Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.     

Relating familiarity-based recognition and the tip-of-the-tongue phenomenon: Detecting a word’s recency in the absence of access to the word

After viewing a list of single-word answers to general knowledge questions, participants received a test list containing general knowledge questions, some of whose answers were studied, and some of whose were not. Regardless of whether participants could provide the answer to a test question, they rated the likelihood that the answer had been studied. Across three experiments,participants consistently gave higher ratings to unanswerable questions whose answers were studied than to those whose answers were not studied. This discrimination ability persisted in the absence of reported tip-of-the-tongue (TOT) states and when no information about the answer could be articulated. Studying a question's answer did not increase the likelihood of a later TOT state for that question, yet participants gave higher recognition ratings when in a TOT state than when not in a TOT state. A possible theoretical mechanism for the present pattern is discussed, as are relevant theories of familiarity-based recognition and of the TOT phenomenon.     

Consultation-based Academic Interventions for Children with ADHD: Effects on Reading and Mathematics Achievement

The purpose of this investigation was to evaluate the relative efficacy of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention-deficit/hyperactivity disorder (ADHD). Children (N=167) meeting DSM-IV criteria for ADHD were randomly assigned to one of two consultation groups: Individualized Academic Intervention (IAI; interventions designed using a data-based decision-making model that involved ongoing feedback to teachers) and Generic Academic Intervention (GAI; interventions designed based on consultant-teacher collaboration, representing "consultation as usual"). Teachers implemented academic interventions over 15 months. Academic outcomes (e.g., standardized achievement test, and teacher ratings of academic skills) were assessed on four occasions (baseline, 3 months, 12 months, 15 months). Hierarchical linear modeling analyses indicated significant positive growth for 8 of the 14 dependent variables; however, trajectories did not differ significantly across consultation groups. Interventions in the IAI group were delivered with significantly greater integrity; however, groups did not differ with respect to teacher ratings of treatment acceptability. The results of this study provide partial support for the effectiveness of consultation-based academic interventions in enhancing educational functioning in children with ADHD; however, the relative advantages of an individualized model over "consultation as usual" have yet to be established.     

Recognition with and without identification: dissociative effects of meaningful encoding

In a series of four experiments, the effects of levels of processing and generation on the recognition of identified versus unidentified word fragments were examined. After studying a list of words, participants took a word fragment completion test in which half of the fragments came from studied words and half came from nonstudied words. Regardless of whether they could complete a given fragment, the participants were asked to rate the likelihood that it came from a studied word. Recognition of identified fragments was best whenever the focus of the encoding task was on meaning. Recognition of unidentified fragments did not benefit from meaningful encoding in any of the experiments reported here but did benefit from generation. It is suggested that whereas recognition with identification involves the use of meaning, recognition without identification involves the use of abstract orthographic information in memory.     

Patterns of Coping Among Persons with HIV Infection: Configurations, Correlates, and Change

This study examines coping in response to HIV infection, using longitudinal data from a nationally representative sample (n = 2,864) of HIV-infected persons. We investigated configurations of coping responses, the correlates of configuration membership, the stability of coping configurations, and the relationship of coping to emotional well-being. Four coping configurations emerged from cluster analyses: relatively frequent use of blame-withdrawal coping, frequent use of distancing, frequent active-approach coping, and infrequent use of all three coping strategies (passive copers). Passive copers had few symptoms, high levels of physical functioning, and high emotional well-being; blame-withdrawal copers had the opposite pattern. Of those completing a second interview 1 year after baseline, 46% had the same coping configuration. Increases in the number of HIV-related symptoms raised the probability of blame-withdrawal coping at follow-up, whereas decreases raised the probability of passive coping. Infrequent use of coping responses at baseline was related to greater emotional well-being 1 year later. This result, in conjunction with the high levels of emotional well-being in the passive cluster, suggests that high levels of distress can induce blame-withdrawal coping whereas coping efforts are minimal when social support and emotional well-being are high. Results highlight issues in ascertaining the causal direction between coping and psychological outcomes, as well as in specifying the nature of stressful situations with which people are coping.     

