Subjects then participated in six 1-hour learning sessions, followed by posttesting. Results demonstrated a positive relationship between autonomy and self-care agency and mixed findings for autonomy and internal locus of control in children. Additionally, as children's autonomy increased, their self-care agency increased; however, their internal locus of control did not. It was concluded that the methods used in this study to promote children's autonomy promoted their self-care agency but not their internal locus of control.
3735362	This paper concerns those patients whose brain is irreversibly damaged to the point where they will never recover significant mental life. I examine the reasons which justify the decision to withhold or discontinue active medical intervention in these patients. They involve the identity, quality of life and agency of those beings whom we value as persons.Gillett, a fellow in neurosurgery and in philosophy, presents a rationale for the abandonment of active medical intervention in cases of severe brain damage.  His argument is based--not on consequential calculations or on social utility--but on the concept of personhood, as embodied in personal identity, quality of life, and responsibility for self.  He maintains that, when the individual can no longer develop and express personality, pursue personal projects, show awareness and appreciation of life, and be morally responsible for his life and actions, then the person in an ethical sense is no longer alive.  What remains is a body in which the former patient has no further interest.	
3722702	There is a place for the theory of the self in psychoanalysis. To justify that claim, I return to an era in the development of psychoanalytic thinking about the self that preceded Kohut's formulations and that has set itself on a course of evolving a concept of the self more congruent with extant structural theory. I try to articulate the potential role of such a self-concept in connection with the issues of personal agency and subjectivity, complex personal qualities, areas of the complex interaction and integration of intrapsychic structures, object relations, narcissism, and internalization. The intent of this discussion is to facilitate the further development and articulation of the psychoanalytic theory of the self, particularly in terms of its integration with structural theory, to promote clearer thinking and more effective clinical efforts.
6744978	A survey of a small sample of adults who grew up in long-term foster care under the supervision of an agency that provided supportive counseling shows that the experience of "impermanence" did not impair their abilities to lead independent, outwardly satisfactory lives but left them at risk of an impaired self-image from the deeply felt stigma of foster care, a difficulty in establishing emotional intimacy, and an unresolved sense of loss.
6482433	The lives of men convicted for driving while intoxicated (DWI) were compared with those of other men who spent their childhoods in the same neighborhoods. The comparisons were based on interviews, questionnaires and agency records. Although not distinguishable by their age at first conviction, the men convicted for DWI were more likely to have been convicted for serious crimes. They were also more likely to be alcoholics. As children, they were less likely to have appeared to be insecure or dependent. During adolescence, those who would later be convicted for DWI were more likely to have parents who were inconsiderate and aggressive, and who fought with one another. The men convicted for drunken driving seemed independent and relatively self-confident, both during early childhood and in middle age. Their history of antisocial behavior belies a view that these men have inadvertently risked the safety of others during an unaccustomed lapse in self-control.
6686479	The community is faced with an increasing number of children suffering from social and emotional difficulties. As all children attend school, this is a highly suitable place to examine possible means of identifying and helping children suffering from social and emotional difficulties. For the last 20 years most schools have lagged in their adjustment to the full range of needs of students. They act as a censurer by: domination of academic requirements causing many to fail; failure to meet the expressed needs of children; inadequate teacher training; too little help given to children and often too late; uncoordinated assistance within the school or with community agencies; and by not reducing peer abuse. The school can play a significant role in child development, but for the child with adjustment difficulties coherent assistance is rarely offered. The school can liberate by: recognition of the needs of non-academic children; recognition of the affective needs of all; providing affective training for selected teachers; giving appropriate curriculum time for a programme in personal growth and social relationships; by developing a multidisciplinary community agency which interacts with the school. A model is proposed outlining how effective intervention will break and prevent the cycle of abusive behaviour. This programme proceeds sequentially through each grade. Basically it is one of effective student group interaction in the presence of a specially selected and trained group leader. Such a programme contributes to change in school philosophy, and increases the possibility of the child becoming a more adequate adult/parent.(ABSTRACT TRUNCATED AT 250 WORDS)
7153504	In this study, the acculturative stress experienced by Puerto Rican migrants to the urban U.S. is examined. Acculturative stress is defined as length of residence in a novel cultural environment while lacking psychosocial resources to support adaptation to that environment. In a sample of 67 patients seen in a public health nursing agency, it was found that acculturative stress was associated with poorer health status, more behavioral problems, and higher levels of ethnomedical belief. The implications of these results for research on stress and adaptation are discussed.
