An Effectiveness Open Trial of Internet-Delivered Parent Training for Young Children With Conduct Problems Living in Regional and Rural Australia

There is accumulating evidence for the efficacy of online parent management training (PMT) programs to improve conduct problems in young children, and findings have been used to support the potential of online programs to close the research-to-practice gap in underserved rural settings. However, to date, no study has evaluated the effectiveness of online PMT under real-world conditions; that is, delivered by community practitioners as part of services-as-usual to families residing in rural communities. This has resulted in a critical lack of evidence supporting the capacity of online PMT to ameliorate actual geographical disparities in service accessibility. Accordingly, the current study evaluated effectiveness and engagement outcomes of Internet-delivered Parent-Child Interaction Therapy (I-PCIT) delivered from a community-based early childhood clinic to rural consumers. Participants were 27 mothers and their 1.5- to 4-year-old child with conduct problems (M age = 3.02, SD = 0.73) living in regional and rural New South Wales, Australia. Parent-rated and observed child conduct problems and observed parenting behaviors were assessed pre and post I-PCIT, and treatment attrition, parental satisfaction with treatment, and homework compliance provided indicators of treatment engagement. Results of linear mixed and marginal models indicated that I-PCIT produced significant improvements in parent-reported and observed child conduct problems and observed parenting behaviors, with “small” to “very large” effect sizes (ds = 0.3-1.4). Treatment retention was adequate (63%), and treatment-completing parents reported high treatment satisfaction and good homework compliance. Findings provide preliminary evidence for the real world effectiveness of I-PCIT, supporting its capacity to narrow the research-to-practice gap. Findings suggest a role for I-PCIT in a stepped care model of remote treatment for childhood conduct problems in Australia.     

Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES – Australia

Objective: Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management.

Design: Diabetes MILES–Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (age: M = 52.1, SD = 13.9) with type 1 (T1D; n = 680) or type 2 diabetes (T2D; n = 944), who responded to a version of the survey containing key measures.

Main Outcome Measures: self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA_1c, medication/insulin adherence.

Results: We used Preacher and Hayes’ bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes < .06).

Conclusion: Support for mediation was weak, suggesting that relationships amongst these variables are small and that future research might explore other aspects of self-management in diabetes.     

Predispositions to Lymphoma: <Emphasis Type="Italic">A Practical Review for Genetic Counselors</Emphasis>

This review provides a synopsis for genetic counselors of the major concepts of lymphoma predisposition: genomic instability, immune deficiency, inappropriate lymphoproliferation, and chronic antigen stimulation. We discuss syndromes typifying each of these mechanisms. Importantly, our review of the genetic counseling literature reveals sparse discussion of genetically-based immune-mediated lymphoma predisposition, which we address in depth here. We aim to increase awareness among genetic counselors and colleagues in oncology about familial susceptibility and facilitate critical thinking about lymphoma risk assessment. Clinical application of this knowledge is aided by recommendations for collection of personal and family history to guide risk assessment and testing. Lastly, we include a special discussion of genetic counseling issues including perceptions of the context, nature, and magnitude of lymphoma risk, as well as coping with awareness of susceptibility to lymphoma.     

The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors

This study reports the validation of the Hong Kong version of Oxford Cognitive Screen (HK-OCS). Seventy Cantonese-speaking healthy individuals participated to establish normative data and 46 chronic stroke survivors were assessed using the HK-OCS, Albert’s Test of Visual Neglect, short test of gestural production, and Hong Kong version of the following assessments: Western Aphasia Battery, MMSE, MoCA, Modified Barthel Index, and Lawton Instrumental Activities of Daily Living scale. The validity of the HK-OCS was appraised by the difference between the two participant groups. Neurologically unimpaired individuals performed significantly better than stroke survivors on the HK-OCS. Positive and significant correlations found between cognitive subtests in the HK-OCS and related assessments indicated good concurrent validity. Excellent intra-rater and inter-rater reliabilities, fair test–retest reliability, and acceptable internal consistency suggested that the HK-OCS had good reliability. Specific HK-OCS subtests including semantics, episodic memory, number writing, and orientation were the best predictors of functional outcomes.     

Subjective Wellbeing Among Adults with Diabetes: Results from Diabetes MILES—Australia

This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which depression and socio-demographic factors account for subjective wellbeing is investigated. People with type 1 or type 2 diabetes have significantly lower subjective wellbeing compared to the general population, even after controlling for covariates (demographic and socio-economic status, diabetes duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health. These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.     

Worlds within worlds: a strategy for using interpretative phenomenological analysis with focus groups

There is increasing interest in applying interpretative phenomenological analysis (IPA) to focus group data and in developing appropriate strategies for doing so. These strategies should exploit the unique features of focus groups, which provide a rich canvas of experiences not seen in individual interviews, while remaining true to the personal, phenomenological perspective of IPA. We present a four-stage approach with specific group focused analytical strategies: looking for “groupness,” clustering reoccurring group interactions, identifying interactional relationships, and incorporating group elements into an analysis. These stages are illustrated with worked examples developed while working with data from focus groups of women with gynaecological cancer discussing a yoga intervention, and explain how these can enrich our understanding of participants’ lived experiences. This approach demonstrates a suggested framework for developing IPA themes from focus group data by analysing and interpreting the group setting. We discuss links to psychological concepts, potential applications and limitations. This empirically based methodology is presented as a practical guide for other researchers grappling with this type of data.     

Early Verb Learning: How Do Children Learn How to Compare Events?

An important problem verb learners must solve is how to extend verbs. Children could use cross-situational information to guide their extensions; however, comparing events is difficult. In 2 studies, researchers tested whether children benefit from initially seeing a pair of similar events (“progressive alignment”) while learning new verbs and whether this influence changes with age. In Study 1, 2.5- and 3.5-year-old children participated in an interactive task. Children who saw a pair of similar events and then varied events were able to extend verbs at test and differed from a control group; children who saw 2 pairs of varied events did not differ from the control group. In Study 2, events were presented on a monitor. Following the initial pair of events that varied by condition, a Tobii x120 eye tracker recorded 2.5-, 3.5-, and 4.5-year-olds’ fixations to specific elements of events (areas of interest) during the 2nd pair of events, which were the same across conditions. After seeing the pair of events that were highly similar, 2.5-year-olds showed significantly longer fixation durations to agents and to affected objects as compared with the all-varied condition. At test, 3.5-year-olds were able to extend the verb, but only in the progressive alignment condition. These results are important because they show children’s visual attention to relevant elements in dynamic events is influenced by their prior comparison experience, and they show that young children benefit from seeing similar events as they learn to compare events to each other.     

Menopause Symptoms and Attitudes of African American Women: Closing the Knowledge Gap and Expanding Opportunities for Counseling

Menopause, a normal midlife transition for women, remains poorly understood, especially for minority women. A total of 226 African American midlife women completed the Menopause Symptoms List (J. M. Perz, 1997); Menopause Attitude Scale (C. Bowles, 1986); Attitudes Toward Menopause checklist (B. L. Neugarten, V. Wood, R. J. Kraines, & B. Loomes, 1963); and instruments to elicit information about health status, stressful life events, social support, and demographics. The results reveal strengths as well as areas of concern for African American women in responding to normative midlife changes. Implications for counselors are explored.