Maternal Experience with Online Information on Parenting and Infant Care: Qualitative Findings from Quebec,Canada

Journal of Child and Family Studies - Use of online health information is positively associated with citizen knowledge, empowerment, self-care, health outcomes, and quality of life. However, little...     

Conducting a Pragmatic Trial in Integrated Primary Care: Key Decision Points and Considerations

Pragmatic trials testing the effectiveness of interventions under “real world” conditions help bridge the research-to-practice gap. Such trial designs are optimal for studying the impact of implementation efforts, such as the effectiveness of integrated behavioral health clinicians in primary care settings. Formal pragmatic trials conducted in integrated primary care settings are uncommon, making it difficult for researchers to anticipate the potential pitfalls associated with balancing scientific rigor with the demands of routine clinical practice. This paper is based on our experience conducting the first phase of a large, multisite, pragmatic clinical trial evaluating the implementation and effectiveness of behavioral health consultants treating patients with chronic pain using a manualized intervention, brief cognitive behavioral therapy for chronic pain (BCBT-CP). The paper highlights key choice points using the PRagmatic-Explanatory Continuum Indicator Summary (PRECIS-2) tool. We discuss the dilemmas of pragmatic research that we faced and offer recommendations for aspiring integrated primary care pragmatic trialists.

     

Feeling the ease: How the use of oral motor fluency changes in amnesia

The present study examined the evolution observed in amnesic patients’ use of motor fluency when making recognition memory decisions. In this experiment, 9 patients with amnesia and 18 matched controls were presented with two recognition memory tasks composed of 3 types of items: (1) natural words, (2) nonwords difficult to pronounce, and (3) nonwords easy to pronounce, the latter having been shown to be processed in a surprisingly fluent manner as long as participants can articulate them at a subvocal level (i.e., oral motor fluency). Our results provide evidence that the motor-movement manipulation was successful to induce a fluency effect. More specifically, data revealed that both amnesic patients and control participants showed a pattern of response consistent with the use of fluency as a cue to memory for studied items. However, only control participants relied on fluency to increase their rate of “yes” responses for unstudied items. These results suggest that patients with amnesia set a more conservative response criterion before relying on oral motor fluency, showing a pattern consistent with the idea that fluency is only used as a cue to memory when it exceeds a certain threshold. These findings are discussed in terms of adaptative metacognition strategies implemented by amnesic patients to reduce fluency-based memory errors as well as in terms of the variations that seem to occur in these strategies depending on the type of fluency that is experienced.     

Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy.

OBJECTIVE: Evidence indicates that depression is linked to the development and worsening of diabetes, but the mechanisms underlying this link are not well understood. The authors examined the hypothesis that diabetes-related symptoms mediate the effect of both behavioral adherence and body mass index (BMI) on depression. In addition, they examined whether a prior finding that self-efficacy mediates the effect of behavioral adherence and BMI on depression would replicate with a larger sample size (W. P. Sacco, K. J. Wells, C. A. Vaughan, A. Friedman, S. Perez, & R. Morales, 2005). Also, the relative contributions of diabetes-related symptoms and self-efficacy to depression were evaluated. DESIGN AND PARTICIPANTS: Cross-sectional design involving adults diagnosed with Type 2 diabetes (N = 99). MAIN OUTCOME MEASURES: The primary outcome measure was depression (Patient Health Questionnaire: Nine Symptom Depression Checklist). Predictors of depression were diet and exercise adherence (Summary of Diabetes Self-Care Activities Questionnaire), diet and exercise self-efficacy (Multidimensional Diabetes Questionnaire), diabetes symptoms (Diabetes Symptom Checklist), and BMI (based on height and weight data from medical records). RESULTS: Path and mediation analyses indicated that adherence and BMI each contributed to depression indirectly, via their effects on self-efficacy and diabetes-related medical symptoms. CONCLUSION: Results provide evidence consistent with two independent pathways by which BMI and adherence could increase depression in people with Type 2 diabetes. The first pathway indicates that the effects of higher BMI and poor adherence on depression are mediated by lower self-efficacy perceptions. The second pathway indicates that the effect of higher BMI on depression is mediated by increased diabetes symptoms.     

Marital Interactions,Family Intervention,and Disagreements: A Daily Diary Study in a Low‐income Sample

Little research has examined associations between low‐income married couples’ daily interactions and severity of disagreements. Similarly, few researchers have considered how family‐strengthening interventions for low‐income couples may affect the quality of daily interactions and associations between interactions and conflict experiences. This study aims to fill these gaps in the literature by leveraging daily diary data from a random assignment study of a family‐strengthening intervention with low‐income husbands and wives 30 months postenrollment. Married couples randomly assigned to the intervention participated in 10 weeks of relationship education services. Control group couples received no services. Thirty months postrandom assignment, participants reported on the severity of daily marital disagreements over a 15‐day period, as well as their positive and negative emotions during inter‐spousal interactions. Multi‐level models demonstrated associations between reports of emotions in interactions and severity of disagreements. In addition, wives assigned to the family strengthening program reported fewer negative emotions during interactions at follow‐up than wives in the control condition. Finally, negative associations between positive emotions in interactions and severity of disagreements were stronger for wives assigned to the intervention, while positive associations between negative emotions in interactions and severity of disagreements were weaker for wives assigned to the intervention. Implications for future research and intervention development are discussed.     

