Healthcare provider cultural competency: development and initial validation of a patient report measure.

OBJECTIVE: Health researchers have proposed that provider cultural competency may contribute to health disparities. Yet, this belief continues to lack empirical support, and this is due in part to measurement issues that have plagued the cultural competency construct. In the present research, we report on the development of a theoretically grounded, generally applicable, and patient report measure of provider cultural competency. DESIGN: Samples of predominantly African American patients (N=310) were recruited from three urban medical clinics to complete a survey about their relationship with their physician. MAIN OUTCOME MEASURES: We examined the factor structure, validity and other psychometric characteristics of a newly proposed patient report measure of provider cultural competency. RESULTS: Psychometric analyses supported a tripartite model of cultural competency that was comprised of patient judgments of their physician's cultural knowledge, awareness, and skill. In addition, this result was replicated across multiple clinical contexts, while also demonstrating convergent and incremental validity when correlated with measures of trust, satisfaction and discrimination. CONCLUSION: This newly proposed measure addresses prior limitations in cultural competency measurement and may enhance future research by providing a standardized tool for use in multiple clinical and cultural contexts.     

Subjectivity uncertainty theory of objectification: Compensating for uncertainty about how to positively relate to others by downplaying their subjective attributes

Why do people sometimes view others as objects rather than complete persons? We propose that when people desire successful interactions with others, yet feel uncertain about their ability to navigate others' subjectivity, they downplay others' subjective attributes, focusing instead on their concrete attributes. This account suggests that objectification represents a response to uncertainty about one's ability to successfully interact with others distinct from: instrumentalizing others in response to power; dehumanizing others in response to threat; and simplifying others in response to general uncertainty. Supporting this account: When uncertainty about navigating women's subjectivity was salient, men showed increased sexual objectification to the extent that they desired successful interactions with women (Study 1) and were primed to view such interactions as self-esteem relevant (Study 2). In a workplace scenario, participants made uncertain about their managerial ability felt less confident about their ability to navigate employees' subjectivity and, consequently, role-objectified employees (Study 3).     

Risk assessment behaviors associated with corticosterone trigger the defense reaction to social isolation in rats: role of the anterior cingulate cortex

The extent to which the hypothalamic-pituitary-adrenal axis is activated by short-term and long-term consequences of stress is still open to investigation. This study aimed to determine (i) the correlation between plasma corticosterone and exploratory behavior exhibited by rats subjected to the elevated plus maze (EPM) following different periods of social isolation, (ii) the effects of the corticosterone synthesis blocker, metyrapone, on the behavioral consequences of isolation, and (iii) whether corticosterone produces its effects through an action on the anterior cingulate cortex, area 1 (Cg1). Rats were subjected to 30-min, 2-h, 24-h, or 7-day isolation periods before EPM exposure and plasma corticosterone assessments. Isolation for longer periods of time produced greater anxiogenic-like effects on the EPM. However, stretched attend posture (SAP) and plasma corticosterone concentrations were increased significantly after 30?min of isolation. Among all of the behavioral categories measured in the EPM, only SAP positively correlated with plasma corticosterone. Metyrapone injected prior to the 24?h isolation period reversed the anxiogenic effects of isolation. Moreover, corticosterone injected into the Cg1 produced a selective increase in SAP. These findings indicate that risk assessment behavior induced by the action of corticosterone on Cg1 neurons initiates a cascade of defensive responses during exposure to stressors.     

Finding the Cause: Verbal Framing Helps Children Extract Causal Evidence Embedded in a Complex Scene

In making causal inferences, children must both identify a causal problem and selectively attend to meaningful evidence. Four experiments demonstrate that verbally framing an event (“Which animals make Lion laugh?”) helps 4-year-olds extract evidence from a complex scene to make accurate causal inferences. Whereas framing was unnecessary when evidence was isolated, children required it to extract and reason about evidence embedded in a more complex scene. Subtler framing stating the causal problem, but not highlighting the relevant variables, was equally effective. Simply making the causal relationship more perceptually obvious did facilitate children's inferences, but not to the level of verbal framing. These results illustrate how children's causal reasoning relies on scaffolding from adults.     

Think-aloud protocols and the selection task: Evidence for relevance effects and rationalisation processes

Two experiments are reported that employed think-aloud methods to test predictions concerning relevance effects and rationalisation processes derivable from Evans' (1996) heuristic-analytic theory of the selection task. Evans' account proposes that card selections are triggered by relevance-determining heuristics, with analytic processing serving merely to rationalise heuristically cued decisions. As such, selected cards should be associated with more references to both their facing and their hidden sides than rejected cards, which are not subjected to analytic rationalisation. Experiment 1 used a standard selection-task paradigm, with negative components permuted through abstract conditional rules. Support was found for all heuristic-analytic predictions. This evidence was shown to be robust in Experiment 2, where “select - don't select” decisions were enforced for all cards. Both experiments also clarify the role played by secondary heuristics in cueing the consideration of hidden card values during rationalisation. We suggest that whilst Evans' heuristic-analytic model and Oaksford and Chater's (e.g., 2003) optimal data selection model can provide compelling accounts of our protocol findings, the mental models theory fares less well as an explanation of our full dataset.     

Non‐human Support: Broadening the Scope of Attachment Theory

Attachment theory proposes that people form strong social ties because certain relationships provide feelings of security and support. Traditionally, theorists and researchers have assumed that because this process is innate and evolved, only human targets are capable of meeting a person's needs for security. Recent research challenges this assumption by demonstrating that an array of targets, such as places and pets, can also satisfy needs for security, particularly under conditions of threatened or absent connection to other people. We bring together these diverse findings and discuss how they enrich our understanding of the nature and operation of attachment processes and related phenomena. Specifically, this line of research contributes to a comprehensive picture of the diverse means by which people flexibly seek and maintain psychological security both within and outside of their close, interpersonal relationships. It also raises new research questions concerning the similarities and differences between human and non‐human support.