Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES – Australia

Objective: Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management.

Design: Diabetes MILES–Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (age: M = 52.1, SD = 13.9) with type 1 (T1D; n = 680) or type 2 diabetes (T2D; n = 944), who responded to a version of the survey containing key measures.

Main Outcome Measures: self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA_1c, medication/insulin adherence.

Results: We used Preacher and Hayes’ bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes < .06).

Conclusion: Support for mediation was weak, suggesting that relationships amongst these variables are small and that future research might explore other aspects of self-management in diabetes.     

Subjective Wellbeing Among Adults with Diabetes: Results from Diabetes MILES—Australia

This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which depression and socio-demographic factors account for subjective wellbeing is investigated. People with type 1 or type 2 diabetes have significantly lower subjective wellbeing compared to the general population, even after controlling for covariates (demographic and socio-economic status, diabetes duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health. These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.     

The electronic mood device: Design, construction, and application

The electronic mood device (EMD) is designed to help answer questions about the variability and dynamics of emotions. It is a small, portable instrument used for repeated recording of moods and feelings. Both construction and operation of the EMD are described. The EMD can best be conceived of as an electronic mood adjective checklist. Persons using the EMD are signaled at designated (e.g., hourly) or random intervals to register their mood or feelings. Paper and pencil are not required. An application is given. It shows how feelings vary within and between persons and during the day. It is concluded that the EMD offers several advantages over paper-and-pencil instruments. Retrospective use is impossible. Timing and registration are accurate. Data handling is fast. Potential future applications are suggested.     

Intellectual ability, learning style, personality, achievement motivation and academic success of psychology students in higher education

This study is directed towards an integration of intellectual ability, learning style, personality and achievement motivation as predictors of academic success in higher education. Correlational analyses partly confirmed and partly disconfirmed our expectations in a sample of 409 first-year psychology students. Consistent with the literature, intellectual ability and achievement motivation were associated positively with academic success. For the meaning directed, reproduction directed and application directed learning style, no positive association with academic success could be detected. The undirected learning style, however, appeared to be a consistent negative predictor. For the Big Five personality factors (extraversion, agreeableness, conscientiousness, neuroticism and openness to experience), a consistent, positive association for conscientiousness with academic success was found. The very first examination at the university came out as the most important predictor for academic success, even after two and three years of study. The implications of the results are discussed in relation to the literature and the policy of the Dutch Ministry of Education.     

Beyond the forest and the trees: local and global interference in hierarchical visual stimuli containing three levels

Our visual world can be thought of as organised in a hierarchical manner. Studies on hierarchical letter stimuli (a large letter composed of smaller letters) suggest that processing of a visual scene is global to local, a phenomenon known as the global-precedence effect. Elaborating on this global-to-local hypothesis we tested whether global interference will increase with increasing level of globality. For this, we used three-level hierarchical letter stimuli with a global, middle, and local level. When attending to the local level of the stimulus, only the middle level showed an interference effect, whereas the global level did not interfere at all. We argue that, considering the perceptual and attentional contributions to this effect, the hypothesis of global-to-local processing of a visual scene may only hold within a limited spatial attentional window.     

Copying without rewards: socially influenced foraging decisions among brown capuchin monkeys

An individual’s foraging activity can be influenced by the choices made by nearby conspecifics. The interest shown in the location and characteristics of a feeding patch may depend on the feeding success of a conspecific there, a process that needs to be distinguished from choices guided by rewards to the observer itself. We investigated how rewards for both self and others influence the foraging choices of captive capuchin monkeys (Cebus apella). Thirteen adult capuchins observed familiar female conspecific models explore one of three opaque boxes under three conditions. In the first, there were no rewards available to either monkey; in the second, rewards were available to the model only; and in the third, both monkeys could retrieve a reward. Under all conditions, subjects more often explored the same box as the model than was expected by chance. Thus, without ever receiving a reward themselves or without seeing another receive rewards, subjects’ searches were directed at the box explored by another monkey. The tendency to match the model’s choice increased if the subject was rewarded. We compared these results to control conditions in which the model was either absent, or present but not allowed to demonstrate. Subjects’ located the reward less often in control conditions, than in the experimental conditions. We conclude that extrinsic rewards, while helpful, are not required for partners to influence the foraging choices of capuchins, and that the unrewarded copying of foraging choices demonstrated here may provide the basis for additional social influences on learning. This contribution is part of the Special Issue “A Socioecological Perspective on Primate Cognition” (Cunningham and Janson 2007)     

Risk and Religion: Toward a Theology of Risk Taking

Historically the concept of risk is rooted in Renaissance lifestyles, in which autonomous agents such as sailors, warriors, and tradesmen ventured upon dangerous enterprises. Thus, the concept of risk inseparably combines objective reality (nature) and social construction (culture): Risk = Danger + Venture. Mathematical probability theory was constructed in this social climate in order to provide a quantitative risk assessment in the face of indeterminate futures. Thus we have the famous formula: Risk = Probability (of events) × the Size (of future harms). Because the concept of harm is always observer relative, however, risk assessment cannot be purely quantitative. This leads to the question, What are the general conditions under which risks can be accepted? There is, after all, a difference between incurring a risk and bearing the costs of risks selected for by other agencies. Against this background, contours of a theology of risk emerge. If God creates a self‐organizing world of relatively autonomous agents, and if self‐organization is favored by cooperative networks of autopoietic processes, then the theological hypothesis of a risk‐taking God is at least initially plausible. Moreover, according to the Christian idea of incarnation, God is not only taking a risk but is also bearing the risks implied by the openness of creation. I thus argue for a twofold divine kenosis—in creation as well as in redemption. I discuss some objections to this view, including the serious counterargument that risk taking on behalf of others remains, even for God, a morally dubious task. What are the conditions under which the notion of a risk‐taking God can be affirmed without leaving us with the picture of God as an arbitrary, cosmic tyrant? And what are the practical implications for the ways in which human agents of faith, hope, and love can learn to cope with the risks of everyday life and of political decisions?     

New perspectives on career and identity in the contemporary world

For much of the 20th century, career and identity have been intimately interwoven: to know about work has been to know about the self. But meanings for both are differently constructed at different times in different discourses.This article re-examines the meaning of the concept of 'identity' under late modern conditions. It draws on discourses ranging from neuro-physiology to autobiography. The primary purpose of the piece is to set up some signposts for alignment of the careers-work field to the demands of our time. In particular, the article concludes that much of policy-directed development in this field takes too little account of emerging and significant relationships between career and identity.     

Effect of a Faith-Based Education Program on Self-Assessed Physical,Mental and Spiritual (Religious) Health Parameters

The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire’s (SAQ’s) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27–76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18–84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p < 0.0001; PSS p < 0.0001; BIPQ p < 0.0001; and CES-D p < 0.0001; and at 1 month (S1:S3) for STAI-Trait p < 0.001; all changes were sustained (S3 through S5). This FBEP produced statistically and clinically significant changes; these lasted in those followed up >1 year.