Sexual risk behaviour among HIV-infected women in the first twelve months after delivery in South Africa

This study aimed to assess sexual risk behaviour and its social correlates in HIV-infected women living in rural South Africa at six and twelve months post-partum. Participants were 699 HIV-positive women recruited prenatally by systematic sampling from twelve community health centres in Mpumalanga province, South Africa (mean age = 28.4 years, SD = 5.7; married =41.1%; serodiscordant or unknown partner status = 74.9%). They self-reported on their sexual activity six to twelve months after delivery; including use of condoms and partner involvement. Generalised linear mixed models were utilised to estimate unsafe sex outcomes from a prevention of mother to child transmission (PMTCT) intervention, socio-demographic factors, disclosure, and male involvement. About 20% of sexually active women in the past week had used condoms inconsistently at six and twelve months after delivery. Moreover, 16% and 18% of the women had not used a condom at last sex and 11% and 13% had unprotected sex with HIV-uninfected or unknown-status partners following delivery at six and twelve months, respectively. Higher inconsistent condom use was likely with lower male involvement. Promotion of condom use post-partum, as well as male involvement in sexual decisions, are important for safer sex post-partum by seropositive women.     

From “Longshot” to “Fantasy”: Obligations to Pediatric Patients and Families When Last-Ditch Medical Efforts Fail

Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from longshot to fantasy using two pediatric cases. This progression may be differentiated into four distinct stages of care related to the potential of achieving the initial goals of care. Physicians are often ill prepared for the progression of treatments from a longshot hope to an unfeasible and, therefore, typically unjustified intervention. We present a structured approach to guide clinicians at referral institutions where these situations may be common. The transition of care from “longshot” to “fantasy” is an inherent part of quaternary care for the sickest of patients that has been underexplored. Physicians are often poorly equipped to approach that transition. We advocate this approach to the shift from longshot to fantasy with the belief that such a structured method will have multiple benefits, including: reduced suffering for the patient; decreased emotional burden on patient and family; decreased provider moral distress; increased likelihood of seeking high quality palliative care earlier; and provision of honest and straightforward information to patients and their families.     

Visuo-spatial representations of the alphabet in synaesthetes and non-synaesthetes

Visuo-spatial representations of the alphabet (so-called 'alphabet forms') may be as common as other types of sequence-space synaesthesia, but little is known about them or the way they relate to implicit spatial associations in the general population. In the first study, we describe the characteristics of a large sample of alphabet forms visualized by synaesthetes. They most often run from left to right and have salient features (e.g., bends, breaks) at particular points in the sequence that correspond to chunks in the 'Alphabet Song' and at the alphabet mid-point. The Alphabet Song chunking suggests that the visuo-spatial characteristics are derived, at least in part, from those of the verbal sequence learned earlier in life. However, these synaesthetes are no faster at locating points in the sequence (e.g., what comes before/after letter X?) than controls. They tend to be more spatially consistent (measured by eye tracking) and letters can act as attentional cues to left/right space in synaesthetes with alphabet forms (measured by saccades), but not in non-synaesthetes. This attentional cueing suggests dissociation between numbers (which reliably act as attentional cues in synaesthetes and non-synaesthetes) and letters (which act as attentional cues in synaesthetes only).     

Effects of a concurrent task on fixed-interval responding in humans

Subjects pressed a telegraph key to illuminate a meter dial on which pointer deflections appeared at fixed intervals. Upon detecting a deflection they were required to press another key to reset the pointer to zero. This detecting and resetting operation reinforced the behavior of pressing the light-flashing key (i.e., the observing responses). The usual pattern of responding on the light-flashing key was a long pause following the reinforcement and an abrupt transition to a steady response rate toward the end of the interval. When the subjects were required to perform a concurrent subtraction task, the pattern of responding changed in varying degrees, ranging from complete loss of typical fixed-interval behavior to a slight shortening of the post-reinforcement pause. These effects were attributed to the disruption of the self-produced verbal chains (counting or reciting) that ordinarily govern human behavior on this schedule.     

