The detection and management of mental health disorders in pediatric primary care

We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of skills in managing mental health disorders. Few efforts have been made by pediatric psychologists to develop strategies for enhancing detection rates and management or to empirically evaluate the integration of pediatric psychology services into the primary care context. A conceptual model of factors influencing detection rates and ongoing management of mental health disorders within pediatric primary care is presented. Recommendations are made for more direct involvement of pediatric psychologists within the primary care context.     

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n?=?107) or head and neck cancers (n?=?99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs.

Methods: Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses.

Results: More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption.

Conclusions: Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.     

南北朝象数易学发展特点述略

南朝郑、王易学并立,北朝象数易学占主导,但后期也呈现儒玄并融的趋势．《易传《》和汉代易学创造出来的象数成果得到南北朝易学家的继承,南朝易学家对象数易学中的形式主义学风给予了批判,并呈现出本体论思维与易学象数相结合的思想萌芽．象数易学受到佛教缘起性空理论的批判,但南北朝佛教仍利用易学象数来说明现象世界．在南北朝道教养生理论中,象数易学得到了丰富和发展．在南北朝的宗教风气下,象数易学占验派沦为方伎．     

The Emergence of Counseling in Sierra Leone

Sierra Leone has endured a turbulent history, including a decadelong civil war and the devastation of Ebola virus disease. Despite the psychological consequences of such events, only limited therapeutic services are available. The authors review mental health services in Sierra Leone and document the emergence of counseling as a profession in the face of challenges. They conclude by highlighting the multiple contributions that professional counselors can make to address critical mental health needs in Sierra Leone.     

Structure and content of affective associations with health behaviours: Is the behaviour ‘good OR bad’ or ‘good AND bad’

Objective: The feelings and emotions individuals associate with health-related behaviours influence engagement in those behaviours. However, the structure and the content of these affective associations have not been examined. The studies reported here examined competing hypotheses about the structure (unidimensional or bidimensional) and content (generalised affect or specific emotions) of affective associations with two health-related behaviours: physical activity and fruit/vegetable consumption.

Design: For each behaviour, participants (fruit and vegetable consumption n = 149; physical activity n = 199) completed an assessment of the association of 40 positive and 51 negative affect concepts with the behaviour.

Main outcome measures: Ratings of affective associations with each behaviour.

Results: Confirmatory factor analyses comparing unidimensional and bidimensional affect structure models showed that the structure of individuals’ affective associations was bidimensional for both behaviours – positive and negative affective associations were shown to be separate and distinct constructs. Exploratory factor analyses supported a model of affective associations as generalised affect for both behaviours.

Conclusion: Affective associations with both physical activity and with fruit/vegetable consumption consist of separate positive and negative dimensions of generalised affect. These findings lead to recommendations for research and intervention development based on the implications for how affective associations might operate to influence behavioural decision-making.