Cognitive control and consistency in compliance

Abstract

The purpose of this prospective study was two-fold. First, three modes of compliance assessment were used to examine whether renal dialysis patients comply consistently across medical regimens (fluid, potassium, phosphorous, protein) and whether compliance is consistent across mode of assessment (patient self assessment, medical staff ratings, physiological data). Second. a cognitive model predicting fluid compliance was tested to see if it would generalize to predict dietary compliance and medication taking. Patients' self-control perceptions of compliance, staff assessments of compliance, and physiological data were collected prospectively for 85 end-stage renal disease (ESRD) patients. Results indicated substantial consistency across medical regimen depending on the mode of assessment; staff assessment showed the most consistency, followed by patients' self-assessments and lastly by physiological data. Despite this consistency across medical regimens, the cognitive-control model only predicted fluid compliance; the model failed to explain dietary and medication compliance. Reasons and implications for these results are discussed.     

Magnitude and determinants of behavioral risk reduction: Longitudinal analysis of a cohort at risk for AIDS

The magnitude and predictors of longitudinal behavioral change are reported in a cohort of homosexual men at risk for AIDS. Self-reports of sexual behavior were obtained at two points in time separated by an interval of approximately six months. These self-reports were used to construct both dichotomous and continuous measures of changes in behavior consistent with reduction in the transmission of the AIDS virus (HIV). Although there was considerable variability in behavior. mean changes were consistently in the desired direction. Avoidance of anonymous sexual partners, monogamy, and modification of receptive anal sex to reduce exposure to semen by condom use or withdrawal prior to ejaculation appeared to be especially important in this cohort. Both multiple linear regression and multiple logistic regression were used to examine the relationship between a model of health behavior and these outcomes. Variables examined included knowledge of AIDS. perceived risk of AIDS. the perceived efficacy of behavior in reducing AIDS risk, difficulties with sexual impulse control, belief in biomedical technology to provide a prevention or cure, social norms supportive of behavioral change, and gay network affiliation. Of all these factors, only the availability of supportive peer norms was consistently, significantly and positively related to multiple measures of outcome. Differences between these analyses and longitudinal analyses reported elsewhere are discussed. These results suggest the policies regarding HIV antibody testing should be developed cautiously. taking account of the failure of a sense of risk to predict subsequent behavioral change. They also emphasize the important role of gay organizations in developing social norms supportive of behavioral risk reduction.     

Ethical Perceptions of Field Sales Personnel: An Empirical Assessment

Much research attention has been directed over the past twenty-five years to ethical issues in marketing. One area of marketing that is gaining research interest is the selling arena. Despite the extant literature on selling ethics, few studies have focused on identifying situations that pose ethical problems for field sales personnel. This paper reports results of an investigation that examined salespeople's perceptions concerning what selling situations or practices are ethical questions, what situations are presently addressed by company policies, and what situations should be addressed by company policies. Findings reveal that salespersons seemingly are desirous of receiving more management guidance than they currently are receiving regarding their ethical concerns. Implications for managers and researchers are provided.     

Perceptions of Motivational Components: Salesmen and Saleswomen Revisited

Although empirical work has examined differences between salesmen and saleswomen on various aspects, no comprehensive study has examined gender-based distinctions in salespeople's work motivation. The paucity of research attention on this topic is surprising given the plethora of literature in organizational behavior. This paper reports the results of an investigation that explored male and female salespeople's perceptions of expectancies, instrumentalities, and valence for rewards. Findings reveal minimal contrast between the two groups. Implications for practitioners and researchers are provided.     

Predicting short and long-term exercise intentions and behaviour in patients with coronary artery disease: A test of protection motivation theory

The purpose of this study was to examine the utility of protection motivation theory (PMT) in the prediction of exercise intentions and behaviour in the year following hospitalisation for coronary artery disease (CAD). Patients with documented CAD (n?=?787), recruited at hospital discharge, completed questionnaires measuring PMT's threat (i.e. perceived severity and vulnerability) and coping (i.e. self-efficacy, response efficacy) appraisal constructs at baseline, 2 and 6 months, and exercise behaviour at baseline, 6 and 12 months post-hospitalisation. Structural equation modelling showed that the PMT model of exercise at 6 months had a good fit with the empirical data. Self-efficacy, response efficacy, and perceived severity predicted exercise intentions, which, in turn predicted exercise behaviour. Overall, the PMT variables accounted for a moderate amount of variance in exercise intentions (23%) and behaviour (20%). In contrast, the PMT model was not reliable for predicting exercise behaviour at 12 months post-hospitalisation. The data provided support for PMT applied to short-term, but not long-term, exercise behaviour among patients with CAD. Health education should concentrate on providing positive coping messages to enhance patients’ confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity.     

