Illness perceptions, beliefs and prevention of Type 2 Diabetes among British Pakistani mothers and young British Pakistani women

The prevalence rates of type2 diabetes mellitus (T2DM) continues to rise among British Pakistanis. The aim of this project was to explore T2DM perceptions and any preventative intentions among British Pakistani women and to discover whether they are doing anything to prevent the onset in themselves and their families. Initially a systematic review was conducted to investigate 20 existing prevention interventions and to assess their effectiveness (n=12,419). Mixed methods approach was adopted and three studies were conducted. The first study consisted of two focus groups with T2DM mothers (n=8) and three focus groups with non-T2DM mothers (n=17). The second study consisted of four focus groups young British Pakistani females (n=11). All focus groups were transcribed verbatim and analysed using thematic analysis. Following these a quantitative study was undertaken comprising of a questionnaire survey; 12 prevention-perception items (derived from the qualitative data) and the Illness-Perception Questionnaire Revised (IPQ-R) using participants from the same populations: T2DM mothers (n=41), non-T2DM mother (n=47) and young women (n=42). Results were analysed using multiple/hierarchical regression. The systematic review highlighted that the most effective prevention programmes focussed on behaviour and lifestyle with a combination of support and education to participants. The research studies demonstrated that T2DM was seen as an older person’s disease to be dealt with if/when it happens. T2DM mothers demonstrated knowledge and prevention understanding. There were non-significant relationships between prevention perceptions and T2DM illness perceptions across all three groups. The finding of this thesis emphasised that lifestyle interventions are crucial to aiding T2DM preventions as a good healthy diet and regular physical activity are the key components to T2DM prevention, and the importance of personal experience in perceived severity and lay-beliefs regarding T2DM and on family/cultural influences in British-Pakistanis. The findings of this project can be used to design culturally specific interventions towards preventing T2DM in the British Pakistani community.

The development of Cannabidiol as a psychiatric therapeutic:a review of its antipsychotic efficacy and possible underlying pharmacodynamic mechanisms

Cannabidiol (CBD), a once-considered inert cannabis constituent, is one of two primary constituents of cannabis, alongside delta-9-tetrahydrocannabinol (?9-THC/THC). In the last 30 years, CBD has become implicated with a range of pharmaceutical mechanisms of great therapeutic interest and utility. This review details the literature speculating CBD’s attenuation of psychotic symptoms, particularly in light of a marked elevation in mean THC concentrations, and a concomitant decline in CBD concentrations in the prevalent U.K street market cannabis derivatives since c. 2000. CBD is purported to exhibit pharmacology akin to established atypical antipsychotics, whilst THC has been implicated with the precipitation of psychosis, and the induction of associated symptoms. The aim of the review was to clarify the conjecture surrounding CBD’s antipsychotic efficacy, before going on to detail prominent theories about its associated pharmacodynamics. Were CBD’s antipsychotic efficacy established, then there is potential for major latent anthropological repercussions to manifest, such as significant elevations in psychosis manifestations in the U.K. The review found a largely affirmative body of evidence asserting CBD’s antipsychotic efficacy. CBD exhibited capacity to attenuate natural and artificially induced psychoses in both animal and human cohorts, the latter of which included individuals considered resistant to conventional treatment. CBD also shows promising potential for use as an antipsychotic drug for Parkinson’s disease (PD) patients with psychosis, owing to its low rate of extra-pyramidal side-effect induction. A range of potential pharmacological mechanisms behind CBD’s neuroleptic pharmacology are outlined, with particular emphasis on its prevention of the hydrolysis and reuptake of the endogenous cannabinoid, anandamide. However, given the nebular aetiological basis for psychoses, explicit conclusions on how CBD attenuates psychotic symptoms remains to be determined.

Response to out of stock produce and its underlying economic considerations

The goal of this research is to investigate consumer response to out-of-stock product in the produce category. We do this by comparing results from a survey conducted in Greece and the United States to previous research on consumer response to out-of-stock situations for other perishable and non-perishable products. We further examined the underlying economic reasoning as well as the cultural and physical differences between the United States and Greece as explanations of different reactions. Out of Stock produce response proved different in produce than in other perishables and non-perishables. There is some evidence that produce does follow previous the suggested economic reasoning from the previous research, especially within transaction costs. Finally, the respondent’s country proved very significant in dictating response.

Stability and continuity of women's core beliefs and psychopathological symptoms from pregnancy to one year postpartum

Unhealthy core beliefs are theorized to be stable constructs throughout the life-span, but no research to date, outside of the context of clinical intervention, has addressed this claim over a period of greater than 6 weeks. This study explores the stability and continuity of core beliefs and psychopathological symptoms in a group of women over a major life event and for 1 year subsequently. Eighty-seven women completed measures assessing their core beliefs and psychopathological symptoms during pregnancy and at 6 and 12 months after giving birth. General maternal psychopathological symptoms significantly decreased across the group between pregnancy and 6 months postpartum, and between pregnancy and 1 year, but showed evidence of stability in the ranks of individuals across time. The majority of core beliefs remained both stable and continuous throughout this period of major transition. These findings generally support the theoretical contention that core beliefs are relatively stable and continuous self-constructs. Science+Business Media, LLC.

