Counselling in primary care: a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost‐effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non‐specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost‐effectiveness trials are needed together with surveys of more typical users of primary care services.     

Person-environment congruence in relation to career change and career persistence

This study examined Holland’s theoretical proposition, that personality-work environment congruence influences career stability and change, with a sample of 212 career changers (respondents who expressed an intent to change career and had engaged in preliminary career change activity) and 249 career persisters (respondents who indicated an intent to remain in their current career). Independent groups ANCOVA (controlling for age and current career tenure) indicated that career persisters scored higher on congruence than career changers, however, the effect size was within the small to medium range. Repeated-measures ANCOVA indicated, with a medium effect size, that career changers moved towards careers that were more congruent with their personality profiles than their current careers. Practical and theoretical implications are discussed.     

Environmental and Family Associations With Racism1

Environmental and family factors related to racism in college students were investigated. Students (N=114) at a southern liberal‐arts college filled out an extensive survey about childhood activities and family of origin, and 40 of their mothers completed a similar survey. The Attitudes Toward Blacks ( Brigham, 1993 ) scale measured racism. Several hypotheses were supported. Students who exhibited less racism also reported that they made more diverse friends in school, came from a more diverse hometown, had diverse encounters and friendships at an earlier age, and had more positive foreign travel experiences. In addition, more racist students perceived their mothers as being more prejudiced while they were growing up, and they perceived their fathers as being more prejudiced currently. Finally, students judged their mothers as less racist than their fathers, and also reported that their mothers exhibited less racist behaviors than did their fathers. The importance of racially diverse experiences and friendships early in life are discussed as means to decrease racism.     

"If You're Frail You've Had It": A Theory of Planned Behavior Study of Student Nurses' Attitudes Towards Working with Older Patients

Background: The developed world's population is aging but care of older patients is unpopular in nursing.
Objectives: To determine student nurses' attitudes towards working with older patients and analyze underlying factors.
Method: 172 UK student nurses were surveyed using the theory of planned behavior.
Results: Positive intentions were related to attitudes ( p <0.01) and subjective norms ( p <0.05). Three underlying factors, intolerance ( p <0.01), humanism ( p <0.05), and concern about aging ( p <0.01) differentiated more and less positive participants.
Discussion: Results are only partly consistent with previous findings. Future attitudinal research in this area must be more tightly specified to be relevant to health care and should measure actual behavior and employed nurses' views. Nursing curricula should refer to the three relevant factors.     

Line-bisectioning and obstacle avoidance: Evidence for separate strategies

Previous studies have frequently applied a combination of line-bisection tasks (in which participants indicate the middle of a line) and obstacle avoidance tasks (in which participants move their hand between two obstacles) with the aim of revealing perception–action dissociations in certain neurological disorders, such as visual form agnosia and optic ataxia. However, valid conclusions about the underlying processing pathways can only be drawn if participants apply the same strategy in both tasks (i.e. finding the middle between the obstacles). Yet, this assumption has never been tested directly. In this experiment, we investigated whether participants perform obstacle avoidance and line-bisectioning using similar strategies by manipulating the position of the obstacles and the start position of the hand relative to the obstacles. Our results indicate that the lateral hand position during obstacle avoidance does not only vary as a function of obstacle location but also strongly depends on the start position. Moreover, participants showed increased sensitivity to obstacle shifts occurring closer to the hand's start position. In contrast, during line-bisectioning the sensitivity to obstacles shifts was unaffected by the hand's start position. The findings suggest that during obstacle-avoidance the need to keep a safe distance from the obstacles is balanced with the requirement to minimise energetic demands. In contrast, the main intention during line-bisectioning is to move to the perceived midpoint as accurately as possible. The fact that very different constraints underlie trajectory planning in both tasks implies that caution has to be taken when interpreting differences in performance levels.     

18- and 24-month-olds' discrimination of gender-consistent and inconsistent activities

18- and 24-month-olds' ability to discriminate gender-stereotyped activities was assessed. Using a preferential looking paradigm, toddlers viewed male and female actors performing masculine and feminine-stereotyped activities. Consistent with our predictions, and previous research, 24-month-olds, but not 18-month-olds, looked longer at the gender-inconsistent activities than the gender-consistent activities. Results are discussed in terms of toddlers emerging gender stereotypes and perception of everyday events.     

Does mood state change risk taking tendency in older adults?

No study has been conducted to evaluate the influences of age differences on specific moods for risk taking tendencies. This study examined the patterns of risk taking tendencies among younger and older persons in 3 transient affective states: positive, neutral, and negative moods. By means of viewing happy, neutral, or sad movie clips, participants were induced to the respective mood. Risk taking tendencies were measured with decision tasks modified from the Choice Dilemmas Questionnaire (N. Kogan & M. A. Wallach, 1964). Consistent with the affect infusion model (J. P. Forgas, 1995), risk taking tendency was greater for those individuals who were in a happy mood than for those who were in a sad mood, for both young and older participants. However, an asymmetrical effect of positive and negative mood on risk taking tendency was identified among both the young and older participants, but in opposite directions. These results are consistent with the predictions of the negativity bias and the positivity effect found in young and older adults, respectively, and are interpreted via information processing and motivation effects of mood on the decision maker.