Caring for the Caregiver: Identifying the Needs of Those Called to Care Through Partnerships with Congregations

As the older adult population continues to grow, the prevalence of chronic diseases is also increasing, leading to the need for novel ways of managing this large population of patients. One solution is to focus on informal caregivers. These informal caregivers already make a substantial contribution to our nation’s healthcare finances and patient health outcomes. Caregivers also derive benefits from caring for their family member or friend; however, it is not uncommon for these individuals to experience negative health consequences, or what is often called “burden of care.” Those called to care are not without their own burdens, and they must frequently make significant lifestyle adjustments that impact their own health. Therefore, for caregivers to be effective, caring for the caregivers must be a focus of medicine in the twenty-first century.     

Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study

Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009–2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles–rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.     

Emotional intelligence and job performance: The mediating role of work-family balance

In this study, we examine the dynamics between emotional intelligence, work-family balance, and job performance. A review of the literature to date has shown distinct relationships between emotional intelligence to job performance and work-family balance to job performance. We utilize a sample of 233 respondents to empirically test our set of hypotheses that contend work-family balance mediates the relationship between emotional intelligence and job performance. Our results support these hypotheses. Practical implications and directions for future research are discussed.     

The Spiritual and Theological Challenges of Stillbirth for Bereaved Parents

Journal of Religion and Health - Stillbirth is recognized as one of the most challenging experiences of bereavement raising significant spiritual and theological questions. Semi-structured...     

Accommodating Small Sample Sizes in Three-Level Models When the Third Level is Incidental

Small samples sizes are a pervasive problem when modeling clustered data. In two-level models, this problem has been well studied, and several resources provide guidance for modeling such data. However, a recent review of small-sample clustered data methods has noted that no studies have investigated methods for modeling three-level data with small sample sizes. Furthermore, strategies for two-level models do not necessarily translate to the three-level context. Moreover, three-level models are prone to small samples because the “small sample” designation is primarily based on the sample size of the highest level, and large samples are increasingly difficult to amass as one progresses up a hierarchy. In this study, we focus on the case when the third level is incidental, meaning that the third level is important to consider but there are no explicit research questions at the third level. This study performs a simulation study to examine the performance of seven methods for modeling three-level data with a small sample at the third level. A motivating educational psychology example is also provided to demonstrate how the choice of method can greatly affect results.     

Age slowing down in detection and visual discrimination under varying presentation times

The reaction time has been described as a measure of perception, decision making, and other cognitive processes. The aim of this work is to examine age‐related changes in executive functions in terms of demand load under varying presentation times. Two tasks were employed where a signal detection and a discrimination task were performed by young and older university students. Furthermore, a characterization of the response time distribution by an ex‐Gaussian fit was carried out. The results indicated that the older participants were slower than the younger ones in signal detection and discrimination. Moreover, the differences between both processes for the older participants were higher, and they also showed a higher distribution average except for the lower and higher presentation time. The results suggest a general slowdown in both tasks for age under different presentation times, except for the cases where presentation times were lower and higher. Moreover, if these parameters are understood to be a reflection of executive functions, these findings are consistent with the common view that age‐related cognitive deficits show a decline in this function.     

Differences in alexithymia and emotional awareness in exhaustion syndrome and chronic fatigue syndrome

Symptoms of Exhaustion Syndrome (ES) and Chronic Fatigue Syndrome (CFS) are overlapping and create difficulties of differential diagnosis. Empirical studies comparing ES and CFS are scarce. This study aims to investigate if there are any emotional differences between ES and CFS. This cross‐sectional study compared self‐reported alexithymia and observer‐rated emotional awareness in patients with ES (n = 31), CFS (n = 38) and healthy controls (HC) (n = 30). Self‐reported alexithymia was measured with the Toronto Alexithymia Scale‐20 (TAS‐20) and emotional awareness with an observer‐rated performance test, the Level of Emotional Awareness Scale (LEAS). Additionally, depression and anxiety were scored by the Hospital Anxiety and Depression Scale (HADS). Results show that patients with ES expressed higher self‐reported alexithymia in the TAS‐20 compared to HC, but had similar emotional awareness capacity in the observer‐rated performance test, the LEAS. Patients with CFS expressed more difficulties in identifying emotions compared to HCs, and performed significantly worse in the LEAS‐total and spent more time completing the LEAS as compared to HC. Correlation and multiple regressions analyses revealed that depression and anxiety positively correlated with and explained part of the variances in alexithymia scores, while age and group explained the major part of the variance in LEAS. Findings of this study indicate that emotional status is different in patients with ES and CFS with respect to both self‐reported alexithymia and observer‐rated emotional awareness. Emotional parameters should be approached both in clinical investigation and psychotherapy for patients with ES and CFS.     

Tracking the emergence of memories: A category-learning paradigm to explore schema-driven recognition

Previous research has shown that prior knowledge structures or schemas affect recognition memory. However, since the acquisition of schemas occurs over prolonged periods of time, few paradigms allow the direct manipulation of schema acquisition to study their effect on memory performance. Recently, a number of parallelisms in recognition memory between studies involving schemas and studies involving category learning have been identified. The current paper capitalizes on these findings and offers a novel experimental paradigm that allows manipulation of category learning between individuals to study the effects of schema acquisition on recognition. First, participants learn to categorize computer-generated items whose category-inclusion criteria differ between participants. Next, participants study items that belong to either the learned category, the non-learned category, both, or neither. Finally, participants receive a recognition test that includes old and new items, either from the learned, the non-learned, or neither category. Using variations on this paradigm, four experiments were conducted. The results from the first three studies suggest that learning a category increases hit rates for old category-consistent items and false alarm rates for new category-consistent lures. Absent the category learning, no such effects are evident, even when participants are exposed to the same learning trials as those who learned the categories. The results from the fourth experiment suggest that, at least for false alarm rates, the effects of category learning are not solely attributable to frequency of occurrence of category-consistent items during learning. Implications for recognition memory as well as advantages of the proposed paradigm are discussed.     

Emotion dysregulation and threat-related attention bias variability

Although theory suggests that a bias for attending to threat information (ABT) may be a biobehavioral process underlying the transdiagnostic vulnerability factor of emotion dysregulation, there is a paucity of empirical evidence showing direct associations between emotion dysregulation and ABT. The purpose of the present study was to examine the relation between ABT and emotion dysregulation. Participants (N?=?200) completed a battery of self-report questionnaires and a modified dot-probe task with both neutral and threat stimuli and four stimulus presentation durations. Task response times were used to examine traditionally calculated ABT scores, as well as attention bias variability (ABV). As predicted, those with greater emotion dysregulation exhibited greater ABV. Importantly, emotion dysregulation was not associated with response time variability on trials for which only neutral stimuli were presented, thus increasing confidence that emotion dysregulation-related ABV is specific to the presence of threat stimuli and not merely a function of general variability in response times. Results suggest that those with greater emotion dysregulation exhibit attentional dyscontrol in the presence of perceived threat that is characterized by dynamic shifts between vigilance and avoidance.