http://www.dspace.cam.ac.uk:80/handle/1810/221681 Tue, 21 May 2013 23:33:51 GMT 2013-05-21T23:33:51Z http://www.dspace.cam.ac.uk:80/handle/1810/244266 Title: Chinese parenting and children's compliance to adults: a cross-cultural comparative study Authors: Huang, Ching-Yu Soar Abstract: The current study examined the parenting beliefs and practices of Taiwanese, Chinese immigrant (all first-generation immigrants in the UK) and English mothers, and the compliance of their young children (aged 5–7), in order to elucidate the effects of child temperament, culture and acculturation strategies on reported parenting beliefs and practices, observed parental behaviour, child behaviour, mother–child interaction dynamics and children’s compliance. The data were collected from a total of 90 families with 5- to 7-year-old children in Taiwan and the UK. Child temperament, parenting beliefs and practices and acculturation were assessed using questionnaires, and parental behaviour, child behaviour, dyadic interaction dynamics and child compliance were assessed using observation in two tasks (Etch-A-Sketch and clean-up). Semi-structured interviews were also conducted with the Chinese immigrant parents to gather more information regarding their acculturation and parenting. Cultural differences were found between groups in reported as well as observed parenting and children’s compliance. The Taiwanese mothers reported greater use of Chinese-specific parenting and physical coercion and were observed to use more (gentle and assertive) physical intervention than both the Chinese immigrant and English mothers. The Chinese immigrant mothers reported a higher degree of child autonomy than the Taiwanese and English mothers, and also reported cultivation of their children’s independence. The stronger the Chinese immigrant mothers' affiliation with Chinese culture, the more they reported adopting the Chinese-specific parenting style; the longer they had been in the UK, the less they reported authoritarian parenting. The English mothers were rated as more responsive and less negatively controlling than the Chinese immigrant mothers; they also showed more positive affect than both the Chinese immigrant and Taiwanese mothers. There were few cultural differences between groups in the children’s behaviour, although Taiwanese children showed more situational compliance than Chinese immigrant children. Further regression analyses showed that child characteristics, such as child age and temperament, affected the parents’ and children’s behaviour as well as dyadic interactional dynamics. Committed compliance, situational compliance and opposition were associated with different predictors, suggesting that they are qualitatively different and are associated with different developmental processes. Committed compliance may develop as children grow older, mediated by surgency; situational compliance, on the other hand, was associated with authoritarian parenting and mothers’ use of negative control, which varied by culture. Child opposition was predicted by neither child characteristics nor parenting. These findings provide valuable insights into parenting and children’s compliance in different cultural contexts. The results underscore the importance of looking at human development from a holistic perspective. The active role that children play in shaping their developmental process, their parents’ parenting and the culture they live in should all be taken into account when attempting to understand their development. Tue, 05 Feb 2013 00:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/244266 2013-02-05T00:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/242012 Title: Families created by gamete donation: disclosure and family functioning when children are seven years old Authors: Blake, Lucy Abstract: Recent advances in assisted reproductive technologies have resulted in an increasing number of children born by gamete donation. Children conceived by egg donation lack a genetic link with their mother whereas children conceived by donor insemination lack a genetic link with their father. In families in which parents do not disclose their use of donated gametes, the child is unaware that their mother or their father in not their genetic parent. The aim of this thesis was to assess the impact of non-disclosure, and of the absence of a genetic link between parent and child, on family functioning and child adjustment. Data were obtained from a representative sample of 36 donor insemination, 32 egg donation and 54 natural conception families when the target child was 7 years old. Standardised interview, questionnaire and observational data were obtained from mothers, fathers, children and the child’s teacher. Few differences in family functioning were found between disclosing and non-disclosing gamete donation families. Likewise, few differences emerged between gamete donation families and natural conception families. The families were found to be functioning well irrespective of whether the parents had disclosed and of whether the child lacked a genetic link with a parent. However, comparisons between donor insemination and egg donation families showed that disclosure status and family type interacted in complex ways. Contrary to predictions, disclosure was not always associated with favourable outcomes. Children in disclosing donor insemination families were rated by teachers as having fewer behavioural problems. However, observational ratings showed lower levels of positive mother-child interaction in disclosing egg donation families. The process of disclosure was also explored. In all but one disclosing family, parents had started to talk to their child about their donor conception by age 4, with disclosure typically initiated and maintained by the mother. Despite