Physicians' understanding of patients' personal representations of their diabetes: accuracy and association with self-care

The degree of accuracy with which physicians understand their patients' views may be of central importance for promoting self-care in the majority of chronic illnesses and in type 2 diabetes in particular. The objectives of this study were to measure the accuracy of the general practitioners' understanding of the patients' views and relate it to health behavioural outcomes in patients with non-complicated type 2 diabetes. The participants in this cross-sectional study consisted of 14 clinicians and 78 of their patients from Paris, France. The predictors were levels of accuracy in understanding the patients' views derived from the illness perception questionnaire-revised (IPQ-R). The outcomes were patient-reported self-care measures. In regression models controlling for clinical and personal variables, higher accuracy on chronicity beliefs was associated with an improved diet and increased blood glucose self-testing and higher accuracy in identifying treatment control beliefs was associated with better dietary self-care. Accuracy was higher with regard to beliefs about causes, treatment control and consequences. These results suggest that accuracy may impact self-care in specific domains of illness perception but not others. The results may help identify useful avenues of communication training designed for professionals.     

Reviews: Books

SCHOPENHAUER'S PORCUPINES: INTIMACY AND ITS DILEMMAS. By Deborah Anna Luepnitz. 275 pp. New York: Basic Books, 2002. $25.00. CITY OF ONE A MEMOIR. By Francine Cournos. 253 pp. New York: Plume, 2000. $12.95. YIDDISHE KOP: CREATIVE PROBLEM SOLVING IN JEWISH LEARNING, LORE, AND HUMOR. By Rabbi Nilton Bonder. Boston: Shambhala, 1999.     

Reviews: Books

ATTACKED BY POISON IVY: A PSYCHOLOGICAL UNDERSTANDING. By Ann Belford Ullanov, 203 pp. York Beach, ME: Nicholas-Hays, Inc., 2001. $18.95. WHERE WAS GOD ON SEPTEMBER 11? SEEDS OF FAITH AND HOPE. By Donald B. Kraybill and Linda Gehman Peachy (Eds.). Scottdale, PA: Herald Press, 2002. $10.95. GENETIC TURNING POINTS: THE ETHICS OF HUMAN GENETIC INTERVENTION. By James C. Peterson. Grand Rapids, MI: Wm B. Eerdmans Year, 2001. $22.00. RELIGIOUS THERAPEUTICS: BODY AND HEALTH IN YOGA, AYURVEDA, AND TANTRA. By Gregory P. Fields. 222 pp. Albany, NY: State University of New York Press, 2001. $17.95. TRANSCENDING: REFLECTIONS OF CRIME VICTIMS. By Howard Zehr. Scottdale, PA: Herald Press, 2001. $18.95. SANDPLAY THERAPY, A STEP-BY-STEP MANUAL FOR PSYCHOTHERAPISTS OF DIVERSE ORIENTATIONS. By Barbara Labovitz Boik and E. Anna Goodwin, 278 pp. New York: W. W. Norton &; Company, 2000. $35.00. CELTIC PARABLES. By Robert Van De Weyer, 64 pp. Nashville: Abingdon Press, 1999. $10.00. SECOND OPINION: REFLECTING ON CONTEMPORARY ISSUES IN BIOETHICS. By Bruce Hilton. Nashville: Abingdon Press, 2001. $12.00. PROTECTING THE EMOTIONAL DEVELOPMENT OF THE ILL CHILD: THE ESSENCE OF THE CHILD LIFE PROFESSION. By Evelyn K. Oremland, Ph.D., edited by Jerome D. Oremland, M.D., 266 pp. Madison, CT: Psychosocial Press, 2000. $45.00.     

Deliver us from evil: the effects of mortality salience and reminders of 9/11 on support for President George W. Bush

According to terror management theory, heightened concerns about mortality should intensify the appeal of charismatic leaders. To assess this idea, we investigated how thoughts about death and the 9/11 terrorist attacks influence Americans' attitudes toward current U.S. President George W. Bush. Study 1 found that reminding people of their own mortality (mortality salience) increased support for Bush and his counterterrorism policies. Study 2 demonstrated that subliminal exposure to 9/11-related stimuli brought death-related thoughts closer to consciousness. Study 3 showed that reminders of both mortality and 9/11 increased support for Bush. In Study 4, mortality salience led participants to become more favorable toward Bush and voting for him in the upcoming election but less favorable toward Presidential candidate John Kerry and voting for him. Discussion focused on the role of terror management processes in allegiance to charismatic leaders and political decision making.     

Exposure to a retrieval cue in rats induces changes in regional brain glucose metabolism in the amygdala and other related brain structures

Pre-test exposure to training-related cues is known to improve subsequent retention performance. To identify brain regions engaged in processes promoted by retrieval cues, a brain imaging approach using the [6-14C]glucose autoradiographic technique was used. Sprague-Dawley rats trained in a brightness discrimination avoidance task were submitted to different cueing conditions after a 1- or a 21-day training-to-test interval (TTI). Animals were either non-cued, cued with a box, or cued with a box and the light that served as a discriminative stimulus. Effects of the different cueing conditions on retention performance or on metabolic activity in 58 different brain regions were investigated. Rats cued with the light exhibited a subsequent improvement of their retention performance relative to controls, when tested at the 1- but not 21-days TTI, confirming our previous results. At the 1-day retention interval, a comparison between rats cued with the box and rats cued with the box and the light showed that the light cue significantly increased glucose uptake in a neuronal network composed of the lateral, basal, and central nuclei of the amygdala, the anterior and suprachiasmatic hypothalamic nuclei, the nucleus accumbens, the medial septum, and the insular cortex. In contrast, at the 21-day retention interval, both groups demonstrated similar cerebral metabolic activity. The present results indicate that exposure to a light cue increased metabolic activity in the previously mentioned brain structures only when the light acted as an effective retrieval cue, suggesting an involvement of this network in the processes triggered by a retrieval cue. Arguments are provided supporting the notion that the amygdala may play a key role in these processes. Whether the amygdala is a part of a neural network involved in retrieval processes or in neuromodulating systems that favour the efficacy of retrieval processes is also discussed.     

