Modelling elderly patients’ perception of the community pharmacist image when providing professional services*

Professional pharmaceutical services may impact on patient’s health behaviour as well as influence on patients’ perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients’ beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients’ perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients’ HBs to patient’s perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that ‘Perceived benefits’ were significantly associated with ‘Perceived Pharmacist Image’ in the whole sample. Differences were found in the IG with also ‘Self-efficacy’ significantly influencing ‘Perceived pharmacist image’. A model of patients’ HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients’ HBs that in turn influence public perception of the pharmacist.     

Renewed behavior produced by context change and its implications for treatment maintenance: A review

Behavioral treatment gains established in one setting do not always maintain in other settings. The present review examines the relevance of basic and translational research to understanding failures to maintain treatment gains across settings. Specifically, studies of the renewal effect examine how transitioning away from a treatment setting could evoke a return of undesirable behavior, rather than newly trained appropriate behavior. Studies of renewal typically arrange three phases, with a response trained and reinforced under a particular set of contextual stimuli in the first phase. Next, that response is extinguished, often under a different set of contextual stimuli. Finally, that response returns despite extinction remaining in effect upon returning to the original training context or transitioning to a novel context. Thus, removing the extinction context is sufficient to produce a recurrence of the response. The findings suggest treatment effects can become specific to the context in which the treatment was delivered. This literature offers promising methods for systematically assessing the factors contributing to treatment maintenance and improving generalization of treatment gains across contexts. Therefore, the present review suggests basic and translational research on renewal provides an empirical literature to bring greater conceptual systematization to understanding generalization and maintenance of behavioral treatment.     

Integrating fieldwork into employment counseling for methadone‐treatment patients

An innovative employment counseling model, Customized Employment Supports, was developed for methadone‐treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, “vocational fieldwork,” the delivery of services in the community rather than only within the clinic, was assessed through a quasi‐experimental study of the first 55 patients receiving the model in 2 clinics. Employment outcomes after 6 months were compared between patients who received vocational fieldwork (n = 18) and those who did not (n = 37). Logistic regression analysis demonstrated that patients receiving vocational fieldwork had significantly better outcomes for competitive work, informal work, and any paid work.     

The spiritual well-being questionnaire: Testing for model applicability, measurement and structural equivalencies, and latent mean differences across gender

Fisher (1998) proposed a spiritual well-being model, comprising primary factors for the domains of personal, communal, environmental and transcendental well-being, that cohere to form a single higher order or global spiritual well-being dimension. In line with this model, Gomez and Fisher (2003) published the Spiritual Well-Being Questionnaire (SWBQ), with scales for measuring personal, communal, environmental and transcendental spiritual well-being. This study used multi-group confirmatory factor analysis (CFA) to examine gender equivalencies of the measurement and structural models of the SWBQ, and the latent mean in the four SWBQ factors. A total of 3101 females and 1361 males, with age ranging from 15 to 32 years, completed the SWBQ. The statistical fit results supported the invariance of the measurement model, and some aspects of the structural model. The practical fit indices results provided support for the invariance of both the measurement and structural models. The results also showed little gender differences. Together, these findings support gender equivalencies for the SWBQ.     

On the learnability of frequent and infrequent word orders: An artificial language learning study

Most languages have a basic or "canonical" word order, which determines the relative positions of the subject (S), the verb (V), and the object (O) in a typical declarative sentence. The frequency of occurrence of the six possible word orders among world languages is not distributed uniformly. While SVO and SOV represent around 85% of world languages, orders like VSO (9%) or OSV (0.5%) are much less frequent or extremely rare. One possible explanation for this asymmetry is that biological and cognitive constraints for structured sequence processing make some word orders easier to be processed than others. Therefore, the high frequency of these word orders would be related to their higher learnability. The aim of the present study was to compare the learnability of different word orders between groups of adult subjects. Four artificial languages with different word orders were trained: two frequent (SVO, SOV) and two infrequent (VSO, OSV). In a test stage, subjects were asked to discriminate between new correct sentences and syntax or semantic violations. Higher performance rates and faster responses were observed for more frequent word orders. The results support the hypothesis that more frequent word orders are more easily learned.     

Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visualanalogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self-ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as "enmeshed" with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts.     

Item response theory analyses of adult self-ratings of the ADHD symptoms in the Current Symptoms Scale

The graded response model, which is based on item response theory, was used to evaluate the psychometric properties of adult self-ratings (N = 852) of the attention deficit/hyperactivity disorder inattention, hyperactivity, and impulsivity symptoms presented in the Current Symptoms Scale. This scale has four ordered response categories. The results for the discrimination parameters showed that all symptoms were generally good for discriminating their respective latent traits. For virtually all symptoms, their threshold values showed that they were especially good at representing the appropriate traits from around the mean trait level onward. The item information function values for most symptoms indicated reasonable reliability from approximately the mean trait level onward. All these findings are new and extend existing psychometric information for adult self-ratings of the attention deficit/hyperactivity disorder symptoms in the Current Symptoms Scale.     

Interference in visual perception by verbal and spatial cognitive activity

In two experiments we tested the hypothesis that cognitive processing based on spatial imagery produces more deterioration of visual perception than cognitive processing based on verbal codes. So, we studied the effect on visual perception of two cognitive tasks, one of spatial imagery and the other a verbal task. In the first one, with 30 participants, we analyzed the mental load and ocular behaviors in both cognitive tasks. In the second experiment, with 29 participants, we studied the effect of both tasks on a visual search task, using a dual-task experimental paradigm. The verbal task presented higher mental load than the imagery task when both tasks were carried out with visual search task, and there was more deterioration in stimulus detection with the verbal task. We can conclude that: (1) cognitive tasks produce important deterioration in the capacities of visual search and identification of stimuli; (2) this deterioration has two components: (a) an inefficient search, associated with alterations of the gaze patterns while performing cognitive tasks, and (b) a general interference, nonspecific to spatial codes, in the process of identification of looked-at stimuli; (3) this cognitive interference is related to the mental load or effort required by the cognitive task.     

Assessing women's responses to sexual threat: validity of a virtual role-play procedure

This study evaluated the validity of a role-play procedure that uses virtual reality technology to assess women's responses to sexual threat. Forty-eight female undergraduate students were randomly assigned to either a standard, face-to-face role-play (RP) or a virtual role-play (VRP) of a sexually coercive situation. A multimethod assessment strategy was used to evaluate the efficacy of the role-play procedure in creating a realistic and immersive situation. Consistent with our hypotheses, women in the VRP condition exhibited greater negative affect and immersion than women in the RP condition. In addition, the level of assertive refusal in the VRP, but not the RP, condition differentiated between women with and without a prior history of sexual victimization. These findings provide evidence of the validity of a virtual role-play procedure for assessing women's responses in sexually threatening situations.