mothers’ concerns, children did not appear distressed by information about their donor conception. However, interviews with the children themselves suggested that most had little understanding of their donor conception at age 7. Tue, 07 Feb 2012 00:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/242012 2012-02-07T00:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/241595 Title: Service user and carer experiences of seeking help for a first episode of psychosis: a UK qualitative study Authors: Tanskanen, Sanna; Morant, Nicola; Hinton, Mark; Lloyd-Evans, Brynmor; Crosby, Michelle; Killaspy, Helen; Raine, Rosalind; Pilling, Stephen; Johnson, Sonia Abstract: Abstract Background Long duration of untreated psychosis (DUP) is associated with poor outcomes and low quality of life at first contact with mental health services. However, long DUP is common. In order to inform initiatives to reduce DUP, we investigated service users' and carers' experiences of the onset of psychosis and help-seeking in two multicultural, inner London boroughs and the roles of participants' social networks in their pathways to care. Method In-depth interviews were conducted with service users and carers from an early intervention service in North London, purposively sampled to achieve diversity in sociodemographic characteristics and DUP and to include service users in contact with community organisations during illness onset. Interviews covered respondents' understanding of and reaction to the onset of psychosis, their help-seeking attempts and the reactions of social networks and health services. Thematic analysis of interview transcripts was conducted. Results Multiple barriers to prompt treatment included not attributing problems to psychosis, worries about the stigma of mental illness and service contact, not knowing where to get help and unhelpful service responses. Help was often not sought until crisis point, despite considerable prior distress. The person experiencing symptoms was often the last to recognise them as mental illness. In an urban UK setting, where involved, workers in non-health community organisations were frequently willing to assist help-seeking but often lacked skills, time or knowledge to do so. Conclusion Even modest periods of untreated psychosis cause distress and disruption to individuals and their families. Early intervention services should prioritise early detection. Initiatives aimed at reducing DUP may succeed not by promoting swift service response alone, but also by targeting delays in initial help-seeking. Our study suggests that strategies for doing this may include addressing the stigma associated with psychosis and community education regarding symptoms and services, targeting not only young people developing illness but also a range of people in their networks, including staff in educational and community organisations. Initiatives to enhance the effective involvement of staff in community organisations working with young people in promoting help-seeking merit research. Description: RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are. Thu, 29 Sep 2011 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/241595 2011-09-29T23:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/241366 Title: Sex differences in general intelligence: a psychometric investigation of group differences in mean and variability as measured by the Raven's Standard Progressive Matrices Authors: Savage-McGlynn, Emily Abstract: Researchers and the general public alike continue to debate ‘which is the smarter sex?’ Research to date suggests that males outperform females, females outperform males, while others find no differences in mean or variance. These inconsistent results are thought to occur for two reasons. First, studies rely on opportunity samples rather than samples that represent the general population. Second, researchers have not availed themselves of advances in psychometrics that allow for identification of bias in test items and the reliable evaluation of group differences. This dissertation addresses these two identified needs in the literature. Using a large representative U.K. sample, 926 seven to 18 year olds were assessed with the Raven’s Standard Progressive Matrices Plus (SPM+), a measure considered to be one of the best measures of general intelligence. In assessing a one-factor model of general intelligence, four research aims were addressed. First, confirmatory factor analyses and assessment of measurement invariance revealed that the SPM+ is not biased to either sex. Second, multiple group confirmatory factor analyses revealed there to be no significant differences between males and females in either mean or variance. Third, analyses revealed no significant sex differences in mean or variability in younger or older participants. Finally, method effects of Gestalt and Visuospatial answering strategies explained some of the residual variance in the model. For the overall sample, males were significantly disadvantaged by the visuospatial element of some of the items. For older participants, the influence of the methods effects was equivalent. It can generally be concluded that there are no significant sex differences in mean or variability on the SPM+ suggesting that there is no sex difference in general intelligence. Future research should employ representative samples and robust statistical methodologies to assess sex differences on the Raven’s from a multiple factor perspective. Description: Approved hardbound copy has subtitle "a psychometric investigation of group differences in mean and variability as measured by the Raven's Standard Progressive Matrices Plus" Mon, 11 Jul 2011 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/241366 2011-07-11T23:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/237847 