Community treatment of severe, refractory obsessive-compulsive disorder

Despite the existence of effective psychological and pharmacological interventions for obsessive-compulsive disorder (OCD), there are a large proportion of individuals for whom intervention is not effective. The study reports on the results of a community treatment service for individuals with treatment-refractory OCD who have not benefitted from previous cognitive behavioural or pharmacological treatment by community mental health services. A total of 205 individuals accepted for treatment by a specialist community OCD treatment service in London were provided with a combination of behavioural, cognitive, and pharmacological treatment within a specialist OCD service, with 158 completing treatment. Treatment was associated with significant reduction in clinician-rated and self-reported OCD symptoms after 12 weeks, with further reductions in OCD symptoms over a subsequent 12-week period. A significant reduction in symptoms of depression was also observed after 12 and 24 weeks. Approximately 40% of individuals treated experienced clinically significant improvement in their symptoms, with approximately 10% deemed to have recovered by the end of treatment. Our results add to previous research into refractory OCD, and provide support for the existence of specialist community treatment services which may provide assistance to individuals who have not responded to previous treatment.     

Examining dimensions of vulnerability among children in Uganda

Insufficient data on the nature and extent of children's vulnerability in Uganda has challenged government and donors in priority setting, resource allocation and developing effective approaches to improve well-being. We conducted a population-based survey among a nationally representative sample of 2551 households, covering a total of 7946 children. We engaged national stakeholders in a priority-setting exercise to develop a scoring system to assess dimensions of children's vulnerability. The exercise identified individual and household characteristics to assess vulnerability--many of which had not been measured previously--to which numerical weights representing vulnerability level were assigned. Highly weighted characteristics included maternal death, disability, child labour and pregnancy before age 17. Psychosocial elements included living apart from siblings, having nobody to talk to and never visiting a living parent. According to this approach, an estimated 51.1% of children in Uganda (weighted for national population distribution) are considered critically or moderately vulnerable. It is to these children, equivalent to a national total of 8.7 million, that support services should be prioritised. However, survey data suggest that the most critically vulnerable children are under-represented in several types of support services. This pioneering, participatory methodology provides a rudimentary, but valuable, first step towards quantifying the vulnerability of children in Uganda and assessing their resource needs. It has been used by the Government of Uganda to determine subcategories of vulnerability for resource allocation. A major advantage is that it uses local contextual knowledge of child vulnerability rather than generic criteria applied in international surveys. Further analytical work is required to validate the methodology, link it to child well-being outcomes and devise a practical tool for service providers to refine programme targeting. The approach may be useful to national, regional or local service providers seeking an overview of their client base to monitor and improve programme-targeting efforts.     

How valuable is a well‐crafted design and name brand?: Recognition and willingness to pay

Preferences for similarly designed consumer products, evaluated blind and branded and also with and without prices, were tested in a consumer setting. The consumer's perceptual experience led to preference of the well‐crafted high‐priced option. This preference was enhanced by priming consumers with background information about the brand, perhaps causing the subjects to guess which choice was the well‐known brand before evaluation. Preferences for that choice increased again when brand names were visible during evaluation. When actual prices were added to the evaluations, preferences for the well‐known brand were very robust to high prices, indicating the strength of the brand name. Using the least preferred option and the lowest price as an anchor, the consumers' price threshold to pay for the preferred design and the brand name was computed. Attempts to explain and predict individual differences of choices using measures of inherent design acumen, prior experience, and purchasing behavior were largely unsuccessful. Copyright © 2011 John Wiley & Sons, Ltd.     

Sampling and Data Collection Methods in Sales Force Research: Issues and Recommendations for Improvement

Samples used in sales force research studies found in JM, JMR, JPSSM, and IMM over a seventeen year period were examined to discover the extent to which sales force sampling has met the issues of covering different industries and types of salespeople, of satisfying technical sampling requirements, and of clearly reporting on sampling methods. Recommendations for improving standards for conducting and reporting sales force sampling methodology in terms of the resources available are offered.     

Job strain and rumination about work issues during leisure time: A diary study

Previous research has suggested that high job strain (high demand, low control at work) is associated with an inability to “unwind” physiologically after work. It was speculated that one mechanism related to the “unwinding process” is an individual's ability to “cognitively switch-off” about work related issues after work. This hypothesis was tested in a diary study of primary and secondary school teachers who were asked to keep an hourly record of their work-related thoughts over a workday evening between 17.00 hrs and 21.00 hrs. As expected both groups demonstrated a degree of unwinding and disengagement from work issues over the evening. High strain (n = 34) teachers however took longer to unwind and ruminated more about work-related issues, relative to low job strain (n = 35) teachers. High job strain teachers also reported they had less personal control over what they were doing in the evening. Across the evening all individuals reported higher ruminative thoughts about work issues when alone than when with family and friends, but high strain teachers reported more ruminative cognitions when watching television and with family and friends than low strain teachers. The results could not be explained by work patterns as there was no difference in the number of hours worked in the evening between the two groups. It is argued that one reason why high job strain teachers failed to successfully unwind after work is that they ruminated more about work issues, than did low job strain teachers.     

Proficiency and Workload in Simultaneous and Successive Proofreading Tasks

The prevalence of video display terminals (VDTs) in data processing settings has encouraged research into the factors affecting proofreading performance in electronic and hard copy formats. The present study undertook the initial investigation of the effect of side-to-side head movements on proofreading from hard copy to VDT. Subjects proofread by visually comparing two lines of alphanumeric code, which simulated original and keyed-in (processed) data, in two display configurations. Speed and accuracy were degraded in the successive (side-to-side) condition, relative to performance with a simultaneous (head-on) VDT display. Subjects' ratings of mental workload mirrored these findings, with workload rated higher in the successive condition. The results are congruent with a taxonomy of sustained attention tasks developed by Davies and Parasuraman (1982), which emphasizes a distinction between tasks requiring working memory and those that do not. Additional implications of the present results for a resource allocation model of proofreading are discussed.     

Winnicott: A research perspective

This paper describes research conducted over the past twenty years that was informed by Winnicott's thinking on the importance for child development of the early mother-infant relationship.     

Motivational pursuits in the context of human sexual relationships

The current article examines how close relationships combine with individual differences in sex motives (Cooper, Shapiro, & Powers, 1998) to shape sexual experience. We first provide an overview of the motivational approach as it relates to sexual behavior and then describe 2 broad mechanisms (1 transactional, the other interactional) by which motives and relational context combine to shape behavior. Drawing on our past research, we review evidence showing that people select relationship contexts based partly on their motives and that these contexts in turn shape future motives and behavior; that partner motives shape sexual experience above and beyond one's own motives; and that both the broader relationship context and partner motives moderate the effects of one's own motives on sexual experience. We conclude that the nature of motivational pursuits cannot be adequately understood in the abstract, but rather we must take into account the relational context in which one's needs are pursued.