Trends in Telehealth versus On-site Clinical Genetics Appointments in Manitoba: A Comparative Study

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.     

Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis

We describe the association between postpartum depression and the quantity and content of infant media use. Households with depressed mothers viewed twice as much television as households with non-depressed mothers did, and depressed mothers appeared to derive comparatively greater pleasure from television viewing. Maternal depression was associated with an increased exposure to child-directed content by 6–9-month-old infants, although it was not associated with an increased exposure to adult-directed programming. Depressed mothers also reported being less likely to sit and talk with their children during television use or to consult outside sources of information about media. This increase in television exposure without corresponding parental involvement could negatively affect developmental outcomes.     

Improving the quality of medical care: the normativity of evidence-based performance standards

Poor quality medical care is sometimes attributed to physicians?? unwillingness to act on evidence about what works best. Evidence-based performance standards (EBPSs) are one response to this problem, and they are increasingly employed by health care regulators and payers. Evidence in this instance is judged according to the precepts of evidence-based medicine (EBM); it is probabilistic, and the randomized controlled trial (RCT) is the gold standard. This means that EBPSs suffer all the infirmities of EBM generally??well rehearsed problems with the external validity of research findings as well as the inferential leap from study results in the aggregate to individual patient care. These theoretical weaknesses promise to have a practical impact on the care of patients. To avoid this, EBPSs should be understood as guidelines indicative of average effectiveness rather than standards to be applied in every case.     

Executive function in Parkinson’s disease: contributions of the dorsal frontostriatal pathways to action and motivation

Disruption of the dorsal frontostriatal pathways in Parkinson’s disease (PD) is associated with impairments in motivation, as well as in executive function. The goal of this study was to investigate whether these impairments are related and, if so, whether the disruption of frontostriatal pathways compromises the ability to process the motivational aspects of feedback in such tasks. In Experiment 1, informative feedback improved the performance of young, healthy participants in a task-switching paradigm. This task-switching paradigm was then used in Experiment 2 to test whether feedback would improve the performance of 17 PD patients and age-matched controls. The PD group benefitted from feedback to the same degree as control participants; however, depression scores on the Beck Depression Inventory were significantly related to feedback usage, especially when response selection demands were high. Regardless of feedback, PD patients were more impaired when response demands were high than in an equally difficult condition with low action demands. These results suggest that response selection is a core impairment of insufficient dopamine to the dorsal frontal striatal pathways.     

Emotional regulation of fertility decision making: What is the nature and structure of "baby fever"?

Baby fever-a visceral physical and emotional desire to have a baby-is well known in popular culture, but has not been empirically studied in psychology. Different theoretical perspectives suggest that desire for a baby is either superfluous to biological sex drives and maternal instincts, a sociocultural phenomenon unrelated to biological or evolutionary forces, or an evolved adpatation for regulating birth timing, proceptive behavior, and life history trajectories. A series of studies (involving 337 undergraduate participants and 853 participants from a general population Internet sample) found that: (a) a simple scale measure could elicit ratings of desire frequency; (b) these ratings exhibited significant sex differences; (c) this sex difference was distinct from a general desire for sexual activity; and (d) these findings generalize to a more diverse online population. Factor analyses of ratings for desire elicitors/inhibitors identified three primary factors underlying baby fever. Baby fever appears to be a real phenomenon, with an underlying multifactorial structure. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Day-to-day variability in nap duration predicts medical morbidity in older adults

