Applying the Interactive Systems Framework to the Dissemination and Adoption of National and State Recommendations for Hypertension

The Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention (DHDSP), commissioned an Institute of Medicine (IOM) report to identify the highest priority action areas for CDC, state health departments, and other public health partners in their efforts to reduce and control hypertension. To assess the dissemination and adoption of the IOM report recommendations, DHDSP developed an evaluation based on the Interactive Systems Framework for Dissemination and Implementation (ISF). The evaluation incorporates data collection at critical points across 3 years. In this article, we focus on the ISF systems to describe the role of funded state partners and their relationship with CDC in implementing public health recommendations. We describe baseline results for three data collection activities: (1) key informant interviews, (2) a Web‐based survey, and (3) content analysis of state workplans to determine the degree of alignment with IOM recommendations. For example, currently 30 % of surveyed programs are implementing most (or all) of the recommendations in the IOM report, however 76 % intend to change hypertension program priorities based on the recommendations of the IOM report. Qualitative data suggest that there are several facilitators and barriers in implementing public health policy recommendations. DHDSP will use these baseline results to provide additional technical assistance and support to state health departments in their efforts to implement the IOM report's recommendations. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

The effect of public social context on self-control: depletion for neuroticism and restoration for impression management

The present study explores the role of personality in moderating the effect of public social context on self-control. The authors predicted that in public settings neuroticism would be associated with ego-depletion effects and individual differences in impression management (IM) would be associated with restoration effects. Three experiments supported the hypothesis. In Study 1 neuroticism was associated with impaired self-control and IM was associated with enhanced self-control following an initial phase of working on a simple task in public (vs. in private). Study 2 replicated and extended these results to other domains of self-control. Study 3 explored whether public social context can cancel out early depletion effects. In this study, depleted participants engaged in a task that required self-control either alone or in public. As expected, the public settings were associated with restored self-control resources mostly among high IM individuals. Implications for self-control, neuroticism, and IM are discussed.     

Assessing metacognitive skills in waking and sleep: a psychometric analysis of the Metacognitive, Affective, Cognitive Experience (MACE) questionnaire

The Metacognitive, Affective, Cognitive Experience (MACE) questionnaire was designed to assess metacognition across sleep and waking (Kahan & LaBerge, 1996). The present research evaluates the psychometric properties of the MACE. Data from two recent studies (N=185) were used to assess the inter-item consistency, test-retest reliability, and factorial, convergent, and discriminant validity of the MACE. Results show that the MACE is a reliable measure with good construct validity. Exploratory factor analyses revealed one self-regulation and two monitoring factors. One monitoring factor emphasized monitoring internal conditions; the other emphasized monitoring external conditions. This factor structure is consistent with the Metacognitive Model (Nelson & Narens, 1990). Tests of convergent and discriminant validity suggest that the MACE is assessing metacognition and is appropriately related to similar constructs such as mindfulness and self-consciousness. The implication of these findings as well as suggestions for research and clinical applications of the MACE are discussed.     

Ventromedial prefrontal-subcortical systems and the generation of affective meaning

The ventromedial prefrontal cortex (vmPFC) comprises a set of interconnected regions that integrate information from affective sensory and social cues, long-term memory, and representations of the 'self'. Alhough the vmPFC is implicated in a variety of seemingly disparate processes, these processes are organized around a common theme. The vmPFC is not necessary for affective responses per se, but is critical when affective responses are shaped by conceptual information about specific outcomes. The vmPFC thus functions as a hub that links concepts with brainstem systems capable of coordinating organism-wide emotional behavior, a process we describe in terms of the generation of affective meaning, and which could explain the common role played by the vmPFC in a range of experimental paradigms.     

Distinct Facial Characteristics Differentiate Communicative Intent of Infant‐Directed Speech

Adults and infants can differentiate communicative messages using the nonlinguistic acoustic properties of infant‐directed (ID) speech. Although the distinct prosodic properties of ID speech have been explored extensively, it is currently unknown whether the visual properties of the face during ID speech similarly convey communicative intent and thus represent an additional source of social information for infants during early interactions. To examine whether the dynamic facial movement associated with ID speech confers affective information independent of the acoustic signal, adults' differentiation of the visual properties of speakers' communicative messages was examined in two experiments in which the adults rated silent videos of approving and comforting ID and neutral adult‐directed speech. In Experiment 1, adults differentiated the facial speech groups on ratings of the intended recipient and the speaker's message. In Experiment 2, an original coding scale identified facial characteristics of the speakers. Discriminant correspondence analysis revealed two factors differentiating the facial speech groups on various characteristics. Implications for perception of ID facial movements in relation to speakers' communicative intent are discussed for both typically and atypically developing infants. Copyright © 2012 John Wiley & Sons, Ltd.     