7129769	Freud maintained that the Oedipus complex as a development landmark could be conceptualized as taking place only at the time of the phallic phase. Freud's theory is that it is the culmination of a very long process whose primary result, in developmental terms, was that the ego now had to act as an organizing and unifying agent of all of one's past, while at the same time adding a new agency of the mind which he called the superego. With the resolution of the Oedipus complex, infantile sexuality would begin to be left behind. Since Freud, there have been a number of developments and controversies related to the Oedipus complex. The confusion which has arisen is that some of us use the insights we have gained about pre-oedipal life as themselves holding the answers to many of the psychopathologies we meet with clinically. My own view is that unless these insights about pre-oedipal life become part of a development framework, culminating in the Oedipus complex and, through its resolution, in the internalization of the superego, then we miss something which is fundamental in our understanding and in our efforts to undo psychopathology. For Freud, the relationship between sexuality and the Oedipus complex was inseparable. The assumption I put forward about the Oedipus complex is that the image of one's own body which has been organized by the end of the phallic-oedipal period determines the form of the oedipal resolution, and remains central to one's later sexual life and psychopathology. If, in our clinical work, we avoid the meaning of genital sexuality and the meaning of the sexual body image, but interpret mainly those aspects of the patient's life which are pre-oedipal (and therefore non-incestuous), then we lose the chance of creating the possibility of the patient having an active relationship to his sexual/genital body, and the patient loses the chance of ever feeling himself to be the owner of his own sexuality.
7302040	"Self" as an isolated term is an abstraction. The concept of self, on the other hand, is an important component of psychoanalytic psychology. Does the designation of "self" as a superordinate agency add to our understanding? This paper considers the relation of the concept of self to the structural theory. In both theory and clinical practice the concept of self is prominently associated with the concepts of identity and narcissism. The latter are discussed briefly. Illustrative cases are included.
12264160	The National Population Family Planning Outreach Project was launched in mid-1977 in all of the provinces and cities of the Philippines.  The program's objectives are the following:  1) to shift from the predominantly clinic-oriented program to a community-based program through the nationwide deployment of full-time outreach workers (FTOWs) and the establishment of a network of Barangay Service Point Officers (BSPOs); 2) to shift from a largely physician centered approach to a wider base of service providers; 3) to decentralize program implementation and to integrate the population program into local government structure and activities; 4) to change from a largely contraceptive-oriented program to an integrated family welfare-oriented approach; and 5) to achieve self-reliance through partnership between the U.S. Agency for International Development (USAID), the national government, and the local government.  As of June 1981, a total of 2800 FTOWs and supervisors were deployed nationwide and backed up by a grassroot network of about 46,000 volunteer BSPOs.  An impact assessment, conducted in 1980, revealed the following:  1) outreach program variables had a significant impact on contraceptive prevalence in the outreach covered areas, independent of other program efforts and of concurrent social change; 2) the rapid growth of prevalence for all methods was due to the rapid increase in the use of less effective methods since the mid-1970s; 3) in outreach covered areas, the community outreach survey revealed higher prevalence rates than those revealed by the 1978 Republic of the Philippines Fertility Survey or by the Area Fertility Survey--an overall prevalence rate of 48%, 11 points higher than the 1978 Republic of the Philippines Fertility Survey.  The bulk of the difference was due to the high rate of contraceptive prevalence for less effective methods especially withdrawal, abstinence, and combinations.  Possible explanations for high rates of less effective methods are included.  There was substantial decline in family size preferences, particularly among women with 3 or more children.  Evaluation of recent fertility data that are available extending back as far as a decade suggest that the crude birth rate fell by 1 point a year and the total fertility rate about 2% a year.  On the whole, the outreach program has been pronounced a fundamentally sound concept and a solid basis for future program implementation.
7425096	Psychological reactions of childless couples applying to an adoption agency are examined. Infertility can be a developmental life crisis and may be experienced as a narcissistic trauma, resolution of which depends upon individual character structure. Intrapsychic tasks include acceptance and working though of grief for the loss of the self-ideal, restitution of body-image deficiency, and assessment of the importance of parenthood as a developmental phase. An adaptive resolution is seen as a necessary condition for successful adoptive parenting.
