Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

Curriculum-Based Measurement

Abstract

Curriculum-based measurement (CBM) has evolved as a reliable and valid method for measuring and monitoring student performance in basic academic skills. While the efficacy of CBM for assessing reading skills is not in question, issues remain regarding whether or not a difference exists between CBM probes derived directly from the instructional curriculum and generic probes. The current study extends previous research comparing the utility of two types of CBM reading probe materials. Both types of probes were administered to 13 second grade students twice weekly for 5 weeks. No significant differences were found between the two probe types' measurement of performance or progress over time, which suggests that school psychologists and educational professionals can use generic or curriculum-dependent probes in curriculum-based measurement.     

Children with Attention Deficit Hyperactivity Disorder

ABSTRACT

It is estimated that there have been over 4,000 articles in the literature on the subject of attentional problems, addressing its etiology, epidemiology, assessment, diagnosis, and treatment. This article reviews recent and relevant literature with an eye toward functional conclusions and linkages between assessment and intervention. The article concludes by providing a problem-solving model that integrates parent or teachers' referral concerns, reasons for these concerns, assessment methods, and intervention strategies. In the end, four definitive conclusions are drawn, and the importance of multimodal strategies that collaboratively involve home, school, and community settings is emphasized.     

Frequent Versus Non-frequent Prompts and Task Performance in Persons with Severe Intellectual Disability

Abstract

This study extended the evaluation of frequent vs non-frequent prompts to support task performance with people with severe intellectual disability. Three participants were involved in the study. The data indicated that the frequent prompts strategy promoted higher levels of on-task behaviour and correct responding for 2 participants and on-task behaviour for 1 participant. The relation of these data with previous findings and their implications for daily occupation programmes for persons with severe developmental disabilities are discussed     

Beteendeterapi vid ångestneuros. En evaluerande översikt

Abstract

De olika kontrollerade gruppstudier och okontrollerade fallstudier som finns publicerade rörande beteendeterapeutiska metoder vid ångestneuros presenters och evalueras. Studierna har uppenbara brister vad gäller presentation av patientmaterialet, mätmetoderna och tillämpningen av vissa behandlingsmetoder. Resultaten visar i allmänhet på relativt små och sällan kliniskt signifikanta förbättringar. Artikeln avslutas med rekommendationer för fortsatt forskning framför allt rörande andra behandlingsmetoder än de hittills prövade.     

Test anxiety and metacognitive skillfulness: Availability versus production deficiencies

Abstract

This paper focuses on the role of metacognition in test anxiety. In two experiments, the metacognitive skillfulness of high vs. low test-anxious secondary school students was contrasted. Low test-anxious subjects exhibited a superior metacognitive skillfulness during math performance relative to high test-anxious subjects. Furthermore, differences in metacognitive skillfulness were performance related. In order to unravel causality in the relation between metacognition and test anxiety, two types of test-anxious students may be distinguished analogous to Naveh-Benjamin (1991). Type-1 students would lack metacognitive skills (availability deficiency), through which they experience failure and develop test anxiety. Type-2 students would experience task irrelevant thoughts, which causes cognitive interference with available metacognitive skills (production deficiency). Results of Study 1 reveal that metacognitive cueing may represent an adequate method for the identification of both types. Due to time-constraints, metacognitive cueing in Study 2 failed to do so.     

LEARNED HELPLESSNESS ATTRIBUTIONAL STYLE AND EXAMINATION PERFORMANCE: ENHANCEMENT EFFECTS ARE NOT NECESSARILY MODERATED BY PRIOR FAILURE

Studies have replicated both negative and positive associations between helpless attributional style and academic performance. Laboratory studies indicate that when enhancement effects occur, they may be moderated by the degree of failure individuals experience prior to task performance. In a longitudinal study of 96 college students who completed four examinations in two introductory psychology courses, we examined the relationship between helpless attributional style and examination performance across the semester, and whether prior examination failure moderated this association. Correlational analyses revealed that helpless attributional style was unrelated to exam performance in the first half of the semester and was positively related to improvements in performance in the second half. Regression analyses indicated that these enhancement effects were not moderated by previous performance on examinations in the course. The present findings underscore the need for longitudinal studies that investigate the pattern of associations between helpless attributional style and performance across time in real-life contexts.     