Interocular conflict attracts attention

During binocular rivalry, perception alternates.between dissimilar images presented dichoptically. Since.its discovery, researchers have debated whether the phenomenon is subject to attentional control. While it is now clear that attentional control over binocular rivalry is possible, the opposite is less evident: Is interocular conflict (i.e., the situation leading to binocular rivalry) able to attract attention?In order to answer this question, we used a change blindness paradigm in which observers looked for salient changes in two alternating frames depicting natural scenes. Each frame contained two images: one for the left and one for the right eye. Changes occurring in a single image (monocular) were detected faster than those occurring in both images (binocular). In addition,monocular change detection was also faster than detection in fused versions of the changed and unchanged regions. These results show that interocular conflict is capable of attracting attention, since it guides visual attention toward salient changes that otherwise would remain unnoticed for longer. The results of a second experiment indicated that interocular conflict attracts attention during the first phase of presentation, a phase during which the stimulus is abnormally fused [added].     

The effects of acute exercise on temporal generalization

Sixteen healthy college students performed a multiple-trial referenced temporal generalization task and an episodic temporal generalization task before and during moderate-intensity aerobic exercise. The same tasks were performed in a resting control condition. Working memory tasks were also administered before, during, and after exercise to determine whether exercise affected working memory processes. Temporal generalization gradients demonstrated leftward shifts during exercise when compared to rest, indicating that the subject perceived intervals to elapse more slowly. This finding is consistent with an increased pacemaker speed. Subjective lengthening of stimuli as the task progressed did not occur during exercise or rest. No significant differences were observed on the episodic timing task, nor were any differences found on the working memory tasks. These findings provide support for the notion that exercise influences the internal clock in a manner similar to other arousal-inducing manipulations.     

Waiting Well: Tips for Navigating Painful Uncertainty

Waiting for uncertain news can be a source of anxiety and distraction. This paper explores the experience of waiting for news that is both uncertain and unchangeable and provides tips for waiting well under these circumstances. During difficult waiting periods people can mitigate anxiety, reduce disruptive rumination, and minimize later harm by (1) distracting themselves from their uncertainty, (2) managing their expectations, (3) looking for the silver lining in all outcomes, (4) keeping perspective regarding the news, and (5) planning ahead for the objective and psychological consequences of bad news.     

An update on the Conceptual-Production Systems model of apraxia: evidence from stroke

Limb apraxia is a neurological disorder characterized by an inability to pantomime and/or imitate gestures. It is more commonly observed after left hemisphere damage (LHD), but has also been reported after right hemisphere damage (RHD). The Conceptual-Production Systems model (Roy, 1996) suggests that three systems are involved in the control of purposeful movements: the conceptual, the production and the sensory/perceptual system. Depending on which system is damaged different patterns of apraxia are expressed. To determine the apraxia pattern, pantomime, delayed, and concurrent imitation tasks need to be administered, as well as conceptual tasks assessing one's knowledge of actions. Based on the model, eight patterns of apraxia should emerge. The purpose of this study is to determine whether these patterns are in fact observed in stroke patients and examine their frequency. If the performance of most stroke patients falls into one of the patterns, then we would have strong support for the conceptual-production model. Stroke (34 LHD and 39 RHD) patients and 27 age- and education-matched healthy controls participated in the study. Participants were assessed in four task modalities: pantomime, delayed imitation, concurrent imitation and conceptual knowledge (two tasks were used: tool naming by action and action identification). Patients were categorized as impaired on a task if they scored 2 SD below the mean performance of the controls for gesture production tasks, or below a cut-off score on the conceptual tasks. They were then classified into patterns depending on their performance on the four task modalities. Most patients (86%) fell into one of seven patterns originally predicted from the Conceptual-Production Systems model. The two most common patterns were deficits in pantomime and imitation with preserved gesture recognition and conduction apraxia (selective deficit in imitation). Four new patterns emerged, but mostly single cases of these were found. Overall, the study provides strong support for the Conceptual-Production Systems model.