Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

From intentions via planning and behavior to physical exercise habits

ObjectivesIndividuals who enact a health behavior effortlessly with minimal conscious deliberation can be assumed to have formed a healthy habit. This can be reflected by increases in self-reported habit strength of a behavior. We examined whether physical exercise intentions facilitate changes in exercise habit strength by increasing the use of action planning and exercise.DesignTwo field studies investigated the effect of behavioral intentions on changes in habit strength through a sequential path from action planning to exercise.MethodExercise intentions, action planning, habit strength, and exercise were assessed at two measurement points in time in 231 university students (Study 1), and at four points in time in 134 rehabilitation patients (Study 2).ResultsIn multiple-step mediation models in both samples, there were indirect effects of intentions on habit strength through action planning and behavior.ConclusionAction planning and behavior operated as sequential mediators to bridge the gap between intentions and habit strength. Exercise habit strength may increase as a result of conscious action planning and frequent behavior enactment. Including these constructs jointly into behavior change models may improve the understanding of the mechanisms involved in behavior maintenance.     

Gender differences in emotion recognition: Impact of sensory modality and emotional category

Results from studies on gender differences in emotion recognition vary, depending on the types of emotion and the sensory modalities used for stimulus presentation. This makes comparability between different studies problematic. This study investigated emotion recognition of healthy participants (N = 84; 40 males; ages 20 to 70 years), using dynamic stimuli, displayed by two genders in three different sensory modalities (auditory, visual, audio-visual) and five emotional categories. The participants were asked to categorise the stimuli on the basis of their nonverbal emotional content (happy, alluring, neutral, angry, and disgusted). Hit rates and category selection biases were analysed. Women were found to be more accurate in recognition of emotional prosody. This effect was partially mediated by hearing loss for the frequency of 8,000 Hz. Moreover, there was a gender-specific selection bias for alluring stimuli: Men, as compared to women, chose “alluring” more often when a stimulus was presented by a woman as compared to a man.     

‘Sticking to a healthy diet is easier for me when I exercise regularly’: Cognitive transfer between physical exercise and healthy nutrition

Objective: Long-term rehabilitation success depends on regular exercise and healthy nutrition. The present study introduces a new framework to explain this association on a psychosocial level. The exercise–nutrition relationship was investigated by exploring the sequential mediation of habit strength and transfer cognitions.

Design: Analyses were performed at two measurement points in time (at 12 and 18?months after rehabilitation), involving 470 medical rehabilitation patients who participated in an exercise intervention.

Main outcome measures: Patients filled in paper-pencil questionnaires assessing exercise (t1) and habit strength, transfer cognitions and healthy nutrition at follow-up (t2).

Results: Habit strength and transfer cognitions mediated the relationship between exercise and nutrition.

Conclusion: Findings suggest that habit strength and transfer cognitions are important factors underlying the relationship between exercise and nutrition.     

Cross-National Replication of the Gender Identity Interview for Children

We administered the Gender Identity Interview for Children, a 12-item child-informant measure, to children referred clinically for gender identity problems in Toronto, Ontario, Canada (N = 329) and Amsterdam, The Netherlands (N = 228) and 173 control children. Confirmatory factor analysis identified a Cognitive Gender Confusion factor (4 items) and an Affective Gender Confusion factor (8 items). Patients from both clinics had a significantly higher deviant total score than the controls, and the Dutch patients had a significantly higher deviant score than the Toronto patients. In this cross-national study, we are the first to report on the validity of this measure to discriminate children with gender identity disorder from controls outside of North America.     