Objective: The objectives for the present study were to (a) examine within-person variability of nap duration and (b) assess how variability in nap duration is related to the number of health conditions in a sample of older adults. For highly variable behaviors such as sleep, it is important to consider fluctuations within the person instead of solely comparing averages of behaviors across persons. Method: Data were drawn from a previous study examining sleep in 103 community-dwelling older adults. Subjective estimates of napping behavior were obtained from sleep diaries and objective estimates of napping behavior were obtained using actigraphy. Both measures were collected for 14 consecutive days. The sampled data were aggregated in terms of (a) average daily time spent napping and (b) average within-person fluctuations in daily nap duration. The health measure consisted of the number of self-reported health conditions. Results: Both the objective and subjective measures revealed that there was considerable day-to-day fluctuation in nap duration and that variability in nap duration, not mean duration, uniquely predicted the number of health conditions, b = .03, b* = .26, t(100) = 2.71, p = .01. Conclusions: Duration of napping in older adults is a highly variable behavior, fluctuating as much within- as between-persons. Furthermore, variability in nap duration from day to day is predictive of greater medical morbidity, suggesting that clinicians should assess for inconsistencies in nap behavior in addition to duration, frequency, and timing. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The influence of emotional labour and emotional work on the occupational health and wellbeing of South Australian hospital nurses

Nursing is an emotionally complex occupation, requiring performance of both emotional labour (for the benefit of the organisation and professional role) and emotional work (for the benefit of the nurse-patient relationship). According to the Conservation of Resources Theory, such processes can have a significant effect on psychological wellbeing and occupational stress, although little is known about the factors that moderate their effects. This exploratory study investigated the relationship between emotional labour and emotional work on psychological wellbeing and occupational stress in 239 nurses sampled from a South Australian hospital. The multi-component questionnaire study focused on the emotional labour elements of emotion expression and suppression, as well as surface acting and deep acting, and examined the companionship, help, and regulation elements of emotional work. In a multivariate model, emotional work was found to be less strongly predictive of negative psychological outcomes than was emotional labour, but was more strongly predictive of positive outcomes. Social support may moderate or be an antecedent to the performance of emotional labour and emotional work. The findings support the Conservation of Resources Theory with emotional work, rather than emotional labour, enabling the uptake of resources and leading to positive occupational health and wellbeing.     

Color categories and color appearance

We examined categorical effects in color appearance in two tasks, which in part differed in the extent to which color naming was explicitly required for the response. In one, we measured the effects of color differences on perceptual grouping for hues that spanned the blue-green boundary, to test whether chromatic differences across the boundary were perceptually exaggerated. This task did not require overt judgments of the perceived colors, and the tendency to group showed only a weak and inconsistent categorical bias. In a second case, we analyzed results from two prior studies of hue scaling of chromatic stimuli (De Valois, De Valois, Switkes, & Mahon, 1997; Malkoc, Kay, & Webster, 2005), to test whether color appearance changed more rapidly around the blue-green boundary. In this task observers directly judge the perceived color of the stimuli and these judgments tended to show much stronger categorical effects. The differences between these tasks could arise either because different signals mediate color grouping and color appearance, or because linguistic categories might differentially intrude on the response to color and/or on the perception of color. Our results suggest that the interaction between language and color processing may be highly dependent on the specific task and cognitive demands and strategies of the observer, and also highlight pronounced individual differences in the tendency to exhibit categorical responses.     

Unique Challenges Facing Female Athletes in Urban High Schools

Although the passage of Title IX secured equity of treatment and opportunity for female high school athletes in the United States, little research has examined the social well-being of girls who participate in sports during high school. The current survey study investigated how 9th grade sports participation relates to perceived gender discrimination from peers and adults at school over four time points spanning 10th through 12th grade. The ethnically diverse sample (46.6?% Hispanic/Latina/Mexican-American, 14.1?% Asian-American/Pacific Islander, 12.8?% African-American/Black, 11.5?% European-American/White, 15.1?% Other/Mixed) consisted of 384 girls in the southwestern United States. Results of growth modeling showed that 9th grade athletes (n?=?309) perceived greater gender discrimination relative to girls who were not involved in sports (n?=?75), and accelerated in peer gender discrimination compared to non-athletes. Athletes and non-athletes did not differ in perceived gender discrimination from adults at school. Analyses conducted separately within each ethnic group revealed that ethnic groups did not differ in patterns of gender discrimination. These findings suggest that girls who play sports may experience differential treatment from their peers. Future directions and policy implications are discussed.