Reducing obstacles to the provision of quality diabetic care

Abstract

High quality diabetic care is seen as influenced by the organisation of care, health care workers' involvement in diabetes-specific areas, co-operation among staff members, the availability of resources, and the competence of medical staff (including both physicians and nurses). In a prospective study we have tested a programme for improvements of the quality of diabetes services which combined organisational development and continuing medical education (CME) measures. The study involved 34 primary health care centres over an 18 month period and was based on the responses to questionnaires answered by 123 general practitioners and 247 registered nurses at the 34 PHCCs.

The combined programme had a considerable influence on inter-group co-operation, staff members' perceptions of resources available, and nurses' involvement in diabetic care (54 versus 30% seeing diabetic patients for regular check-ups).

The results show that, in order to diminish obstacles to high quality care, organisation of care as well as care workers' theoretical knowledge has to be focused.     

Environmentalism as a trait: gauging people's prosocial personality in terms of environmental engagement

According to Hardin (1968), environmental deterioration stems from self-interest undermining people's resource conservation in the collective interest. Not surprisingly, selfless prosocial motives, such as personal feelings of moral obligation, have often been recognized as a key force behind people's environmentalism. In our research, we anticipated that environmentalists-people with an inclination for pro-environmental engagement-would possess a propensity to generally act prosocially. In an extension of previous work, we expected that a well-established self-report measure of past conservation behavior would predict people's active participation in a psychological experiment. Based on subjects' degree of environmental engagement, originally established in 2003, we re-contacted a sample of 502 persons in 2005. Of these 502 (68.5% low, 31.5% high in environmentalism), 131 showed up for the announced experiment. Among those participants, we found that environmentalists' prosocial personalities were additionally reflected in their social value orientations. Ninety percent of the environmentalists turned out to be prosocials, whereas only 65% of the less environmentally engaged subjects were prosocials. Overall, our findings lend credit to a notion of environmentalism as an indicator of even subtle quantitative differences in a person's prosocial trait level. By and large, environmentalists acted more prosocially even in mundane activities unrelated to environmental conservation. Additional evidence comes from the commons dilemma experiment in which the participants partook. There, we generally found comparatively more cooperation with others for the collective good from people high in environmentalism. Our findings represent circumstantial evidence for a prosocial propensity dimension along which people differ, and which is also reflected in people's pro-environmental behavioral performance. If, however, environmentalism has to be regarded as indicative of a prosocial trait rather than a state-like motive, high hopes for moral norms and other prosocial motives in environmental conservation do not seem warranted.     

Self-regulation processes and thriving in childhood and adolescence: a view of the issues

Both organismic and intentional self-regulation processes must be integrated across childhood and adolescence for adaptive developmental regulations to exist and for the developing person to thrive, both during the first two decades of life and through the adult years. To date, such an integrated, life-span approach to self-regulation during childhood and adolescence has not been fully formulated. The purpose of this monograph is to provide such integration; in this introduction, the editors of the monograph explain the purposes of the volume and provide a brief overview of the work of the contributing scholars.     

SECRECY IN CONSEQUENTIALISM: A DEFENCE OF ESOTERIC MORALITY

Sidgwick's defence of esoteric morality has been heavily criticized, for example in Bernard Williams's condemnation of it as 'Government House utilitarianism.' It is also at odds with the idea of morality defended by Kant, Rawls, Bernard Gert, Brad Hooker, and T.M. Scanlon. Yet it does seem to be an implication of consequentialism that it is sometimes right to do in secret what it would not be right to do openly, or to advocate publicly. We defend Sidgwick on this issue, and show that accepting the possibility of esoteric morality makes it possible to explain why we should accept consequentialism, even while we may feel disapproval towards some of its implications.     

