Resilience,religiosity and treatment adherence in hemodialysis patients: a prospective study

Resilience and religiosity have received attention as an important process in the experience and management of chronic comorbidities; however, there is no study evaluating resilience in hemodialysis patients and its association with other psychological dimensions or with treatment adherence. This observational prospective study assessed resilience (25 item Wagnild and Young Resilience Scale), religiosity under three dimensions (organizational, non-organizational and intrinsic) using DUREL scale, depressive symptoms (Patient Health Questionnaire-9) and health-related quality of life (Short Form-36 questionnaire). The main outcomes were medication adherence using the Morisky Medication Adherence Scale-8 (MMAR-8) and the missing/shortened dialysis sessions in the following six months. Of 208 patients approached, 202 (97.1%) agreed to participate. One hundred twenty-three patients (60.9%) were males and mean age was 52.8 ± 14.8 years-old. The median time on hemodialysis was 36 months (IQR, 12, 84). 82 (40.6%) patients obtained a MMAS-8 score <6 and were considered as having ‘poor adherence’. Overall, the mean score of medication adherence was low (5.7 ± 2.1). About adherence to hemodialysis sessions, patients missed a total of 234 (1.6%) hemodialysis sessions. Forty-eight patients (23.7%) missed an average of at least three sessions in six months. Regarding adherence to medication, there was no association in the uni- or multivariate analysis between religiosity dimensions and MMAS-8 score. After adjustment, resilience was positively associated with MMAS-8 score (standardized β coefficient .239, p = .016). Organized and intrinsic religiosity were associated with adherence to dialysis sessions (standardized β coefficient .258, p = .004 and .231, p = .026, respectively). Interestingly, opposite to medication adherence, more resilient patients were associated with less adherence to hemodialysis sessions (standardized β coefficient ?.296, p = .001). Religiosity was associated with dialysis adherence but not with medication adherence. Resilience was associated with higher medication adherence but lower adherence to dialysis sessions.     

Sustained attention development during the toddlerhood to preschool period: associations with toddlers' emotion regulation strategies and maternal behaviour

The current study examined the role of maternal behaviour and toddlers' emotion regulation strategies in the development of children's sustained attention abilities. Participants for this study included 447 children (232 girls) obtained from three different cohorts participating in a larger ongoing longitudinal study. When the children were 2 years of age, mothers brought their children to the laboratory and were videotaped during several tasks designed to elicit emotion regulation and mother–child interaction. Sustained attention was also measured at the same visit via a laboratory task and in a subsequent visit when children were 4.5 years of age. Results indicated that toddlers' use of help‐seeking emotion regulation strategies was positively related to sustained attention, while avoidance behaviours and maternal behaviour characterized by high levels of overcontrolling/intrusiveness were negatively related to sustained attention at age 2. Significant interactions emerged such that high levels of maternal warmth/responsiveness buffered the negative associations between low use of distraction and high use of self‐comforting emotion regulation strategies and sustained attention at age 2. Maternal behaviour characterized by high levels of warmth/responsiveness also predicted greater growth in sustained attention from age 2 to 4.5. These findings are discussed in terms of how maternal behaviours and children's use of active versus passive emotion regulation strategies relate to sustained attention abilities. Copyright © 2011 John Wiley & Sons, Ltd.     

The high-performance work system and commitment of the Portuguese Navy personnel

This study evaluates the relationship between the high-performance work system (HPWS) as perceived by the Portuguese Navy military and their affective (AC), normative (NC), and continuance commitment (CC). The sample is representative and composed of 1,003 individuals (officers, warrant/petty officers, and seamen—as a reference, these last two categories are called ratings in the British Royal Navy, and enlisted in the United States Navy) from different naval units. A structural models analysis was carried out, and the results showed, as expected, that the perception of an HPWS was positively related to the commitment of the military personnel, in both its affective and normative dimensions. Nevertheless, contrary to our expectations, we also observed that the perception of an HPWS was positively related to the continuance commitment as well. On the other hand, we examined the moderator role played by the professional category—the relationship between the perception of the HPWS and the AC was stronger in commissioned officers and seamen than in warrant and petty officers—and by the contractual relationship. In the latter, the relationship between the HPWS and the AC and the CC was stronger in the individuals having a fixed-term contract than in those with a permanent position. The theoretical and practical implications of these results will be discussed.     

Cultural innovation and transmission of tool use in wild chimpanzees: evidence from field experiments

Chimpanzees (Pan troglodytes) are the most proficient and versatile users of tools in the wild. How such skills become integrated into the behavioural repertoire of wild chimpanzee communities is investigated here by drawing together evidence from three complementary approaches in a group of oil-palm nut- (Elaeis guineensis) cracking chimpanzees at Bossou, Guinea. First, extensive surveys of communities adjacent to Bossou have shown that population-specific details of tool use, such as the selection of species of nuts as targets for cracking, cannot be explained purely on the basis of ecological differences. Second, a 16-year longitudinal record tracing the development of nut-cracking in individual chimpanzees has highlighted the importance of a critical period for learning (3–5 years of age), while the similar learning contexts experienced by siblings have been found to result in near-perfect (13 out of 14 dyads) inter-sibling correspondence in laterality. Third, novel data from field experiments involving the introduction of unfamiliar species of nuts to the Bossou group illuminates key aspects of both cultural innovation and transmission. We show that responses of individuals toward the novel items differ markedly with age, with juveniles being the most likely to explore. Furthermore, subjects are highly specific in their selection of conspecifics as models for observation, attending to the nut-cracking activities of individuals in the same age group or older, but not younger than themselves. Together with the phenomenon of inter-community migration, these results demonstrate a mechanism for the emergence of culture in wild chimpanzees.     