Title: Tackling Africa's chronic disease burden: from the local to the global Authors: de-Graft Aikins, Ama; Unwin, Nigel; Agyemang, Charles; Allotey, Pascale; Campbell, Catherine; Arhinful, Daniel Abstract: Abstract Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them. Description: RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are. Sun, 18 Apr 2010 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/237847 2010-04-18T23:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/237790 Title: Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: The PREVENT trial Authors: Kuyken, Willem; Byford, Sarah; Byng, Richard; Dalgleish, Tim; Lewis, Glyn; Taylor, Rod; Watkins, Edward R; Hayes, Rachel; Lanham, Paul; Kessler, David; Morant, Nicola; Evans, Alison Abstract: Abstract Background Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM) can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. We need to develop psychological therapies that prevent depressive relapse/recurrence. A recently developed treatment, Mindfulness-based Cognitive Therapy (MBCT, see http://www.mbct.co.uk) shows potential as a brief group programme for people with recurring depression. In two studies it has been shown to halve the rates of depression recurring compared to usual care. This trial asks the policy research question, is MBCT superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and, secondary outcomes of (a) depression free days, (b) residual depressive symptoms, (c) antidepressant (ADM) usage, (d) psychiatric and medical co-morbidity, (e) quality of life, and (f) cost effectiveness? An explanatory research question asks is an increase in mindfulness skills the key mechanism of change? Methods/Design The design is a single blind, parallel RCT examining MBCT vs. m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT plus ADM-tapering with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre/post-treatment and a qualitative study of service users' views and experiences. Discussion If the results of our exploratory trial are extended to this definitive trial, MBCT will be established as an alternative approach to maintenance anti-depressants for people with a history of recurrent depression. The process studies will provide evidence about the effective components which can be used to improve MBCT and inform theory as well as other therapeutic approaches. Trial registration number ISRCTN26666654 Description: RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are. Tue, 19 Oct 2010 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/237790 2010-10-19T23:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/237712 Title: Developing effective chronic disease interventions in Africa: insights from Ghana and Cameroon Authors: de-Graft Aikins, Ama; Boynton, Petra; Atanga, Lem L Abstract: Abstract Background Africa faces an urgent but 'neglected epidemic' of chronic disease. In some countries stroke, hypertension, diabetes and cancers cause a greater number of adult medical admissions and deaths compared to communicable diseases such as HIV/AIDS or tuberculosis. Experts propose a three-pronged solution consisting of epidemiological surveillance, primary prevention and secondary prevention. In addition, interventions must be implemented through 'multifaceted multi-institutional' strategies that make efficient use of limited economic and human resources. Epidemiological surveillance has been prioritised over primary and secondary prevention. We discuss the challenge of developing effective primary and secondary prevention to tackle Africa's chronic disease epidemic through in-depth case studies of Ghanaian and Cameroonian responses. Methods A review of chronic disease research, interventions and policy in Ghana and Cameroon instructed by an applied psychology conceptual framework. Data included published research and grey literature, health policy initiatives and reports, and available information on lay community responses to chronic diseases. Results There are fundamental differences between Ghana and Cameroon in terms of 'multi-institutional and multi-faceted responses' to chronic diseases. Ghana does not have a chronic disease policy but has a national health insurance policy that covers drug treatment of some chronic diseases, a culture of patient advocacy for a broad range of chronic conditions and mass media involvement in chronic disease education. Cameroon has a policy on diabetes and hypertension, has established diabetes clinics across the country and provided training to health workers to improve treatment and education, but lacks community and media engagement. In both countries churches provide public education on major chronic diseases. Neither country has conducted systematic evaluation of the impact of interventions on health outcomes and cost-effectiveness. Conclusions Both Ghana and Cameroon require a comprehensive and integrative approach to chronic disease intervention that combines structural, community and individual strategies. We outline research and practice gaps and best practice models within and outside Africa that can instruct the development of future interventions. Description: RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are. Sun, 18 Apr 2010 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/237712 2010-04-18T23:00:00Z http://www.dspace.cam.ac.uk:80/handle/1810/237631 Title: Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review Authors: Agyemang, Charles; Addo, Juliet; Bhopal, Raj; de-Graft Aikins, Ama; Stronks, Karien Abstract: Abstract Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe. Description: RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are. Mon, 10 Aug 2009 23:00:00 GMT http://www.dspace.cam.ac.uk:80/handle/1810/237631 2009-08-10T23:00:00Z