Home Blood Pressure Monitoring: New Evidence for an Expanded Role

In a Perspective, Mark Caulfield discusses potential implications of using home blood pressure monitoring for diagnosis and treatment of hypertension. Please see later in the article for the Editors' Summar

Parenting and child behaviour as predictors of toothbrushing difficulties in young children

Background: Oral disease is one of the most prevalent chronic health conditions affecting children. Twice-daily toothbrushing is recommended to promote good oral health; however, a large proportion of Australian families are not meeting this recommendation. Aim: This study aimed to identify important barriers to regular toothbrushing for young children. Design: In this study, 239 parents of 0- to 4-year-old children completed an online survey that investigated child, family, and parent factors associated with child toothbrushing. Hierarchical linear regression was used to identify predictors of toothbrushing frequency in children and perceived difficulty of the task by parents. Results: We found that parent factors, specifically oral health knowledge, were the most significant predictors of toothbrushing frequency. Conversely, parent factors did not contribute significantly to the prediction of perceived difficulty of toothbrushing once family and child factors were taken into account. Oral health knowledge and use of routines were identified as the most important predictors of toothbrushing frequency, whereas resistant child behaviour and household organisation were found to be the most important predictors of perceived difficulty of regular toothbrushing. Conclusions: The findings of the study have implications for behavioural interventions to support parents, as well as directions for future research

Educating through Exemplars: Alternative Paths to Virtue

This paper confronts Zagzebski’s exemplarism with the intertwined debates over the conditions of exemplarity and the unity-disunity of the virtues, to show the advantages of a pluralistic exemplar-based approach to moral education (PEBAME). PEBAME is based on a prima facie disunitarist perspective in moral theory, which amounts to admitting both exemplarity in all respects and single-virtue exemplarity. First, we account for the advantages of PEBAME, and we show how two figures in recent Italian history (Giorgio Perlasca and Gino Bartali) satisfy Blum’s definitions of ‘moral hero’ and ‘moral saint’ (1988). Then, we offer a comparative analysis of the effectiveness of heroes and saints with respect to character education, according to four criteria derived from PEBAME: admirability, virtuousness, transparency, and imitability. Finally, we conclude that both unitarist and disunitarist exemplars are fundamental to character education; this is because of the hero's superiority to the saint with respect to imitability, a fundamental feature of the exemplar for character education

Mental health status and perceived burden in caregiving spouses of persons with psychotic illness (a study from India)

Mental illness poses a great deal of burden on other family members, particularly the primary caregiver. In the Indian context for a married person with mental illness, the caregiving burden is usually experienced by the spouse, who is considered to be the ‘natural’ option. This quantitative study used survey methodology to assess caregiving burden in fifty spouses of persons diagnosed with a psychotic illness. Data was collected at a neuro-psychiatric facility in Tiruchirappalli, India. The Depression, Anxiety and Stress Scale and the Burden Assessment Schedule were the instruments administered to assess the mental health status of the spouse and their perceived burden. Findings revealed that the majority of spouses were classified as experiencing ‘severe’ and ‘extremely severe’ in terms of their depression, anxiety and stress levels and ‘high’ in terms of perceived burden. The specific ‘type’ of clinical diagnosis, however, did not differentiate the spouses on the key variables studied. The correlation of these key variables with other background variables has also been examined. The implications of the results of this study for psychosocial intervention have also been discussed in this article

General and specific avoidance: the development and concurrent validation of a new measure of avoidance coping

Research on coping has been hampered by psychometric shortcomings in coping scales, which have typically relied on items based on face-value, extracted too many factors or lacked the evidence for the obtained structure from confirmatory factor analysis. The present paper describes the development and concurrent validation of a new three-factor avoidance coping scale, the General and Specific Avoidance Questionnaire (GSAQ), which comprises General Avoidance, Emotional Avoidance and Conflict Avoidance. In contrast to earlier scales the items were derived from a scenario technique which elicits items from participants’ experience, and the three factor structure was endorsed by two confirmatory factor analyses on independent samples and a further exploratory factor analysis based on the total pooled sample of participants from all three analyses. Factor correlations indicate that the scales measure discrete facets of the avoidance coping domain, and while concurrent validation showed that General and Conflict Avoidance were related in predictable ways to criterion measures, the pattern for Emotional Avoidance was unexpected

