Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.     

Group CBT for Externalizing Disorders in Urban Schools: Effect of Training Strategy on Treatment Fidelity and Child Outcomes

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C +) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C +. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C + delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C + resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.     

Evaluation of Breast Cancer Patients with Genetic Risk in a University Hospital: Before and After the Implementation of a Heredofamilial Cancer Unit

The identification of patients at risk for breast cancer by genetic testing has proven to reduce breast cancer mortality. In 2010, due to a lack of systematization in hereditary cancer assistance in our center, we implemented a multidisciplinary Heredofamilial Cancer Unit (HFCU). We analyze if the HFCU improved the rates of referrals and preventive management of breast cancer patients with genetic risk. We retrospectively compared family history records, referrals of high-risk patients to genetic counseling, and detection and management of patients with BRCA1/2 mutations in two cohorts of breast cancer patients diagnosed before (first period: 2007–2010) and after the creation of the HFCU (second period: 2010–2013). In the first period, 893 patients were included, and 902 were included in the second. Due to the inability to establish their genetic risk, 142 patients (15.9%) vs. 70 (7.8%) were excluded from analysis (p?<?0.001). Among the evaluable patients, 194 (25.8%) vs. 223 (26.8%) fulfilled one or more risk criteria (p?=?0.65). Family history documentation in patient’s medical records (92.4 vs. 97.8%, p?<?0.001) and referral rate (26.3 vs. 52%, p?<?0.0001) significantly increased in the second period. Eight BRCA1/2 mutations were detected among patients referred in the first period and 17 among those referred to the HFCU. The rate of preventive surgeries in patients with BRCA mutations significantly increased in the second period (25 vs. 76.5%, p?=?0.03). In conclusion, there was a clear improvement in family history records, referrals, and preventive surgeries in breast cancer patients with genetic risk after the implementation of the HFCU.     

Components of attentional effort for repeated tasks

This paper identifies four attentional processes that increase efficiency and accuracy in repeated lexicographic tasks using an instructed strategy approach. We propose a framework to decompose attentional effort used to make a decision into four components: Orientation, Wrong Target, Duration, and Repetition. Orientation assesses attention to decision rules and the location of relevant information. Wrong Target measures wasted effort on unneeded information. Duration gauges time spent on each piece of needed information. Repetition measures the number of views on each relevant item. Greater Orientation is associated with lower effort in other components and increased accuracy. Repetition is most variable across individuals but generates the greatest improvement with practice. Duration is less affected by the other components and shows minimal improvement with experience. Finally, Wrong Target is similarly resistant to practice, but it is the only component strongly and positively associated with making errors.     

Seek,and ye shall find: Differences between spontaneous and voluntary analogical retrieval

The present study tackles two overlooked aspects of analogical retrieval: (a) whether argumentation activities elicit a spontaneous search for analogical sources, and (b) whether strategic search can relax the superficial bias typically obtained in experimental studies of analogical retrieval. In Experiment 1, participants had to generate arguments for a target situation under three conditions: without indication to use analogies, with indication to use analogies, and with indication to search for sources within domains provided by the experimenters. Results showed that while voluntary search yields analogical retrievals reliably, the argumentation activity seldom elicits spontaneous remindings. A second set of results demonstrated that the superficial bias can be strategically relaxed, leading to a majority of distant retrievals. Experiment 2 replicated this result with the instruction to search within domains different from that of the target, and without providing a list of specific domains. The theoretical and educational implications of these findings are discussed.     

Profiles of emotional intelligence and demotivation to attend school in Chilean adolescents

The aim of this study was twofold: to identify different emotional intelligence (EI) profiles and to verify possible statistically significant differences in school refusal factors that result in a demotivation to attend school. Participants were 2362 Chilean adolescents aged from 13 to 17 (M?=?15.25; SD?=?1.33), who completed the Trait Meta-Mood Scale-24 (TMMS-24) and the School Refusal Assessment Scale-Revised (SRAS-R). Cluster analysis identified four EI profiles: high scores in repair and low in attention, high scores in attention and low in clarity and repair, low EI and high EI. Students with high scores in attention and low in repair scored higher in the first three factors of the SRAS-R, whereas in the fourth factor of the SRAS-R, students with high EI had significantly higher scores. Emotional regulation seems to be one of the determinant factors to prevent the appearance of school refusal. Based on these findings, we recommend that EI training be a part of future programs to overcome school attendance demotivation issues.     

