Evaluation of a Safe Sleep Training for Home Visitors and Their Clients

Sleep-related deaths are a common preventable cause of death, and such deaths occur disproportionately in families of color. Home visitors provide families with education about infant safe sleep guidelines; however, families face many barriers to engaging in safe sleep practices. This study evaluated the efficacy of a program to train home visitors to talk to clients about infant safe sleep using Motivational Interviewing and cultural sensitivity. We examined the effects of the intervention on home visitors’ (n?=?23) knowledge, MI skill use, and cultural sensitivity using a single group pre-post design. We also examined home visiting clients’ (n?=?78) knowledge, attitudes, and behaviors using a quasi-experimental design. Home visitors were primarily female (97%), had a college degree (86%), and were primarily white (50%) or African American (43%). The home visiting clients were all female and were primarily African American (43%) and Caucasian (36%). Most clients (59%) earned less than 30,000 dollars per year. Home visitors showed significant improvement in MI skill use and cultural sensitivity from pre- to post-test. Regarding client outcomes, our results indicate a significant group by time interaction when predicting changes in client knowledge such that the treatment group showed larger gains than the control group. There were no significant differences between groups when predicting changes in client attitudes or behavior. MI may be an effective technique for home visitors to help increase families’ safe sleep knowledge. Additional research is needed to examine whether such training can translate to changes in families’ safe sleep behavior.

     

Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version

Apathy is a common, disabling neuropsychiatric syndrome that occurs across many brain disorders and may be associated with diminished motivation in behavioural, cognitive, emotional and social domains. Assessment is complicated by the variability of symptoms across apathy domains and self-report from patients, which can be misleading due to their lack of insight. Independent evaluation by clinicians also has limitations though if it has to be performed with limited time. Caregiver reports are a viable alternative, but current assessments for them either do not distinguish between different apathy domains or are interview-based and take long to administer. In this study, we developed a brief caregiver questionnaire version of the recently developed Apathy Motivation Index (AMI), which is a self-report tool. We confirmed three apathy factors in this new caregiver measure (AMI-CG) that were also present in the AMI: Behavioural Activation, Emotional Sensitivity and Social Motivation. Furthermore, we validated the scores against more extensive caregiver interviews using the established Lillle apathy rating scale as well as patient self-reports of apathy, measures of depression, anhedonia, cognition, activities of daily living and caregiver burden across four different neurological conditions: Parkinson's disease, Alzheimer's disease, subjective cognitive impairment and limbic encephalitis. The AMI-CG showed good internal reliability, external validity and diagnostic accuracy. It also uncovered cases of social apathy overlooked by traditional instruments. Crucially, patients who under-rated their apathy compared to informants were more likely to have difficulties performing everyday activities and to be a greater burden to caregivers. The findings provide evidence for a multidimensional conceptualization of apathy and an instrument for efficient detection of apathy based on caregiver reports for use in clinical practice.     

Stigma and the delegitimation experience: An interpretative phenomenological analysis of people living with chronic fatigue syndrome

Individual in-depth interviews with 14 people with chronic fatigue syndrome (CFS) were conducted, focusing on the experience of living with CFS. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Here we present two inter-related themes: “Negotiating a diagnosis” and “Negotiating CFS with loved ones”. Participants reported delay, negotiation and debate over diagnosis: further, they perceived their GPs to be sceptical, disrespectful and to be lacking in knowledge and interpersonal skills. However, participants found delegitimising encounters with their partners more difficult to deal with. Participants viewed such delegitimation as a form of personal rejection; they were hurt by their loved ones’ reactions and subsequently pondered the price of love, respect and friendship. The findings are discussed in relation to extant literature, and recommendations for future research are suggested.     

Partial assessment of technologies

Trade‐Offs: Imperatives of Choice in a High‐Tech World, by Ed Wenk, Baltimore, MD: Johns Hopkins University Press, 1986, 238 pages, hb $20     

Training kindergarten students lockdown drill procedures using behavioral skills training

During situations in which a gunman is present on a school campus, lockdowns are initiated until the threat is removed. However, there are no data demonstrating an effective teaching strategy to increase students’ correct responding during a lockdown. We evaluated the effectiveness of behavioral skills training (BST) to teach three groups of kindergarten students how to respond during lockdown drills. Results showed that participant groups displayed increases in correct steps and decreases in noise levels after BST was implemented; these effects maintained following training.     

Leadership and Organizational Culture: Linking CEO Characteristics to Cultural Values

Purpose  The purpose of this study was to empirically examine organizational culture theorists’ assertions about the linkages between leadership and the cultures that emerge in the organizations they lead. Specific hypotheses were developed and tested regarding relationships between chief executive officers’ (CEO’s) personality traits, and the cultural values that are shared among their organization’s members. Design/Methodology/Approach  Thirty-two CEOs completed measures of the Big-Five personality traits and personal values. A total of 467 employees across the 32 organizations completed a competing values measure of organizational culture. Findings  Results indicate support for several hypothesized relationships between CEO personality and cultural values. Exploratory analyses indicated that several CEO personal values were related to culture values. Implications  Organizations need to seriously consider the “fit” between the current or desired organizational culture and CEO characteristics. Organizations attempting to change fundamental aspects of its functioning may need significant behavioral—or personnel—changes at the top of the organization in order to achieve those changes. Originality/Value  This is the first empirical study to establish a link between specific CEO characteristics and the cultural values of their organizations. This study provides evidence that CEO characteristics are felt throughout the organization by impacting the norms that sanction or discourage member behavior and decision making, and the patterns of behavior and interaction among members.     

What's in a smile?

In positive social contexts, both adults and older infants show more Duchenne smiling (which involves high cheek raising) than non-Duchenne smiling (which does not). This study compared Duchenne and non-Duchenne smiles in early infancy for clues to their emotional significance. Infants (N = 13) from 1 to 6 months of age were videotaped weekly for 5 min in 208 face-to-face interactions with their mothers. Levels of Duchenne and non-Duchenne smiling were correlated within interactive sessions, and the 2 smiles had similar developmental trajectories. Duchenne smiles were typically preceded by non-Duchenne smiles. The results suggest these frequently contrasted types of smiles occur in similar situations and are often different temporal phases of a continuous emotional process. In contrast to adults, infant Duchenne smiles had longer durations than non-Duchenne smiles, suggesting infant smiling does not fit adult models of emotional functioning.     

The effect of normative models on individual and group choice

Studied the effect of a normative model (maximization of expected value) upon group and individual choice. 109 MBA students in a Lain square research design chose between two alternatives differing in expected value and in range of outcomes. Group choices were significantly (p < .05) closer to those predicted by the normative model than were individual choices. This difference was not due only to information about the presence and applicability of the normative model but rather it was due to the persuasiveness of the model in a group as a cogent and correct solution to the choice dilemma. Task instructions emphasizing the rewards from risk taking produced significantly more choices (p < .05) of the riskier alternative, particularly by individuals as opposed to groups, than did instructions emphasizing the penalties of risk taking. ‘Risky’ and ‘conservative’ shifts in choice between groups and individuals were explicable through knowledge of the influence of the normative model in individual and group choice.