Assessing the quality of life of HIV infected persons: Clinical and descriptive information from studies with the hopes

Abstract

We have recently developed and psychometrically evaluated an HIV-specific quality of life instrument. The new instrument is called the HIV Overview of Problems-Evaluation System (HOPES) which was adapted from an established cancer-specific quality of life instrument called the CARES. In this paper we review the psychometric properties of the HOPES, examine the quality of life impact of HIV infection in a cross-sectional evaluation of 318 patients using data from the HOPES and describe other work in progress or planned using the HOPES.     

Support of Theological Education in a Cross‐cultural Setting

Based on recent reports on the global status quo of theological education, including a mapping of Danish organizations supporting theological education in a cross‐cultural setting, the paper asks how theological education is best supported. It argues that theological education, while referring to a historical heritage and sacred text, is also exposed to developments in church and society. Stretched between the historical and contemporary perspective, theological education includes a cultural component that we need to consider when discussing development and support. The paper argues further that support of theological education offered in a cross‐cultural setting is susceptible to failure if the cultural aspect is not considered, primarily through engaging in the cultural background of the supporting agencies. As a help to identifying the cultural element, the paper proposes four indicators, challenging agencies of the global North to face latent aspects of culture and secularization, presenting a global and social perspective of theological education. The cultural component visualized in cross‐cultural support reveals that we must complement the classical notion of theological education as Christian leadership training with an understanding of formation, where spiritual and cognitive aspects accompany social and cultural critique of totalitarian regimes both inside and outside churches. Critique in this setting is not a matter of giving in to secularization, but rather expresses an openness to historical and contemporary perspectives and a commitment to the sources of faith.     

Reactions to Terror Attacks: A Heuristic Model

What are the signature features of the reactions of mass publics to terrorist attacks? We argue that the available empirical evidence suggests a general pattern of reactions: The peaks of mass reactions to terrorist attacks are limited in size and duration and their end states marked by a return to baselines values of tolerance. We label this perturbation effects. In this article, we review the available evidence for perturbation effects, build a heuristic model of such effects and provide an explanation of their characteristic pattern, combing theories of emotional arousal and opinion leadership. Finally, we relate the overlooked existence of perturbation effects to widespread fears about the frailty of democratic norms in the face of mass terrorism.     

Solutions to some problems in the implementation of conjoint analysis

Methodological problems encountered in implementing conjoint analysis include (1) the impractically large set of multiattribute choice alternatives created by the factorial combination of more than a few attributes, (2) the hypothetical nature of the alternatives in the choice set, and (3) the assumption that each individual’s preferences can be described by the same composition rule. The techniques of tailoring, belief matching, and axiom testing are suggested as solutions to these problems, and their use is demonstrated in a conjoint analysis study of individuals’ contraceptive preferences. It is noted that tailoring and belief matching can also be used as methodological enhancements in functional measurement studies.     

Effectiveness of an Individualized Case Formulation-Based CBT for Non-responding Youths with Anxiety Disorders

The study examined the effectiveness of an individualized case formulation-based cognitive behavior therapy (CBT) for youths (9–17 years) with anxiety disorders and their parents after unsuccessful treatment with a manualized group CBT program (the Cool Kids). Out of 106 participant youths assessed at a 3-month follow-up after manualized CBT, 24 were classified as non-responders on the Clinical Global Impression-Improvement scale (CGI-I), and 14 of 16 non-responders with anxiety as their primary complaint accepted an offer for additional individual family CBT. The treatment was short-term (M sessions = 11.14) and based on a revised case formulation that was presented to and agreed upon by the families. At post-treatment, nine youths (64.3 %) were classified as responders on the CGI-I and six (42.9 %) were free of all anxiety diagnoses, while at the 3-month follow-up 11 (78.6 %) had responded to treatment and nine (64.3 %) had remitted from all anxiety diagnoses. Large effect sizes from pre- to post-individualized treatment were found on youths’ anxiety symptoms, self-reported (d = 1.05) as well as mother-reported (d = .81). There was further progress at the 3-month follow-up, while treatment gains remained stable from post-treatment to the 1-year follow-up. Results indicate that non-responders to manualized group CBT for youth anxiety disorders can be helped by additional CBT targeting each family’s specific needs.     

Contextual control of letter perception

This study examined the hypothesis that the type of list context in which a given item is embedded may affect the way in which it is perceptually processed. In the first experiment, subjects matched four types of test items inserted in four types of lists. The types of test items and the types of lists in which they were embedded were two-letter words, two-letter spelling clusters, unrelated letter pairs, and pairs of novel letters. The first experiment indicated that only unrelated letter pairs were significantly affected by type of list in which they were inserted. The pattern of the effect was confirmed in the latency data of the second experiment and the interpretation was that only unrelated letter and related letter-group contexts were operating in the first two experiments. The third and fourth experiments were concerned with contrasting contexts at the feature and letter levels of processing. By using lists in which type of catch trial either emphasized local features or global aspects of a pattern, the processing times of both familiar and unfamiliar letters were affected. The results of these experiments suggest that information processing models should incorporate structures which represent the way that context selectively facilitates processing of items at particular levels.     

Adolescents' expectancies of success,self-evaluations,and attributions about performance on spatial and verbal tasks

The present study examined the expectancies of success, evaluations of performance, and achievement-related attributions that high school students made about verbal and spatial tasks that typically show sex differences. Although no sex differences were found in task performance, boys expected to do better than girls on both the spatial and verbal tasks. After completing the task, the girls continued to evaluate their performance more negatively than did boys on the spatial tasks. On spatial tasks girls also attributed to themselves less ability and saw the tasks as being more difficult than did boys. The results suggest that there are generalized, rather than task-specific, sex differences in achievement expectancies, evaluations, and attributions. These findings are discussed in terms of their implications for sex-related differences in cognitive functioning and subsequent achievement behaviors.The authors gratefully acknowledge support from the Judith Offer Fund and from the Spencer Foundation.     

Age-associated memory impairment diagnoses: problems of reliability and concerns for terminology.

Objective memory criteria for diagnosing age-associated memory impairment (AAMI), age-consistent memory impairment, and late-life forgetfulness (LLF) were applied to 523 cognitively normal older persons divided into 2 groups on the basis of the clinical memory assessment battery they received. Seventy-seven percent of Group 2 and 98% of Group 1 met the Crook et al. (1986) cognitive criteria for AAMI on at least 1 test. Rates based on individual tests varied from 7% to 96%. Objective-cognitive criteria for LLF were met by no members of Group 1 but by 31% of Group 2. Results suggest that, as proposed, the criteria for age-related diagnoses lack reliability. Concerns regarding the diagnosis of normal memory in older populations are considered.