Adolescent maternity: A risk factor in poverty situations?

This paper describes the psychosocial characteristics of adolescent mothers living in poverty in urban communities of Uruguay, whose children are now 0 to 5 years old. A sample of 965 mothers representative of the poor urban communities in the entire country was studied. One hundred thirty-six of these mothers were adolescents, 19 years old or younger. Six major areas were explored: socioeconomic status and social support, family characteristics, child-rearing practices, maternal and paternal availability, and characteristics of the child. In the group of children 2 to 5 years of age, psychomotor development was explored using the Test de Desarrollo Psicomotor (TEPSI). Psychosocial risk and child development were compared for adolescent and nonadolescent poor urban mothers. Children in both groups showed negative effects. It was not found that children of adolescent mothers did worse than those of nonadolescent mothers. Therefore, it was concluded that adolescent maternity is a complex phenomenon that cannot be viewed in isolation from the social environment in which it takes place. The results indicated that in poor communities the poverty-related risk factors may obscure the effect of the age-related ones.     

COCAINE ADDICTS AND THEIR FAMILIES: AN EMPIRICAL STUDY OF THE PROCESSES OF IDENTIFICATION

The processes of identification between adolescent cocaine addicts and their parents were studied in 402 subjects, in total 134 familial triads (father"mother"son), subdivided into two groups of 67 triads, one of these groups having as the child an adolescent of masculine sex dependent on cocaine and the other, equal in number, being a control group, duly matched for age and socio-economic status. The instrument employed was the Rorschach test (1922), limited to the application of the Lerner Defense Scale (LDS; Lerner & Lerner, 1980). The findings in the affected triads showed up as consistent statistically for the presence of intense processes of pathological identification, especially between father and son, a sign of the importance of the presence of disturbances of paternal function in the development of this addiction. The utilisation of very regressive defence mechanisms, above all of projective identification, was the predominant mode of procedure in triads with a dependent child. In comparisons between the fathers the odds ratio (OR) for projective identification was 8.66 to 1, which points to the association between cocaine addiction and the primitive mental functioning of the fathers. With empirical methodology these findings serve to corroborate the psychoanalytical conclusions based on studies of single case studies, testifying that the dysfunctions of identificatory phenomena in familial functioning are predominant in the mental organisation of cocaine addicts.     

Hemispheric specialization for word classes with visual presentations and lexical decision task

In the present paper we study the possible RH capabilities for the processing of adjectives and verbs of high frequency and medium imagery using a lexical decision task and a horizontal display. In the analysis of both RTs and mean errors, a RVF advantage is obtained. The interaction VF x Word Class did not reach significance. Therefore, we did not find evidence of differences in the visual-field effect for any syntactic class. These results support a LH superiority for the processing of both adjectives and verbs. For the nonword conditions (pseudoverbs and pseudoadjectives), no visual field differences were observed in either group. Methodological aspects are also discussed.     

Social Support and Postpartum Depression Revisited: The Traditional Female Role as Moderator among Mexican Women

Women who lack social support tend to have a higher risk of postpartum depression. The present study examined the traditional female role, understood here as the adoption of passive and submissive traits specific to Mexican women, as another risk factor for postpartum depressive symptomatology that interacts with social support. Using two waves of data from a longitudinal study of 210 adult Mexican women (20–44 years-old, M _age = 29.50 years, SD = 6.34), we found that lacking social support during the third trimester of their pregnancy was associated with greater depressive symptoms at 6 months in the postpartum, although this relationship depended on the level of endorsement of the traditional female role during pregnancy. Lower social support during pregnancy predicted greater postpartum depressive symptoms for women with higher endorsement of the traditional female role, even when accounting for prenatal depressive symptoms. These results suggest that Mexican women’s experience of social support may depend on their individual adherence to gender roles. Understanding the association between women’s traditional roles and social support in the risk for postpartum depression can improve prevention and educational programs for women at risk.