Quantitation of contacts among sensory, motor, and serotonergic neurons in the pedal ganglion of aplysia

Present models of long-term sensitization in Aplysia californica indicate that the enhanced behavioral response is due, at least in part, to outgrowth of sensory neurons mediating defensive withdrawal reflexes. Presumably, this outgrowth strengthens pre-existing connections by formation of new synapses with follower neurons. However, the relationship between the number of sensorimotor contacts and the physiological strength of the connection has never been examined in intact ganglia. As a first step in addressing this issue, we used confocal microscopy to examine sites of contact between sensory and motor neurons in naive animals. Our results revealed relatively few contacts between physiologically connected cells. In addition, the number of contact sites was proportional to the amplitude of the EPSP elicited in the follower motor neuron by direct stimulation of the sensory neuron. This is the first time such a correlation has been observed in the central nervous system. Serotonin is the neurotransmitter most closely examined for its role in modulating synaptic strength at the sensorimotor synapse. However, the structural relationship of serotonergic processes and sensorimotor synapses has never been examined. Surprisingly, serotonergic processes usually made contact with sensory and motor neurons at sites located relatively distant from the sensorimotor synapse. This result implies that heterosynaptic regulation is due to nondirected release of serotonin into the neuropil.     

Effects of frontalis tension level on discrimination task accuracy and reaction time

The frontalis muscle is a focal point of many relaxation training programmes, so the effects of varying frontalis tension levels on concurrent task performance need consideration when recommending in situ muscle relaxation. Two experiments are reported; performance on a discrimination task was examined across high, moderate, and low induced frontalis tension. When length of exposure to the task stimuli was unlimited, accuracy of discrimination was affected by tension; when exposure was limited, reaction time was affected. In both experiments the high frontalis tension resulted in better performance than the other levels. Implications for the practice of in situ relaxation are considered.     

Some religious beliefs and behaviours of Australian Catholic school students

Students in Catholic schools make up a significant sub group of the Australian population. As such, studies of this group provide valuable information about the religious beliefs and practices of some Australian youth. Many students in Catholic schools express traditional religious views and have relatively high levels of religious behaviours. Over time these levels diminish but in a fashion that invites careful analysis and comparison with standard theories of secularisation. An important finding suggests that student responses are indicative of a loosening of religious affiliation rather than a complete disengagement. These results suggest a more nuanced view of students in Catholic school be adopted with implication for the conduct of Catholic schools in secular cultural contexts.     

A touch-detecting teaching machine with auditory reinforcement

This teaching machine has been designed and used to train reading and other visual discrimination skills with normal and retarded children. On each frame the subject responds by touching one of three response panels on which are projected the multiple-choice alternatives. The response panels are coated with a transparent conducting film which allows electronic detection of this simple and direct response. Correct responses are reinforced by the machine naming the stimulus, while auditory reinforcement is absent for an incorrect response. The subject's performance level is continuously computed as an exponentially weighted moving average. The measure is weighted so that it rapidly follows recent changes in performance.     

Self-regulation, motivation, and math achievement in middle school: Variations across grade level and math context

The current study examined grade level, achievement group, and math-course-type differences in student self-regulation and motivation in a sample of 880 suburban middle-school students. Analysis of variance was utilized to assess group differences in student self-regulation and motivation, and linear regression analysis was used to identify variables that best predicted students' use of regulatory strategies. A key finding was that although seventh graders exhibited a more maladaptive self-regulation and motivation profile than sixth graders, achievement groups in seventh grade (high, moderate, low) were more clearly differentiated across both self-regulation and motivation than achievement groups in sixth grade. The pattern of achievement group differences also varied across math course type, as self-regulation and motivation processes more consistently differentiated achievement groups in advanced classes than regular math courses. Finally, task interest was shown to be the primary motivational predictor of students' use of regulatory strategies during math learning. The study highlights the importance of identifying shifting student motivation and self-regulation during the early middle school years and the potential role that context may have on these processes.