Arousal interventions for athletic performance: Influence of mental preparation and competitive experience

Abstract

Mental preparation, or “psych-up” strategies have been assumed to promote physical arousal which subsequently improves certain athletic performances. The present experiment examined the role of arousal changes in the use of psych-up strategies on a physical strength task and a reaction time-decision task for subjects varying in competitive experience. Eighty-four subjects were reliably divided into high, moderate, or low competitive experience groups and randomly assigned to one of three mental preparation strategies. These strageies, which the subjects employed during a mental preparation period for both tasks, were either: (a) a self-generated arousal strategy, (b) a prescribed arousal strategy, or (c) a placebo-control strategy. While heart rate was being monitored, each subject completed a baseline trial, then one trial following a 45 sec mental preparation period and one trial following a 45 sec distraction interval. Order of presentation of tasks and order of presentation of distraction and mental preparation trials were counterbalanced and statistically analyzed. The results support the utility of different mental preparation strategies for increasing strength performance, but not reaction time-decision performance, for subjects with moderate and high levels of previous competitive experience. Self-generated arousal strategies enhanced performance of moderate experienced subjects. Analyses of the heart rate data failed to support the assumption that physiological arousal mediates the influence of psych-up strategies. Mental preparation strategies improved athletes' performance on certain tasks, however these strategies do not necessarily achieve their effects through increased autonomic arousal.     

Thought listing and endorsement measures of self-referential thinking in test anxiety

Abstract

The primary purpose of the present study was to examine cognitive reactions of high and low test-anxious subjects while performing a task of extreme difficulty. A sample of 44 subjects (28 females, 16 males) attempted a difficult analogies task and then reported their thoughts during the task. Subjects also completed the Sarason Test Anxiety Scale and several other self-report measures of their cognitive reactions to the task. Thought listings were classified according to their referent (self, task, or unrelated) and their valence (positive, negative, or neutral). Correlational analyses were then performed with the various measures and revealed an association between test anxiety and reports of negative thoughts involving the self. Test anxiety was not related significantly to the number of thoughts involving the task nor to actual performance on the task. However, test-anxious subjects did report more negative expectancies for their performance and greater cognitive interference during the task. Negative self-expectancies were also related to more negative self thoughts, fewer positive self thoughts, and fewer positive task-related thoughts. The results are interpreted as further evidence for both the role of negative self-related cognitions in the experience of test anxiety and the usefulness of unstructured measures in anxiety research.     

Effects of lifestyle and stress on the employee and organization: Implications for promoting health at work

Abstract

This research was designed to determine the extent to which employee health and performance are predicted by lifestyle and stress. Data were collected from 345 employees working in a variety of organizations in southern California. Additionally, supervisors evaluated the work performance of the participating employees whom they directly supervised, and company records of employee health care costs were obtained. Hierarchical multiple regression analyses revealed (a) that physical lifestyle (i.e., exercise pattern, eating habits, and general health practices) predicted unique variance in vitality and positive well-being; (b) that psychosocial lifestyle (i.e., social relations, intellectual activity, occupational conditions, and spiritual involvement) predicted unique variance in vitality, positive well-being, anxiety, depression, lack of self-control, and somatic complaints; (c) that employee stress predicted unique variance in vitality, positive well-being, anxiety, depression, physician visits, somatic complaints, illness absences, and supervisory ratings of job performance, absenteeism and tardiness; (d) that physical lifestyle buffered the adverse consequences of stress for anxiety, depression, physician visits, and company health care costs; and (e) that there was a Physical x Psychosocial Lifestyle interaction for anxiety, depression, and lack of self-control. However, the employee lifestyle factors were not related to supervisory ratings of performance at work. The findings have direct implications for organizational health programs and policies.