Adherence to HAART: perspectives from clients in treatment support programs

The development of highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and mortality for HIV-infected individuals. Because the long-term efficacy of HAART is dependent on near perfect adherence, many providers offer services to support adherence, including education, regimen review, counseling, and reminder tools. Little is known regarding the utilization or efficacy of these services. In this paper, we report on data collected during 32 open-ended interviews conducted with individuals receiving services through the New York State Treatment Adherence Demonstration Project. Participants in the project reported deriving benefits from a broad range of project activities. Educational efforts helped clients to recognize HIV as a manageable, rather than terminal, illness. Information and tools focused on specific regimens provided clients with concrete knowledge and skills. Effective communication with medical providers and pharmacists was facilitated by adherence staff who proactively advocated for client needs. Program-based social support was particularly valuable for many participants, helping them to retain needed motivation and strength. Educational, practical, and supportive services were all considered valuable to clients participating in adherence support programs. A mix of services may best meet the range of needs found among persons taking HAART.     

Inference vs control sentences: are readers able to detect our intended differences?

The reliance of comprehension processes on knowledge to form explanatory inferences has been well established (Grasser, Singer, & Trabasso, 1994), yet the evidence that supports these studies is derived from sentence pairs that are largely unexamined. While some recent studies have suggested that the stimulus sentences utilized in comprehension research need further specification (Shears & Chiarello, 2004), there has been little 'normal reading' data provided that examines what readers are able to detect from traditional inference-requiring vs control sentence pairs. The current study utilized stimuli sentences that have historically been used to support inference research (Singer, 1995) as well as some newly developed sentences, to examine whether readers detect differences between control vs inference conditions, and to further examine whether readers could discern when inference sentences achieved an outcome or goal vs when these sentences did not achieve an outcome or goal.     

Sociotropy and perceptions of interpersonal relationships as predictors of eating disturbances among college women: two prospective studies

The authors examined the relationship between sociotropy and perceptions of interpersonal relationships and subsequent eating disorder symptoms among young women. In Study 1, 118 women from a liberal arts college in northern Wisconsin completed self-report measures of sociotropy, perceived close social support, and eating disorder symptoms. The women returned 6 weeks later to complete the same measures. After controlling for initial levels of reported eating disturbances, higher levels of Time 1 sociotropy and reductions in perceived social support at Times 1 and 2 made unique contributions to eating disturbances at Time 2, although the interaction of Time 1 sociotropy and Time 2 social support did not add to the model. In Study 2, 138 women completed measures of eating disturbances, sociotropy, and interpersonal hassles on two occasions, 10 weeks apart. Self-reported eating pathology at Time 1 accounted for most of the variance in Time 2 eating disorder symptoms, but increased eating disturbances also were predicted by measures of interpersonal hassles. A final regression analysis using combined samples indicated that both T1 and T2 measures of interpersonal functioning made unique contributions to changes in reported eating disturbances. In sum, the findings suggested that perceptions of reduced support in close relationships and increased interpersonal hassles contribute to increases in reported eating disturbances among college-aged women, independent of baseline levels of eating disturbances and a highly sociotropic personality style.     

Environmental toxicants and developmental disabilities: a challenge for psychologists

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children.     

The contribution of EEG coherence to the investigation of language

The contribution of EEG coherence analysis to the investigation of cognition and, in particular, language processing is demonstrated with examples of recent EEG studies. The concept of EEG coherence analysis is explained, and its importance emphasized in the light of recent neurobiological findings on frequency-dependent synchrony as a code of information processing between nerve cell assemblies. Furthermore, EEG coherence studies on naturally spoken and written word and sentence processing are reviewed and experimental results are presented giving new insights into the occurrence of "transient functional language centers" within the brain.