How to Increase Vaccination Acceptance Among Apostolic Communities: Quantitative Results from an Assessment in Three Provinces in Zimbabwe

A worldwide increasing trend toward vaccine hesitancy has been reported. Measles outbreaks in southern Africa in 2009–2010 were linked to objections originating from Apostolic gatherings. Founded in Zimbabwe in the 1950s, the Apostolic church has built up a large number of followers with an estimated 3.5 million in Zimbabwe in 2014. To inform planning of interventions for the 2015 measles–rubella vaccination campaign, we assessed vaccination status and knowledge, attitudes and practices among purposive samples of Apostolic caregivers in three districts each in Harare City, Manicaland and Matabeleland South in Zimbabwe. We conducted structured interviews among 97 caregivers of children aged 9–59 months and collected vaccination status for 126 children. Main Apostolic affiliations were Johanne Marange (53%), Madida (13%) and Gospel of God (11%) with considerable variation across assessment areas. The assessment also showed considerable variation among Apostolic communities in children ever vaccinated (14–100%) and retention of immunization cards (0–83%) of ever vaccinated. Overall retention of immunization cards (12%) and documented vaccination status by card (fully vaccinated = 6%) were low compared to previously reported measures in the general population. Mothers living in monogamous relationships reported over 90% of all DTP-HepB-Hib-3, measles and up to date immunizations during the first life year documented by immunization card. Results revealed opportunities to educate about immunization during utilization of health services other than vaccinations, desire to receive information about vaccinations from health personnel, and willingness to accept vaccinations when offered outside of regular services. Based on the results of the assessment, specific targeted interventions were implemented during the vaccination campaign, including an increased number of advocacy activities by district authorities. Also, health workers offered ways and timing to vaccinate children that catered to the specific situation of Apostolic caregivers, including flexible service provision after hours and outside of health facilities, meeting locations chosen by caregivers, using mobile phones to set up meeting locations, and documentation of vaccination in health facilities if home-based records posed a risk for caregivers. Coverage survey results indicate that considerable progress has been made since 2010 to increase vaccination acceptability among Apostolic communities in Zimbabwe. Further efforts will be needed to vaccinate all Apostolic children during routine and campaign activities in the country, and the results from our assessment can contribute toward this goal.     

Exploring classical conditioning for strengthening the links between semantic and lexical representations in pure anomia: Preliminary findings from a single case study

The same language symptom might arise at different functional loci in people with aphasia. Therefore, it is plausible that different therapeutic interventions should be adopted to approach the same difficulties in different patients. Although this point of view is still widely accepted, recently the focus has shifted from the functional locus of a rehabilitative intervention to the mechanisms of action underlying the relearning process. We maintain that both aspects should be taken into account when programming a rehabilitative intervention; furthermore, investigating relearning mechanisms might shed new light on the functional architecture of the disrupted processes. Here, we investigated, in a single case study, whether classical conditioning was a suitable relearning paradigm for targeting word‐finding difficulties in pure anomia, that is in a patient with an impairment in accessing intact output lexical representations from a spared semantic system. Using a word‐repetition task on picture presentation, we contrasted a condition in which the stimulus onset asynchrony between word and picture stimuli was well suited to produce classical conditioning with a condition in which repetition training could not benefit from this learning mechanism. Only classical conditioning training exerted a significant, long‐lasting effect on our patient's naming skill. Tentative implications of our results for the functional architecture of single‐word processing are discussed.     

HIV/AIDS and Psychosis: Needs,Challenges, and Support of Affected Mothers

Little is known about parenting in the context of HIV and psychosis, two co-existing conditions affecting many mothers in South Africa. In this study a mixed methods approach was used to firstly do qualitative investigation of the illness and parenting experiences of a case group of mothers living with HIV/AIDS and psychosis (n?=?41). Secondly, the support networks of this group are compared with a control group of mothers with HIV/AIDS without psychosis (n?=?44). Integrating qualitative and quantitative data highlight the emotional and physical disruption experienced by the case group that contribute to dysfunctional mother–child interactions. This experience may be detrimental to the child’s well-being and formation of attachment relationships. Healthy support networks may buffer these adversities. The availability of support figures is similar between the groups, but the case group has less spousal support. Paranoia associated with the case group predicted fewer support figures, thus emphasizing the vulnerability of this group of mothers and children.     

The influence of culture on disaster mental health and psychosocial support interventions in Southeast Asia

Southeast Asia (SEA), which has borne the brunt of some of the most severe natural disasters in the past decade, has unfortunately, been largely under-represented in the world literature on disaster mental health. This article describes cultural factors that may inform the design and conduct of disaster-related mental health psychosocial support (MHPSS) interventions. Specifically, it discusses cultural nuances in emotional expression, shame, power distance, collectivism, and spiritual beliefs and their implications on providing post-disaster psychosocial interventions. It describes the MHPSS interventions implemented in the region using the Johns Hopkins Perspectives Model of Disaster Mental Health categories of resistance, resilience and recovery. Given the challenges on the delivery of MHPSS, there is a need for evidence-based interventions and to ensure that disaster responders in SEA understand the cultural factors that impact the delivery of MHPSS interventions.     

Right-left prevalence effect with horizontal and vertical effectors

We investigated the right-left prevalence effect in spatial compatibility tasks by assessing subjects' performance on a two-dimensional task in which both the horizontal and vertical spatial dimensions were task relevant. Two experiments were performed, in which stimulus-response mappings were one-dimensional (Experiment 1) and two-dimensional (Experiment 2). The subjects responded by using either horizontal or vertical effectors to stimuli appearing in four possible locations. With the one-dimensional mapping, the spatial compatibility effect was present only in the dimension relevant to the mapping. With the two-dimensional mapping, the horizontal compatibility effect was always present, whereas the vertical compatibility effect was present only when vertical effectors were used. This pattern of results indicates that horizontal coding takes place with either horizontal or vertical effectors, whereas vertical coding takes place only when vertical effectors are used.     

Testing predictions of the interactive activation model in recovery from aphasia after treatment

This paper presents preliminary results of pre- and post-treatment error analysis from an aphasic patient with anomia. The Interactive Activation (IA) model of word production (Dell, Schwartz, Martin, Saffran, & Gagnon, 1997) is utilized to make predictions about the anticipated changes on a picture naming task and to explain emerging patterns. Error patterns are viewed in light of two putative mechanisms within the IA network, connection strength, and rate of decay. The results suggest that while these mechanisms can successfully account for the magnitude and order of specific errors (e.g., predominance of semantic paraphasias and nonwords followed by formal paraphasias under the conditions of weak connections), the treatment may have influenced the occurrence/absence of some error types.     

Preparing for perception and action (I): the role of grouping in the response-cuing paradigm

Human skilled behavior requires preparatory processes that selectively make sensory and motor systems more efficient for perceiving the upcoming stimulus and performing the correct action. We review the literature concerning these preparatory processes as studied by response-cuing paradigm, and propose a model that accounts for the major findings. According to the Grouping Model, advance or precue information directs a dynamic process of subgroup making-that is, a process of stimulus- and response-set reconfiguration-whereby the internal representation of the task is simplified. The Grouping Model assigns a critical role to the unit of selection, with Gestalt factors and interresponse dependencies mediating the formation and strength of stimulus and response subgroups. In a series of five experiments, we manipulated perceptual and motoric grouping factors, and studied their independent and interactive effects on the pattern of precuing benefits. Generally, the results were consistent with the Grouping Model's account of response-cuing effects.