Community and health facility influences on contraceptive method choice in the Eastern Cape, South Africa

CONTEXT: Although a growing number of studies have examined how community factors influence contraceptive use, few have explored how such factors affect method choice. METHODS: Data from the 1998 South Africa Demographic and Health Survey and the 1998 Eastern Cape Facility Survey were used to examine community and health facility influences on the method choices of 1,165 women aged 15-49 who lived in the Eastern Cape. Relative risk ratios from multilevel multinomial models assessed how method choice varied between communities. RESULTS: The likelihood of using the pill or a more permanent method rather than the injection rose with the proportion of women in a community who controlled their earnings (risk ratios, 3.2 and 3.8, respectively). In communities with higher proportions of females with only a primary education, women were less likely to use the pill instead of the injection (0.1). Higher doctor staffing levels were associated with a greater likelihood of using the pill or a more permanent method (1.5 and 1.4), and having more expired methods in stock was associated with increased use of a more permanent method (2.1). Several facility factors were associated with a decreased likelihood of using the pill rather than the injection: higher numbers of community health workers in an area and higher numbers of facility nurses who had received training on HIV/AIDS in the last year (0.9 for each). Yet a substantial amount of variation in method choice was not accounted for by these variables. CONCLUSION: Future research should emphasize the collection of community-level data on structural, behavioral and cultural factors to help explain the variation in method choice between communities.     

AppMonitor: A tool for recording user actions in unmodified Windows applications

This article describes AppMonitor, a Microsoft Windows-based client-side logging tool that records user actions in unmodified Windows applications. AppMonitor allows researchers to gain insights into many facets of interface interaction such as command use frequency, behavioral patterns prior to or following command use, and methods of navigating through systems and data sets. AppMonitor uses the Windows SDK libraries to monitor both low-level interactions, such as "left mouse button pressed" and "Ctrl-F pressed," as well as high-level "logical" actions, such as menu selections and scrollbar manipulations. The events recorded are configurable, allowing researchers to perform broad or targeted studies. No user input is required to manage logging, allowing participants to seamlessly conduct everyday work while their actions are monitored. The system currently supports logging in Microsoft Word and Adobe Reader; however, it could be extended for use with any Microsoft Windows-based application. To support other researchers wishing to create multilevel event loggers, we describe AppMonitor's underlying architecture and implementation, and provide a brief example of the data generated during our 4-month trial with six users.     

The frozen cyborg: A reply to Selinger and Engström

Selinger and Engstrom, A moratorium on cyborgs: Computation, cognition and commerce, 2008 (this issue) urge upon us a moratorium on ‘cyborg discourse’. But the argument underestimates the richness and complexity of our ongoing communal explorations. It leans on a somewhat outdated version of the machine metaphor (exemplified perhaps by a frozen 1970’s Cyborg). The modern cyborg, informed by an evolving computational model of mind, can play a positive role in the critical discussions that Selinger and Engstrom seek.     

Keeping the collectivity in mind?

The key question in this three way debate is the role of the collectivity and of agency. Collins and Shrager debate whether cognitive psychology has, like the sociology of knowledge, always taken the mind to extend beyond the individual. They agree that irrespective of the history, socialization is key to understanding the mind and that this is compatible with Clark’s position; the novelty in Clark’s “extended mind” position appears to be the role of the material rather than the role of other minds. Collins and Clark debate the relationship between self, agency, and the human collectivity. Collins argues that the Clark’s extended mind fails to stress the asymmetry of the relationship between the self and its material “scaffolding.” Clark accepts that there is asymmetry but that an asymmetrical ensemble is sufficient to explain the self. Collins says that we know too little about the material world to pursue such a model to the exclusion of other approaches including that both the collectivity and language have agency. The collectivity must be kept in mind! (Though what follows is a robust exchange of views it is also a cooperative effort, authors communicating “backstage” with each other to try to make the disagreements as clear and to the point as possible.)

Busting Out: Predictive Brains,Embodied Minds,and the Puzzle of the Evidentiary Veil

Biological brains are increasingly cast as ‘prediction machines’: evolved organs whose core operating principle is to learn about the world by trying to predict their own patterns of sensory stimulation. This, some argue, should lead us to embrace a brain‐bound ‘neurocentric’ vision of the mind. The mind, such views suggest, consists entirely in the skull‐bound activity of the predictive brain. In this paper I reject the inference from predictive brains to skull‐bound minds. Predictive brains, I hope to show, can be apt participants in larger cognitive circuits. The path is thus cleared for a new synthesis in which predictive brains act as entry‐points for ‘extended minds’, and embodiment and action contribute constitutively to knowing contact with the world.     

Learning to fear a second-order stimulus following vicarious learning

Vicarious fear learning refers to the acquisition of fear via observation of the fearful responses of others. The present study aims to extend current knowledge by exploring whether second-order vicarious fear learning can be demonstrated in children. That is, whether vicariously learnt fear responses for one stimulus can be elicited in a second stimulus associated with that initial stimulus. Results demonstrated that children's (5–11 years) fear responses for marsupials and caterpillars increased when they were seen with fearful faces compared to no faces. Additionally, the results indicated a second-order effect in which fear-related learning occurred for other animals seen together with the fear-paired animal, even though the animals were never observed with fearful faces themselves. Overall, the findings indicate that for children in this age group vicariously learnt fear-related responses for one stimulus can subsequently be observed for a second stimulus without it being experienced in a fear-related vicarious learning event. These findings may help to explain why some individuals do not recall involvement of a traumatic learning episode in the development of their fear of a specific stimulus.     

Interpretation of Ambiguity in Children: A Prospective Study of Associations With Anxiety and Parental Interpretations

Interpretation of ambiguity is consistently associated with anxiety in children, however, the temporal relationship between interpretation and anxiety remains unclear as do the developmental origins of interpretative biases. This study set out to test a model of the development of interpretative biases in a prospective study of 110 children aged 5–9 years of age. Children and their parents were assessed three times, annually, on measures of anxiety and interpretation of ambiguous scenarios (including, for parents, both their own interpretations and their expectations regarding their child). Three models were constructed to assess associations between parent and child anxiety and threat and distress cognitions and expectancies. The three models were all a reasonable fit of the data, and supported conclusions that: (i) children’s threat and distress cognitions were stable over time and were significantly associated with anxiety, (ii) parents’ threat and distress cognitions and expectancies significantly predicted child threat cognitions at some time points, and (iii) parental anxiety significantly predicted parents cognitions, which predicted parental expectancies at some time points. Parental expectancies were also significantly predicted by child cognitions. The findings varied depending on assessment time point and whether threat or distress cognitions were being considered. The findings support the notion that child and parent cognitive processes, in particular parental expectations, may be a useful target in the treatment or prevention of anxiety disorders in children.