The development of maternal self-esteem

Although an important theoretical concept, little is known about the development of maternal self-esteem. This study explores the significance of maternal cognitions, psychopathological symptoms, and child temperament in the prediction of prenatal and postnatal maternal self-esteem. During pregnancy 162 women completed measures assessing their unhealthy core beliefs, psychopathological symptoms, and self-esteem. At 1 year postpartum 87 of these women completed measures assessing their self-esteem and their child's temperament. Overall maladaptive maternal core beliefs and psychopathological symptoms during pregnancy explained 19% of the variance in prenatal maternal self-esteem. Forty-two percent of the variance in maternal self-esteem at 1 year could be explained by a combination of prenatal maternal self-esteem, mental health symptoms, maternal core beliefs, and more unsociable infant temperament. Underlying maternal cognitive structures may be important in determining the development of maternal self-esteem. © 2007 2006 Michigan Association for Infant Mental Health.

Maternal core beliefs and children's feeding problems

Background: Although maternal mental health problems have been implicated in the exacerbation of childhood feeding difficulties, little research has assessed the contribution of broader maternal cognitions to these problems. The current study examined gender differences in the relationships between mothers' core beliefs and children's feeding problems. Methods: One hundred and three mothers of girls and 93 mothers of boys (age range, 7-64 months) completed the Young Schema Questionnaire and the Child Feeding Assessment Questionnaire. Results: While controlling for child age, a clear link between maternal core beliefs and perceived feeding difficulties emerged for mothers of girls. In particular, abandonment, failure to achieve, dependence and incompetence, enmeshment and defectiveness, and shame beliefs were associated with increased reports of feeding problems in girls. In contrast, emotional deprivation and subjugation beliefs were associated with maternal reports of food fussiness and food refusal in boys. Conclusions: There appears to be a clear role for maternal core beliefs in the reporting of feeding difficulties in children, and the specificity of these links differs depending on the gender of the child. Further research is required to establish the direction of causality and the specificity of these relationships. © 2005 by Wiley Periodicals, Inc.

Testamentary trusts and the rule against capricious purposes:an underlying rationale?

This paper examines the rule against capricious purpose trusts and examines its application in English law but more particularly drawing upon the experiences of other common law jurisdictions and seeks to create a rationale for the operation o the doctrine in the common law world.

New lecturers' beliefs about learning, teaching and assessment in higher education:the role of the PGCLTHE programme

This study was carried out with new lecturers on a two year Post Graduate Certificate in Learning and Teaching in Higher Education programme in a UK university. The aim was to establish their beliefs about how studying on the programme aligned with their teaching and learning philosophy and what, if anything, had changed or constrained those beliefs. Ten lecturers took part in an in-depth semi-structured interview. Content analysis of the transcripts suggested positive reactions to the programme but lecturers’ new insights were sometimes constrained by departments and university bureaucracy, particularly in the area of assessment. The conflicting roles of research and teaching were also a major issue facing these new professionals.

A mixed methods investigation of parental factors in non-attendance at general paediatric hospital outpatient appointments

Non-attendance at paediatric outpatient appointments results in delayed diagnosis and treatment, putting children at risk of avoidable ill health, and incurring considerable health service costs. Links between missed appointments and clinical, socio-demographic, and access-related factors have been indicated, but parental cognitions associated with non-attendance have yet to be investigated. The aims of this project were to evaluate the effectiveness and theoretical bases of existing interventions designed to reduce non-attendance; to consider the ways in which missed appointments are managed by healthcare providers; to explore parents’ beliefs and experiences of attending and missing appointments; and to investigate the factors underlying these beliefs. A systematic literature review focusing on non-attendance interventions was conducted Within a mixed methods framework, interviews were conducted with healthcare professionals, subsequent interviews were conducted with parents who had attended or missed a General Paediatric outpatient appointment, and a cross-sectional questionnaire study of parents’ beliefs was implemented. The systematic review revealed that text message appointment reminders are effective at reducing non-attendance rates, but that no interventions have thus far been developed using theories of behaviour. Healthcare professionals recognised both barriers and parents’ beliefs as influences on attendance, but also believed there were ‘types’ of families who miss appointments. Healthcare professionals disagreed somewhat about how non-attendance should best be managed. The parent interview study found six themes. The findings reflect parents’ perceptions about the importance of attending and of their ability to attend. The results of the questionnaire study corroborate this structure of beliefs as the analysis produced two factors, the perceived ‘worth’ of attending and anticipated ‘worry’ when attending. This thesis demonstrates an original approach to investigating non-attendance at children’s outpatient appointments, using mixed methods and adopting a psychological rather than service-use perspective. The findings contribute to Health Psychology theory and offer recommendations for healthcare providers.

