Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support.

OBJECTIVE: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA/NCQA recommended diabetes care outcomes. DESIGN: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. MAIN OUTCOME MEASURES: Perceived autonomy support, perceived competence, patient satisfaction, glycemic control (HbA1c), ratio of total to HDL cholesterol, diabetes distress, and depressive symptoms. RESULTS: The computer-assisted intervention increased patient perception of autonomy support relative to a computer-based control condition ( p = .05). Change in perceived competence partially mediated the effects of increased autonomy support on the change in lipids, diabetes distress, and depressive symptoms. The construct of autonomy support was found to be separate from that of patient satisfaction. CONCLUSIONS: A patient-centered, computer-assisted intervention was effective in improving diabetes self-management outcomes, in part, because it increased patients' perception that their autonomy was supported which changed perceived competence. These findings support the self-determination model for health behavior change and the chronic care model and support the further study of the use of these technologies to motivate patients to improve their health outcomes.     

The role of censorship in minority influence

This study was conducted to determine the impact of censoring a minority who had argued persuasively against the majority. While there was no significant increase in minority influence when one-third of the minority's message was censored, the minority was more effective when two-thirds of its message was censored. The minority was most effective when two-thirds of its message was censored and when the minority was prevented from continuing to espouse its position. The results were explained by the theory of psychological reactance.     

A model for the evaluation of the performance of scientists from the developing world,based on journal impact factors

A model is proposed, which can be used to establish sets of impact factors of journals where a specific group of researchers are publishing, such as those used by the Mexican research community. The variations in impact factors between major fields, and even within disciplines pertaining to these fields, were taken into consideration when developing the model. The sets of impact factors can be used as yardsticks to assess the performance of individual scientists in specific fields, provided that these are applied with caution and in combination with other established performance indicators. Her interests are focussed on the scientific research activity of Latin American countries, particulary Mexico, from a scientometric viewpoint.     

Effects of client presenting syndromes on client and therapist dominance and affiliation during early sessions of Rational-Emotive psychotherapy

This is a study of effects of presenting clinical status on interpersonal presentation during early Rational-Emotive therapy (RET). Independent variables were intake scores for clients from the axis I scales of the Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983). Dependent variables, from audiotapes of sessions at the Institute for RET (IRET), were Revised Interpersonal Adjective Scale (IAS-R; Wiggins, Trapnell and Phillips, 1988) ratings of clients and therapists. MCMI scales associated with stimulation seeking (N, hypomania; T, drug abuse) were significantly positively correlated with client dominance. Therapist affiliation was negatively correlated with all client MCMI scales, and these were significant for scales that assessed the most severe intake presenting problems (A, anxiety, D, dysthymia).     

Impulsivity, fight history, and camaraderie as predictors of a willingness to escalate a disturbance

This field study examined the relationships between six predictor variables and a self-report measure of spectators' likelihood of joining in a crowd disturbance. Subjects were males (N = 78) found in attendance at an ice hockey game. The variables jects were males (N = 78) found in attendance at an ice hockey game. The variables related to the likelihood of escalating a disturbance included subjects who were more impulsive, had a history of fighting, were younger, saw provocations as more volatile, liked to watch player fights and attended with others. A multiple regression analysis yielded a solution that accounted for 52.9% of the variance. The results were discussed against the background of previous research examining the factors associated with spectators' propensity for involving themselves in crowd disorders. The authors wish to thank the Medicine Hat Tigers Hockey Club for their cooperation.     

ON THE VALUE OF KNOWING ONE'S LIKES AND DISLIKES:

Abstract— On the basis of laboratory research indicating that accessible altitudes ease decision making we hypothesized that freshmen who enter college knowing their likes and dislikes regarding academically relevant issues may experience better health in this new life setting To test this hypothesis, we conducted a prospective study in which students completed self-report inventories of negative life events and mental and physical health at two points in time. The accessibility of attitudes toward academically relevant issues was assessed in the initial session Regression analyses revealed three-way interactions between attitude accessibility, stress (as indexed by the number of negative life events), and initial health status when initial health, the generally positive relation between stress and illness was buffered by the possession of accessible attitudes For students with relatively poor initial health, recovery Has generally greater among those experiencing less stress, especially as attitude accessibility increased.