Justice in migration

The movement of people across borders is one of the most pressing issues of our time. Yet it is still unclear how migration should be regulated to be fair to the sending societies, the host societies and the individual migrant. What is at issue? Are we discussing migration from an ethical or from a political philosophical perspective, or both? Are we discussing migration from a global justice perspective or social justice perspective? Do we consider political legitimacy and democratic self-determination as part of our analysis? How should we balance demands of justice in immigration compared to those of emigration?     

Longitudinal Patterns of Self-Regulation among Ethnic Minority Children Facing Poverty

Early poverty is associated with a cumulative load of family and community risk factors that can impact the development of self-regulatory abilities and result in socio-emotional and achievement gaps which begin early and persist across the lifespan. Ethnic minorities are disproportionately represented among children living in poverty. The longitudinal trajectories of self-regulation are important to understand in this population, in order to best inform prevention efforts. This study examines patterns of self-regulation over time among young, ethnic minority children living in low income, urban households. A stratified, random sample of 555 children, ages 2 to 4 years, (46% Black, 46% Hispanic; 47% female) were followed over three waves (including 1 and 5 year follow-ups). Internalizing and externalizing behaviors at approximately age nine were predicted by children’s early self-regulation. Latent class analyses revealed low, medium, and high levels of self-regulatory abilities at wave 1 (mean age: 2.99, SD?=?.81) and low and high levels, 1 year later (mean age: 4.39 (SD?=?.94). A gender effect was found whereby girls were more likely than boys to be in the high self-regulation class relative to the low at both waves. Using Latent Transition Analysis, distal outcomes were examined approximately 5 years after the initial assessment (mean age: 8.83, SD?=?.93). Children who sustained a higher level of self-regulation over time had the lowest internalizing and externalizing behaviors. Transition to low self-regulation at wave 2, regardless of initial self-regulation status, was related to greater severity of internalizing symptoms. Implications for prevention and future research are discussed.     

The impact of aging on associative memory for preexisting unitized associations

Aging is accompanied by a decline in associative memory that can, however, be attenuated when associations are unitized at encoding, that is, when they form an integrated entity. Unitization is thought to promote familiarity-based recognition memory, which is preserved in aging. We examined whether preexperimentally unitized associations (compound words (CWs)) do indeed reduce age differences in memory, and whether preexperimental unitization promotes familiarity. In Experiment 1, we assessed the memory of 20 young and 20 older participants for compound versus unrelated word pairs using a yes/no recognition test with Remember/Know/Guess judgments. In Experiment 2, we tested 20 young and 20 older participants using the same procedure, except for the use of a two-alternative forced-choice recognition paradigm, which is thought to enhance the contribution of familiarity. The results of both experiments corroborated the greater contribution of familiarity to recognition of unitized associations. In Experiment 1, however, the use of CWs did not attenuate the age-related associative decline. We suggest that preexisting knowledge associated with recombined compounds induced high absolute familiarity and illusory recollection, leading to high false-recognition rates for the older adults. By contrast, the two groups performed similarly across both conditions in Experiment 2. Thus, the forced-choice procedure facilitates the use of familiarity in such a way that it improves older adults’ associative memory to the level of young participants. These results suggest that the modulation of associative memory in aging by preexisting unitization varies according to methodological parameters, such as the nature of the lures and the test format.     

Influence of early experience on processing 2D threatening pictures by European starlings (<Emphasis Type="Italic">Sturnus vulgaris</Emphasis>)

Stimuli such as visual representations of raptors, snakes, or humans are generally assumed to be universally fear-inducing in birds and considered as a product of evolutionary perceptual bias. Both naïve and experienced birds should thus react to such stimuli with fear reactions. However, studies on different species have shown the importance of experience in the development of these fear reactions. We hypothesized that the responses of adult European starlings to fear-inducing visual stimuli may differ according to experience. We compared the reactions of Hand-raised adults with no experience of predators to those of Wild-caught adults, with potentially extensive experience with predators. Three visual stimuli (i.e. human, raptor, snake) were broadcast to 17 birds as 2D pictures (displayed via a LCD screen) with different modalities of presentation: degree of proximity and with or without movement. The results reveal that the birds were particularly sensitive to proximity and movement, with more attention towards moving stimuli and more withdrawal for close stimuli. The human stimulus elicited attention in both the distant and moving modalities but, like the other stimuli, mostly withdrawal when it was close. Developmental experience appeared to influence the emotional level, as the Hand-raised birds reacted strongly to all stimuli and all modalities, contrarily to the WC birds which performed withdrawals almost only for close stimuli and attention to moving stimuli. Stimuli proximity and movement seemed, therefore, relevant features that elicited negative reactions in Wild-caught birds. The Hand-raised birds were equally attentive to both distant and moving stimuli. Thus the young birds showed no real discrimination. Early and later experiences may, therefore, influence birds’ reactions. Starlings may require experience with real threats to develop adaptive responses, i.e. limiting unnecessary loss of energy by fleeing in front of non-dangerous stimuli.