“I Should not Forget the Apples!”—Mind‐Wandering Episodes Used as Opportunities for Rehearsal in an Interrupted Recall Paradigm

Mind‐wandering is mostly studied for its negative effects on ongoing cognitive tasks but may be also of adaptive value. We tested the idea of mind‐wandering providing opportunities for rehearsal by asking participants to study 20 grocery items for a recall test. After cued recall of 10 items, participants were either told that the recall task was finished or that it was interrupted for another task. All participants then performed a two‐back task during which thought contents were repeatedly probed. Cued recall of the remaining items was better in the interrupted than in the finished condition, and this effect was accompanied by a more efficient rehearsal strategy: Participants' thought‐reports in the interrupted condition revealed a stronger and more persistent engagement in shopping‐task‐related thoughts. Activating a relevant goal led to mind‐wandering episodes being persistently used as opportunities for rehearsal revealing participants' adaptive usage of off‐task thoughts.Copyright © 2017 John Wiley & Sons, Ltd.     

Evaluating Treatments for Functionally Equivalent Problem Behavior Maintained by Adult Compliance with Mands During Interactive Play

A primary goal of behavioral interventions is to reduce dangerous or inappropriate behavior and to generalize treatment effects across various settings. However, there is a lack of research evaluating generalization of treatment effects while individuals with functionally equivalent problem behavior interact with each other. For the current study, the severe problem behavior of two participants with developmental disabilities was targeted for assessment and treatment. Results of a functional analysis indicated that for both participants, problem behaviors occurred when destructive behavior produced reinforcement of participant mands . The use of a multiple schedule that alternated between differential reinforcement of other behaviors and differential reinforcement of alternative behavior (mands) was sufficient to produce a significant reduction in problem behavior for one participant; the addition of differential reinforcement of alternative behaviors via compliance was necessary for the second participant. Extended treatment sessions, which focused on interaction between the two participants, involved one therapist concurrently implementing each participant’s treatment while they were directed to play with one another (a situation that previously evoked problem behavior). Results show that each participant’s treatment produced low to zero rates of problem behavior even during extended interactions.     

Hair cortisol in relation to acute and post-traumatic stress symptoms in children and adolescents

Background: We report on the preliminary results of two independent studies that (1) compare the hair cortisol concentrations (HCC) of healthy controls with patients displaying post-traumatic stress symptoms (PTSS, study 1+2), (2) investigate whether pre-trauma HCC are predictive for the development of acute stress symptoms (ASS) and PTSS (study 1) and (3) determine whether HCC correlate with PTSS in a clinical sample of children (study 2).

Methods: In study 1, the clinical symptoms of 35 minors were examined one (T1) and seven weeks (T2) after surgery following an accident. Hair samples were taken after the accident that reflect cortisol secretion over the past three months before the accident (healthy controls). In study 2, HCC and PTSS symptoms were cross-sectionally assessed in 22 minors who had experienced a psychological trauma.

Results: The HCC of patients with PTSS were lower than the HCC of healthy controls (study 1+2). Secondary analyses showed that HCC were significantly lower in male PTSS patients than in male healthy controls, whereas the HCC in females were comparably low in both groups. Pre-trauma HCC did not predict the total ASS and PTSS scores (study 1) and HCC were not directly related to the total PTSS scores (study 2).     

Changing caring behaviours in rehabilitation after a hip fracture – A tool for empowerment?

Different rehabilitation programs after surgery have been presented to improve the outcome for patients with a hip fracture. Empowerment has been suggested as useful, but requires a change in the caring behaviours of health professionals. The aim with this study was to evaluate if training and supervision of the nursing staff could alter caring behaviours. A case-control study of nursing staff treating hip fracture patients was performed at a hospital with two sites. Training and supervision was given to the nursing staff at the intervention site. The intervention focused on creating positive care interaction by using eight guidelines. The evaluation was performed with recordings of a constructed caring situation before training, and observations of care situations at the ward before and after intervention. The results showed no differences at baseline between the two sites in the caring behaviours. After intervention, significant effects of caring behaviours were seen in seven out of eight guidelines, the effect sizes ranged from medium to large. The findings indicate that the nursing staff can change caring behaviours and facilitate the empowerment of patients with a hip fracture.