Variations in physician practice and covert rationing

The use of recent research on variations in medical practice to promote competitive market oriented cost containment strategies is critically examined. Research demonstrating widespread variations in physician practices for similar patient populations undermines the medical profession's claims about the scientific objectivity of medical practice and indicates the existence of widespread waste and inappropriate utilization of health care resources. Cost containment programs which rely on market-based care avoidance incentives, such as Medicare prospective payment or cost sharing plans, attempt to impact medical practice variations by creating economic barriers between doctor and patient. An alternative interpretation of research on practice variations is presented, emphasizing containing costs while improving quality of care and achieving greater equity through planning and regulation of medical supply factors.     

Attentional asymmetries in a visual orienting task are related to temperament

Spatial asymmetries are an intriguing feature of directed attention. Recent observations indicate an influence of temperament upon the direction of these asymmetries. It is unknown whether this influence generalises to visual orienting behaviour. The aim of the current study was therefore to explore the relationship between temperament and measures of spatial orienting as a function of target hemifield. An exogenous cueing task was administered to 92 healthy participants. Temperament was assessed using Carver and White's (1994) Behavioural Inhibition System and Behavioural Activation System (BIS/BAS) scales. Individuals with high sensitivity to punishment and low sensitivity to reward showed a leftward asymmetry of directed attention when there was no informative spatial cue provided. This asymmetry was not present when targets were preceded by spatial cues that were either valid or invalid. The findings support the notion that individual variations in temperament influence spatial asymmetries in visual orienting, but only when lateral targets are preceded by a non-directional (neutral) cue. The results are discussed in terms of hemispheric asymmetries and dopamine activity.     

Psychometric Properties of the Beck Depression Inventory–II in Low-Income,African American Suicide Attempters

The construct of perfectionistic cognitions is defined as a state-like construct resulting from a perfectionistic self-schema and activated by specific situational demands. Only a few studies have investigated whether and how perfectionistic cognitions change across different situations and whether they reflect stable between-person differences or also within-person variations over time. We conducted 2 studies to investigate the variability and stability of 3 dimensions of perfectionistic cognitions while situational demands changed (Study 1) and on a daily level during a highly demanding period of time (Study 2). The results of both studies revealed that stable between-person differences accounted for the largest proportion of variance in the dimensions of perfectionistic cognitions and that these differences were validly associated with between-person differences in affect. The frequency of perfectionistic cognitions increased during students' first semester at university, and these average within-person changes were different for the 3 dimensions of perfectionistic cognitions (Study 1). In addition, there were between-person differences in the within-person changes that were validly associated with concurrent changes in closely related constructs (unpleasant mood and tense arousal). Within-person variations in perfectionistic cognitions were also validly associated with variations in unpleasant mood and tense arousal from day to day (Study 2).     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Brightness enhancement seen through a tube

We report a fascinating phenomenon that emerges when a surface is viewed through a tube held close to one eye, with the other eye open. The disk-shaped area seen through the tube looks strikingly brighter and, when viewed on a textured background, also of higher spatial contrast than the same surface area viewed without a tube. The effect is reminiscent of a spotlight illuminating the area under consideration. We call this the 'tube effect'. The tube effect is one of the strongest contrast illusions known to us. It requires a matching luminance that is twice as high as the reference luminance seen through the tube. Brightness ratings increase linearly with the log of the background luminance. The effect (i) produces a dark afterimage, (ii) reverses in polarity with low ambient illumination, (iii) assumes the complementary colour of the illuminant, and (iv) persists with fully dilated pupils. Potential explanations include simultaneous contrast (due to the penumbra and dark inner walls of the tube) and veiling of the surround (due to local adaptation and a lower gain factor).     

Sharing Data is a Shared Responsibility

Research data should be made readily available. A robust data-sharing plan, led by the principal investigator of the research project, requires considerable administrative and operational resources. Because external support for data sharing is minimal, principal investigators should consider engaging existing institutional information experts, such as librarians and information systems personnel, to participate in data-sharing efforts.     

Marital Satisfaction,Negative Interaction,and Religiosity: A Comparison of Three Age Groups

This study compared marital satisfaction among three age groups and examined how negative interaction patterns and religiosity relate to marital satisfaction at each age using a sample of Protestants (N = 45,387) diverse in denominations, location, geography, and size. We performed a 1-way ANOVA to compare marital satisfaction among three age groups (younger than 40, 40–59, and 60 and older) and found a U-shape curve with marital satisfaction highest among the youngest group, lowest among middle-age couples, and high among older couples. ANCOVA analysis found negative interaction, age, religiosity, age*negative interaction, and age*religiosity to be predictors of marital satisfaction.