Shared cognitive processes underlying past and future thinking:the impact of imagery and concurrent task demands on event specificity

Recent literature has argued that whereas remembering the past and imagining the future make use of shared cognitive substrates, simulating future events places heavier demands on executive resources. These propositions were explored in 3 experiments comparing the impact of imagery and concurrent task demands on speed and accuracy of past event retrieval and future event simulation. Results provide support for the suggestion that both past and future episodes can be constructed through 2 mechanisms: a noneffortful "direct" pathway and a controlled, effortful "generative" pathway. However, limited evidence emerged for the suggestion that simulating of future, compared with retrieving past, episodes places heavier demands on executive resources; only under certain conditions did it emerge as a more error prone and lengthier process. The findings are discussed in terms of how retrieval and simulation make use of the same cognitive substrates in subtly different ways. © 2011 American Psychological Association.

Adherence to treatment in children and adolescents with cystic fibrosis:a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

Background: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence. Methods: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence. Conclusions: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.

BOWL:augmenting the semantic web with beliefs

As the Semantic Web is an open, complex and constantly evolving medium, it is the norm, but not exception that information at different sites is incomplete or inconsistent. This poses challenges for the engineering and development of agent systems on the Semantic Web, since autonomous software agents need to understand, process and aggregate this information. Ontology language OWL provides core language constructs to semantically markup resources on the Semantic Web, on which software agents interact and cooperate to accomplish complex tasks. However, as OWL was designed on top of (a subset of) classic predicate logic, it lacks the ability to reason about inconsistent or incomplete information. Belief-augmented Frames (BAF) is a frame-based logic system that associates with each frame a supporting and a refuting belief value. In this paper, we propose a new ontology language Belief-augmented OWL (BOWL) by integrating OWL DL and BAF to incorporate the notion of confidence. BOWL is paraconsistent, hence it can perform useful reasoning services in the presence of inconsistencies and incompleteness. We define the abstract syntax and semantics of BOWL by extending those of OWL. We have proposed reasoning algorithms for various reasoning tasks in the BOWL framework and we have implemented the algorithms using the constraint logic programming framework. One example in the sensor fusion domain is presented to demonstrate the application of BOWL.

A new appraisal-based framework underlying hope in conflict resolution

Hope is a positive emotion that plays a pivotal role in intractable conflicts and conflict resolution processes by inducing conciliatory attitudes for peace. As a catalyser for conflict resolution, it is important to further understand hope in such contexts. In this paper we present a novel framework for understanding hope in contexts of intergroup conflict. Utilizing appraisal theory of emotions and heavily relying on the implicit theories framework, we describe three targets upon which hope appraisals focus in intractable conflict - the conflict, the outgroup, and the ingroup. Next, we describe the importance of developing ways to experimentally induce hope, and utilize the appraisal-target framework to describe and classify existing and potential interventions for inducing hope in intractable conflict resolution.

The effects of servant leadership on follower performance and well-being:underlying mechanisms, boundary conditions, and the role of training

Based on a review of the servant leadership, well-being, and performance literatures, the first study develops a research model that examines how and under which conditions servant leadership is related to follower performance and well-being alike. Data was collected from 33 leaders and 86 of their followers working in six organizations. Multilevel moderated mediation analyses revealed that servant leadership was indeed related to eudaimonic well-being and lead-er-rated performance via followers’ positive psychological capital, but that the strength and di-rection of the examined relationships depended on organizational policies and practices promot-ing employee health, and in the case of follower performance on a developmental team climate, shedding light on the importance of the context in which servant leadership takes place. In addi-tion, two more research questions resulted from a review of the training literature, namely how and under which conditions servant leadership can be trained, and whether follower performance and well-being follow from servant leadership enhanced by training. We subsequently designed a servant leadership training and conducted a longitudinal field experiment to examine our sec-ond research question. Analyses were based on data from 38 leaders randomly assigned to a training or control condition, and 91 of their followers in 36 teams. Hierarchical linear modeling results showed that the training, which addressed the knowledge of, attitudes towards, and ability to apply servant leadership, positively affected leader and follower perceptions of servant leader-ship, but in the latter case only when leaders strongly identified with their team. These findings provide causal evidence as to how and when servant leadership can be effectively developed. Fi-nally, the research model of Study 1 was replicated in a third study based on 58 followers in 32 teams drawn from the same population used for Study 2, confirming that follower eudaimonic well-being and leader-rated performance follow from developing servant leadership via increases in psychological capital, and thus establishing the directionality of the examined relationships.

Every hierarchy of beliefs is a type

When modeling game situations of incomplete information one usually considers the players’ hierarchies of beliefs, a source of all sorts of complications. Harsányi (1967-68)’s idea henceforth referred to as the ”Harsányi program” is that hierarchies of beliefs can be replaced by ”types”. The types constitute the ”type space”. In the purely measurable framework Heifetz and Samet (1998) formalize the concept of type spaces and prove the existence and the uniqueness of a universal type space. Meier (2001) shows that the purely measurable universal type space is complete, i.e., it is a consistent object. With the aim of adding the finishing touch to these results, we will prove in this paper that in the purely measurable framework every hierarchy of beliefs can be represented by a unique element of the complete universal type space.