Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Programs of religious/spiritual support in hospitals - five “Whies” and five “Hows”

A contemporary orientation of the hospital experience model must encompass the clients’ religious-spiritual dimension. The objective of this paper is to share a previous experience, highlighting at least five reasons hospitals should invest in this direction, and an equal number of steps required to achieve it. In the first part, the text discourses about five reasons to invest in religious-spiritual support programs: 1. Religious-spiritual wellbeing is related to better health; 2. Religious-spiritual appreciation is a standard for hospital accreditation; 3. To undo religious-spiritual misunderstandings that can affect treatment; 4. Patients demand a religious-spiritual outlook from the institution; and 5. Costs may be reduced with religious-spiritual support. In the second part, the text suggests five steps to implement religious-spiritual support programs: 1. Deep institutional involvement; 2. Formal staff training; 3. Infrastructure and resources; 4. Adjustment of institutional politics; and 5. Agreement with religious-spiritual leaders. The authors hope the information compiled here can inspire hospitals to adopt actions toward optimization of the healing experience.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

Opacity and the double life of singular propositions

In this paper I analyze David Kaplan?s essay “Opacity”. In “Opacity” Kaplan attempts to dismiss Quine?s concerns about quantification across intensional (modal and intentional) operators. I argue that Kaplan succeeds in showing that quantification across intensional operators is logically coherent and that quantified modal logic is strictly speaking not committed to essentialism. However, I also argue that this is not in and of itself sufficient to support Kaplan?s more ambitious attempt to move beyond purely logical results and provide unified, uncontroversial interpretations of both “believes” and “necessarily”. In the paper I raise several questions about the subject matter of logic and the role of semantics, with special focus on singular propositions.     

Context affects the interpretation of low but not high numerical probabilities: A hypothesis testing account of subjective probability

Low numerical probabilities tend to be directionally ambiguous, meaning they can be interpreted either positively, suggesting the occurrence of the target event, or negatively, suggesting its non-occurrence. High numerical probabilities, however, are typically interpreted positively. We argue that the greater directional ambiguity of low numerical probabilities may make them more susceptible than high probabilities to contextual influences. Results from five experiments supported this premise, with perceived base rate affecting the interpretation of an event’s numerical posterior probability more when it was low than high. The effect is consistent with a confirmatory hypothesis testing process, with the relevant perceived base rate suggesting the directional hypothesis which people then test in a confirmatory manner.     

A case of developmental exposure to inorganic mercury

This case report describes behavioral and neuropsychological function in a young man who experienced chronic exposure to elemental mercury at home from age 4 through 9 years. Data are presented on school history, behavior, and performance on standardized tests during the developmental period, and from a full neuropsychological evaluation at age 19 years, several years after environmental exposure had ended. These data specify the course of a decline in function as development proceeds. The patient's progress appeared normal in the preschool period but pronounced academic difficulties and persistent emotional irritability emerged during the elementary school years. At age 19 years, neuropsychological testing revealed diminished executive function, difficulties with language, problems with visuospatial orientation, deficiencies in tine motor control, and manual tremor. Tension, irritability, and depressive affect were evident as well as marked problems with academic performance. These findings suggest widespread cerebral dysfunction, both cortical and subcortical, and are consistent with the diffuse pattern of brain damage seen in children with exposure to heavy metals.     

Expectancy bias mediates the link between social anxiety and memory bias for social evaluation

Social anxiety (SA) involves a multitude of cognitive symptoms related to fear of evaluation, including expectancy and memory biases. We examined whether memory biases are influenced by expectancy biases for social feedback in SA. We hypothesised that, faced with a socially evaluative event, people with higher SA would show a negative expectancy bias for future feedback. Furthermore, we predicted that memory bias for feedback in SA would be mediated by expectancy bias. Ninety-four undergraduate students (55 women, mean age = 19.76 years) underwent a two-visit task that measured expectations about (Visit 1) and memory of (Visit 2) feedback from unknown peers. Results showed that higher levels of SA were associated with negative expectancy bias. An indirect relationship was found between SA and memory bias that was mediated by expectancy bias. The results suggest that expectancy biases are in the causal path from SA to negative memory biases for social evaluation.