Negative Impressions of Childbirth in a North-West England Student Population

Background: Socio-cultural childbirth representations can influence perceptions of childbirth negatively. In this paper we report on a survey study to explore factors associated with negative impressions of childbirth in a North-West England University student sample. We also explored whether different sources and perceptions of childbirth information were linked to fear of childbirth. Methods: All students received a survey link via an online messaging board and/or direct email. Female students who were 18-40 years of age and childless (but planned to have children in the future) were invited to participate. Demographics, birth preferences, a fear of birth and general anxiety measures were included as well as questions about what sources of information shaped students’ attitudes towards pregnancy and birth (i.e. visual/written media, experiences of friends/family members, school-based education, and other) and impressions of birth from these sources (i.e. positive, negative, both positive and negative and not applicable). Results: Eligible students (n=276) completed the online questionnaire. The majority were Caucasian (87%) with a mean age of 22.6 years. Ninety-two students (33.3%) reported negative childbirth impressions through direct or vicarious sources. Students with negative impressions were significantly more likely to report higher fear of birth scores. Negatively perceived birth stories of friends/family members, and mixed perceptions of visual media representations of birth were associated with higher fear of birth scores. Having witnessed a birth first-hand and describing the experience as amazing was linked to lower fear scores. Conclusion: First-hand observations of birth, especially positive experiences, had implications for salutary outcomes. Negative or conflicting perceptions of vicarious experiences were associated with increased levels of childbirth fear. While further research is needed, these 3 insights suggest a need for positive birth stories and messages to be disseminated to mitigate negative effects of indirect accounts

Atypical bodily self-awareness in vicarious pain responders

Vicarious perception refers to the ability to co-represent the experiences of others. Prior research has shown considerable inter-individual variability in vicarious perception of pain, with some experiencing conscious sensations of pain on their own body when viewing another person in pain (conscious vicarious perception / mirror-pain synaesthesia). Self-Other Theory proposes that this conscious vicarious perception may result from impairments in self-other distinction and maintaining a coherent sense of bodily self. In support of this, individuals who experience conscious vicarious perception are more susceptible to illusions of body ownership and agency. However, little work has assessed whether trait differences in bodily self-awareness are associated with conscious vicarious pain. Here we addressed this gap by examining individual difference factors related to awareness of the body, in conscious vicarious pain responders. Increased self-reported depersonalisation and interoceptive sensibility was found for conscious vicarious pain responders compared with non-responders, in addition to more internally-oriented thinking (associated with lower alexithymia). There were no significant differences in trait anxiety. Results indicate that maintaining a stable sense of the bodily self may be important for vicarious perception of pain, and that vicarious perception might also be enhanced by attention towards internal bodily states

Pre-verbal infants perceive emotional facial expressions categorically

Adults perceive emotional expressions categorically, with discrimination being faster and more accurate between expressions from different emotion categories (i.e. blends with two different predominant emotions) than between two stimuli from the same category (i.e. blends with the same predominant emotion). The current study sought to test whether facial expressions of happiness and fear are perceived categorically by pre-verbal infants, using a new stimulus set that was shown to yield categorical perception in adult observers (Experiments 1 and 2). These stimuli were then used with 7-month-old infants (N  =  34) using a habituation and visual preference paradigm (Experiment 3). Infants were first habituated to an expression of one emotion, then presented with the same expression paired with a novel expression either from the same emotion category or from a different emotion category. After habituation to fear, infants displayed a novelty preference for pairs of between-category expressions, but not within-category ones, showing categorical perception. However, infants showed no novelty preference when they were habituated to happiness. Our findings provide evidence for categorical perception of emotional expressions in pre-verbal infants, while the asymmetrical effect challenges the notion of a bias towards negative information in this age group

Recovering from stillbirth: the effects of making and sharing memories on maternal mental health

Objective: This study examined whether the experience of creating and sharing memories of their babies is associated with mothers’ mental health after stillbirth, taking account of factors previously shown to be important. Background: Mothers of stillborn babies are usually offered the opportunity to spend time with and create memories of their babies. However, evidence on whether this leads to better mental health outcomes is equivocal. One possible explanation is that the impact of making memories is mediated by the extent to which women subsequently share these memories. Methods: Cross-sectional questionnaire study. Mothers (N = 162) of stillborn babies completed online questionnaires of how memories were made and shared, satisfaction with memory-making and sharing, professional and social support, and symptoms of depression, anxiety and PTSD. Results: The majority of mothers made and shared memories. The number of different memory-making activities was not associated with mental health outcomes. However, the degree to which mothers shared their memories was associated with fewer PTSD symptoms. Regression analyses showed that good mental health was most strongly associated with time since stillbirth, perceived professional support, sharing of memories and less wish to talk more about the baby. Conclusion: This study confirms research showing that time since stillbirth and perceived professional support is associated with better mental health following stillbirth and for the first time shows the importance of opportunities to share memories of the baby. Variation in sharing opportunities may contribute to inconsistencies in the association between making memories and mental health following stillbirth