Global Human Identification and Citizenship: A Review of Psychological Studies

We review psychological research on global human identification and citizenship, Thomas Paine’s belief that “The world is my country, and all mankind are my brethren.” In turn, we review the theoretical foundations that guided our work, research with measures that preceded our own, and our own work with our correlated scales. We review its foundations, its effects upon attitudes and behaviors, and how it might be enlarged. Global human identification and citizenship is related negatively to ethnocentrism, authoritarianism, the social dominance orientation, and self‐centeredness, but positively to dispositional empathy and the values of universalism, care, and justice. It is expressed in attitudes and behaviors that support human rights and work to reduce global suffering and inequalities. It is associated with greater global knowledge and with efforts to acquire that knowledge. Childrearing that emphasizes cross‐cultural exposure and awareness of others’ suffering may promote global human identification and citizenship, as does education that encourages global mindedness. Environments that support global human identification also induce it, as does envisioning it as a moral ideal.     

Let's Dialogue About Penny: Effectiveness of Dialogue Involvement and Legitimizing Paltry Contribution Techniques1

Earlier research has shown (Cialdini & Schroeder, 1976) that the statement “Even a penny will help” added to a standard request for charity donation considerably increases the probability of carrying it out. The present study tested the effectiveness of this technique in various contexts in a set of 3 field experiments conducted on the streets of 2 Polish cities. The results proved, first, that success can be strengthened when combined with a dialogue in which a requester is involved prior to being asked for a donation. Second, it was shown that the dialogue itself produced more compliance than did a monologue. Third, it was demonstrated that dialogue related to the content of the requested issue may or may not result in an increase in compliance, presumably depending on the in‐group/out‐group focus of the dialogue's content. Practical implications for charity donation are offered.     

Visuospatial skills and their association with math performance in girls with fragile X or Turner syndrome.

The present study was designed to assess object identification ("what") and location ("where") skills among girls with fragile X or Turner syndrome and girls with neither disorder. Participants completed standardized subtests of visual perception and tasks of visuospatial "what" and "where" memory. Girls with fragile X had average performance on most object identification tasks, yet 53% failed to accurately recreate the gestalt of a design during the "where" memory task. Fewer than 7% of girls in the Turner or comparison group made this error. Girls with Turner syndrome had lower scores and longer response times on object perception tasks and had poorer recall of location for internal features of the design on the "where" memory task, relative to girls in the comparison or fragile X group. When limiting analyses to IQ-matched samples, correlations between math and visual perception tasks emerged, but only for girls with fragile X. These results reflect important differences between two cognitive phenotypes and have implications for the role of visuospatial processing in early math performance.     

Spiritual But Not Religious? Evidence for Two Independent Dispositions

Some psychologists treat religious/spiritual beliefs as a unitary aspect of individual differences. But a distinction between mysticism and orthodox religion has been recognized by scholars as well as laypersons, and empirical studies of "ism" variables and of "spirituality" measures have yielded factors reflecting this distinction. Using a large sample of American adults, analyses demonstrate that subjective spirituality and tradition-oriented religiousness are empirically highly independent and have distinctly different correlates in the personality domain, suggesting that individuals with different dispositions tend toward different styles of religious/spiritual beliefs. These dimensions have low correlations with the lexical Big Five but high correlations with scales (e.g., Absorption, Traditionalism) on some omnibus personality inventories, indicating their relevance for studies of personality.     

Brain activation during semantic processing in autism spectrum disorders via functional magnetic resonance imaging

Language and communication deficits are core features of autism spectrum disorders (ASD), even in high-functioning adults with ASD. This study investigated brain activation patterns using functional magnetic resonance imaging in right-handed adult males with ASD and a control group, matched on age, handedness, and verbal IQ. Semantic processing in the controls produced robust activation in Broca's area (left inferior frontal gyrus) and in superior medial frontal gyrus and right cerebellum. The ASD group had substantially reduced Broca's activation, but increased left temporal (Wernicke's) activation. Furthermore, the ASD group showed diminished activation differences between concrete and abstract words, consistent with behavioral studies. The current study suggests Broca's area is a region of abnormal neurodevelopment in ASD, which may be linked with semantic and related language deficits frequently observed in ASD.