The use of tokens as rewards and tools by chimpanzees (Pan troglodytes)

This paper explores the effectiveness of token rewards in maintaining chimpanzees (Pan troglodytes) in working at intellectually costly tasks, and studies the "saving" behavior of the subjects, investigating the factors that can condition it. Two experiments were run. Tokens were introduced as rewards in a matching-to-sample task and used as exchange tools for food by three adult female chimpanzees. Subjects' performances were maintained at constant high levels of accuracy, suggesting that the tokens were almost equivalent to direct food rewards. The results also showed the emergence of saving behavior. The subjects spontaneously saved the tokens during the matching-to-sample task before exchanging them for food. The chimpanzees also learned a new symbolic discrimination task, with tokens as the reward. During this learning process a rarely reported phenomenon emerged: one of the subjects showed symmetry, a form of stimulus equivalence. Accepted after revision: 7 August 2001 Electronic Publication     

Community Implementation of MI-Enhanced Behavior Therapy for Adolescent ADHD: Linking Fidelity to Effectiveness

Evidence-based behavior therapy for adolescent ADHD faces implementation challenges in real-world settings. The purpose of this trial was to investigate the relationship between implementation fidelity and outcomes among adolescents receiving services in the active treatment arm (N = 114; Motivational Interviewing [MI]-enhanced parent-teen behavior therapy) of a community-based randomized trial of adolescent ADHD treatment. Participants received therapy from community clinicians (N = 44) at four agencies in a large, ethnically diverse metropolitan setting. Therapists provided self-report of session-by-session adherence to content fidelity checklists and audio recordings of sample sessions that were coded for MI integrity. Parents provided report of ADHD symptoms and family impairment at baseline, posttreatment, and follow-up, while academic records were obtained directly from the local school district. Results indicated that content fidelity significantly waned across the 10 manualized sessions (d = -1.23); these trends were steepest when therapy was delivered outside the office-setting and parent attendance was low. Community therapist self-report of content fidelity predicted significantly greater improvements in academic impairment from baseline to follow-up. MI delivery quality was not associated with improved outcomes; contrary to hypotheses, lower MI relational scores predicted significantly greater improvements in family impairment over time. Findings indicate that community-based outcomes for evidence-based ADHD treatment are enhanced when treatment is implemented with fidelity. Future work should revise community-based implementation strategies for adolescent ADHD treatment to prevent declines in fidelity over time, thereby improving outcomes.     

Effective use of the blank comparison procedure in simple discrimination by infant capuchin monkeys: A methodological note

In studies of simple and conditional discrimination, procedures are needed to measure those aspects of stimuli that control behavior. The blank comparison procedure is one such procedure. It was designed explicitly for assessing S+ and S- functions when discriminative stimuli are presented simultaneously. In this procedure, a neutral stimulus serves sometimes as S+ and sometimes as S-. Its discriminative function is defined in relation to other stimuli in the display. The present study aimed to prepare 2 infant female capuchin monkeys for the effective use of the blank comparison procedure in a simple discrimination task. First, simple discrimination training was applied up to a stable accuracy criterion of ≥90%. This training was followed by the replacement of S+ and then of S- stimuli with new stimuli. Ultimately, trials with the blank comparison were introduced. Following this sequence, both monkeys immediately displayed highly accurate blank-comparison performances without the need for stimulus control shaping or other preparatory discrimination training. Thus, this procedure sequence may be an efficient, effective method for establishing blank-comparison baselines for experimental analyses of S+/S- discriminative functions and perhaps for other applications in teaching simple and conditional discrimination performances to this species and others.     

How do children deal with socio-moral conflicts? Self-conscious emotions and conflict resolution in the narratives of institutionalized and noninstitutionalized children

Introduction

Self-conscious emotions play an important role in children's psychosocial functioning.

The practices of existential psychotherapists: development and application of an observational grid

Within the major therapeutic paradigms, observational instruments have been developed to assess orientation-specific interventions or processes. However, to date, no such instrument exists to assess existential practices. Recent research indicates the key practices of existential therapists, and forms an empirical basis on which to develop an observatory grid. This paper describes the development of such a grid, and its exploratory testing with eight clients of four Portuguese existential psychotherapists. A total of 32 sessions were observed and both speaking turn and whole-session analysis showed that it was feasible to assess existential therapy using the instrument, although psychometric findings recommend further refinement of the tool. Session-rating data suggest that the chief practices applied by existential therapists were relational, followed by the use of hermeneutic interventions and reformulations. Interventions based on phenomenological and existential assumptions were observable in practice but limited in frequency. Further refinements and developments of the observational grid, together with additional research – using a range of therapists from different schools of existential therapy – are recommended.