10249056	This is a report of an evaluation of citizen board functioning in an eighty-county region. Included in the study were seven county mental health boards, four state hospital boards, one community mental health center and four metropolitan catchment area boards. Board effectiveness criteria (knowledge of mental health legislation, policy-making effectiveness, knowledge of the community and agency procedures, organizational effectiveness) are related to demographic and ideological profiles for each board. Board effectiveness was measured by the Self-Diagnosis Guidelines (Institute for Voluntary Organizations, 1977). Board ideology was assessed with the Community Mental Health Ideology Scale (Baker & Schulberg, 1969). Results indicated that: (1) boards were generally not representative of their communities; (2) most boards saw themselves as only marginally effective; (3) the low self-ratings of boards were due to deficiencies in crucial areas of board responsibility; (4) there were significant differences in effectiveness among boards; and (5) board members reported less support for community mental health philosophy than some professional groups. Implications of the findings for mental health policy and legislation were drawn.
456088	A project at Fort Riley, Kansas, combining military, community and private resources, stresses parent education and problems of isolation and self-concept.

134435	(1) The construction and adaptation of dwelling which are supposed to provide a permanent focal point in the lives of the disabled are approved in purely residential areas. (2) Von den verschiedenen Möglichkeiten trägerschaftlicher Zuordnung einer Wohnstätte für Behinderte erscheint der eingetragene Verein als die geeignetste Rechtsform. (3) Wohnstätten mit mindestens sechs Behinderten unterliegen den Bestimmungen des Heimgesetzes (Heimvertrag, Mitwirkung). (4) Wünschenswert wäre es, dass die Bundesanstalt für Arbeit Zuwendungen wenigstens in dem Umfange gewährt, dass auf dem Gebiet des Wohnstättenbaues für Behinderte ausreichende Erfahrungen gesammelt werden können. (5) Die Toleranzbreite des Gesetzgebers in bezug auf sexuelles Verhalten in Wohnstätten etwa für geistig Behinderte ist grösser als vielfach angenommen. (2) Of the various bodies which come in question as a responsible agency for running these dwellings, the registered association seems to have the most appropriate legal form. (3) Dwellings providing accommodation for six and more disabled persons are goverened by the regulations of the Residential Homes Law (home contract, participation). (4) It would be welcome if the Federal Employment Offices were to grant allowances sufficient to permit, at least, the gaining of the necessary experience in this field of building construction. (5) The legislative degree of tolerance with regard to sexual behaviour in dwellings, for instance, as far as the mentally handicapped are concerned, is larger than often thought.
1249413	Two models of the senior center are examined: (1) the social agency model, which views senior centers as programs designed to meet the needs of the elderly and postulates that the poor and the disengaged are the most likely candidates for participation in senior centers; (2) the voluntary organization model, which hypothesizes that the elderly who are more active in voluntary organizations and who manifest strong attachments to the community are also the ones who make use of senior centers. Personal interviews were conducted with a random sample (920 respondents) of 40 elderly men and women in each of 23 New York State communities. The findings support the voluntary organization model: (1) a high score on the Chapin Social Participation Scale is associated with membership in a senior center; (2) a high score on the Community Attachment Scale is associated with membership in a senior center; (3) there is no association between social class and participation in senior centers; and (4) senior center members do not differ from nonmembers in age identification or in a preference for organizations exclusively for the elderly.
1033157	New York City Narcotics Register data were analyzed to determine the consistency of self-reported age of first drug use among multiple reports on a single individual. There were 15,263 individuals with two or more reports between January 1973 and April 1974 which specified age of first drug use. Discrepancies were noted in 68% of cases; in 31% the responses differed by 3 or more years. Even among reports from a single agency, there were discrepancies in 45% of cases. The degree of consistency was only slightly better when the analysis was restricted to subjects 20 years of age and younger. No comparable inconsistency was observed with respect to self-reported year of birth.
991589	The role of the paraprofessional in the delivery of mental health services is often ambiguously defined. Even while performing the specific task of making a referral, the activities of the paraprofessional are subject to controversy. In this study the clients, the agency board members, and the community mental health agency workers all have different expectations of the qualifications, the knowledge, and the activities of the paraprofessional referral worker. It is suggested that the disparate views the participants bring to the referral situation make it unlikely that the paraprofessional will satisfy the expectations of all of them.