New Wine in a New Bottle: Refining The Assessment of Authentic Leadership Using Exploratory Structural Equation Modeling (ESEM)

The aim of this study was to investigate the multidimensional nature of authentic leadership (AL) through the re-evaluation of the factor structure of the most commonly used scales in AL research, the Authentic Leadership Questionnaire (ALQ) and the Authentic Leadership Inventory (ALI). Results from Exploratory Structural Equation Modeling (ESEM) conducted among 538 workers of private (57,81%) and public (42,19%)? organizations provide support for the multidimensional nature of AL but also reveal excessive content overlap across subscales and an inability to properly reflect the a priori factor structure of both instruments. Further analyses enabled the identification of key items from both instruments providing a cleaner depiction of the a priori dimensionality of AL, leading to the development of an integrated optimized measure, the Authentic Leadership Integrated Questionnaire (AL-IQ). The main contribution of this study is the proposition of an alternative and optimized measure of authentic leadership that sheds light on the distinct theoretical facets of this positive leadership style. Our data suggest that the AL-IQ is a promising tool for characterizing the strengths and weaknesses of leaders and managers’ AL practices. To our knowledge, this is the first study to use a combination of classical Confirmatory Factor Analyses (CFA) and newly developed ESEM framework to assess the construct validity (factor structure, reliability, and criterion-related validity) of the two main AL measures: the ALQ and the ALI.     

The evolution of problem and social competence behaviors during toddlerhood: A prospective population‐based cohort survey

Research in developmental psychopathology has long been preoccupied with rather broad categories of behavior, but we know little about the specific behaviors that comprise these categories. The objective of this study was to: (a) estimate the prevalence of problem and social competence behaviors in the general population of children at 17 months of age, and (b) describe the continuity and discontinuity in the degree to which children exhibit these behaviors between 17 and 29 months of age. The results show that frequent problem behaviors are not typical of children under two years of age. Further, the results suggest that it is possible to distinguish between different types of problem behaviors before two years of age. In addition, the results show that gender differences in some problem behaviors are already present before two years of age, and increase in magnitude during toddlerhood. Finally, the results show that interindividual differences in problem behaviors observed before two years of age are stable. The predictive accuracy of frequent problem behaviors in children at 17 months of age was limited, however, with often a majority of toddlers not behaving this way a year later. Overall, our results suggest that toddlerhood represents a critical period when behavioral and emotional problems of potentially clinical significance emerge. Pediatricians should routinely ask parents to report the frequency of their young children's problem behaviors during child health supervision visits so that children whose frequent problem behaviors persist over time can be identified and possibly referred for treatment.     

Decision making and visibility in cats (Felis catus) in a progressive elimination task

When making decisions animals can rely on information stored in memory and/or on information available through perceptual processes. Under some circumstances, perceptual access to a relevant piece of information can be lost as when a prey hides under a cover. If this piece of information is critical, the animal must be able to keep it active in the working memory until the final decision is made. Species endowed with object permanence can to a certain extent overcome such a lack of perceptual access. Numerous studies have investigated object permanence in animals, but no study systematically examined the interaction when making a decision between an information directly available through perception and an information that can no longer be perceived. In the present study, domestic cats (Felis catus) were administered a progressive elimination task in which they had to visit and deplete either two visible and one hidden target (e.g., Experiments 1 and 2) or one visible and two hidden targets (e.g., Experiments 3 and 4). The cats were brought back to the starting point after each visit to any target whether that target had been previously visited or not. The results revealed that the cats searched at the visible target(s) first and at the hidden target(s) last, which was referred to as the visibility rule. The results also revealed that the position of the bowl that was distinct (e.g., the visible bowl when the two other ones were hidden and the opposite) influenced the way this cognitive rule was implemented. More specifically, when the intermediate bowl was distinct the visibility rule was readily implemented but when either the right of the left bowl was distinct the visibility was violated. That is the cats did no longer choose the visible target(s) first. The visibility rule was interpreted in terms of optimization principles, the external distinct target effect was interpreted in terms of divided attention and lateralization.     

Identification des facteurs liés à la consommation de cigarettes,d'alcool et de drogues à l'adolescence

The goal of this study was to identify protective and risk factors linked to substance use during adolescence. A sample of 1000 subjects participated in a four‐wave data collection. Results showed that precocious substance use is likely to be persistent. Moreover, school inadaptation, lack of parental supervision and positive self‐perception in relationships with peers have been identified as risk factors predictive of cigarette, alcohol and drug use. Protective factors were associated with high moral qualities and negative reaction to mother's use of cigarettes and alcohol. Findings are discussed in terms of developmental trajectories which might lead to substance use and abuse through adult life.