Physical activity and diabetes: An application of the theory of planned behaviour to explain physical activity for Type 1 and Type 2 diabetes in an adult population sample

Physical activity (PA) plays a key role in the management of Type 1 (T1D) and Type 2 diabetes (T2D) but there are few theory-based, effective programs to promote PA for individuals with diabetes. The purpose of this study was to investigate the utility of the Theory of Planned Behaviour (TPB) in understanding PA in an adult population with T1D or T2D. A total of 2311 individuals (691 T1D; 1614 T2D) completed self-report TPB constructs of attitude, subjective norms, perceived behavioural control (PBC), intention and PA at baseline and 1717 (524 T1D; 1123 T2D) completed the PA measure again at 6-month follow-up. Multi-group Structural Equation Modelling was conducted to: (1) test the fit of the TPB structure (2) determine the TPB structural invariance between the two types of diabetes and (3) to examine the explained variances in PA and compare the strength of associations of the TPB constructs in the two types of diabetes. The TPB constructs explained ≥40% of the variance in intentions for both diabetes groups. In cross-sectional models, the TPB accounted for 23 and 19% of the variance in PA for T1D and T2D, respectively. In prospective models, the TPB explained 13 and 8% of the variance in PA for T1D and T2D, respectively. When adjusting for past PA behaviour, the impact of PBC and intention on behaviour was reduced in both groups. The findings provide evidence for the utility of the TPB for the design of PA promotion interventions for adults with either T1D or T2D.     

Mystical union and spiritual desire in late-Reformation devotion: The case of Martin Moller's The Great Mystery (1595)

This article examines the complex relationship between early-modern Protestantism and medieval mysticism. It does so through a case study of a late-Reformation work of devotion, The Great Mystery (1595), which has received very little scholarly attention. The author of this treatise, Martin Moller, an experienced Lutheran pastor, was familiar with mystical literature and drew on it directly in his numerous works of devotion. Especially evident in The Great Mystery, which presents the relationship between Christ and the Christian as a spiritual marriage, is a theme which rarely appeared in the Lutheran devotional literature of the sixteenth century: spiritual desire for God. Moller developed an evangelical theology and spirituality of desire, which marked a crucial development in early-modern Lutheran devotion. The presence of this theme also provides a potential clue for the ‘mystical turn’ in the late Reformation and why this period may have experienced a ‘crisis of piety’.     

Prevalence,correlates, and psychosocial outcomes of sport participation in young adult cancer survivors

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response.ObjectivesTo examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS.DesignA provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables.ResultsOne third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = ?0.10, p = 0.024).Discussion/conclusionsSport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted.     

Incarnation Deep and Wide: A Response to Niels Gregersen

Abstract

This paper responds to Professor Niels Gregersen's theology of deep incarnation by doing three things. Section 1 summarizes and defines the idea of deep incarnation, with particular reference to what is intended by the key adjective “deep.” Section 2 engages Gregersen's proposal critically in relation to traditional options within the Christian doctrine of the incarnation. If Gregersen's language of “incarnation” is to be taken seriously as a proposal that is grounded in but goes beyond traditional ideas, its best chance for success lies in being as clear as possible about relationship with its traditional sources. Finally, Section 3 offers a few suggestions concerning the promise of deep incarnation for contemporary theology, especially for theology informed in part by serious engagement with the natural sciences.     

Structure and organization of research efforts following the bombing of the murrah building

Abstract

In the days and weeks following the Oklahoma City bombing on April 19,1995, Oklahoma state authorities, university faculty and staff, and leading experts from across the nation formed a coalition to address issues of clinical service delivery, educational intervention, and research. This article focuses on the centralized approach applied to the administration of research endeavors. This centralization was designed to minimize revictimization of both survivors and affected families, enhance the quality of data collected, and facilitate cooperation between participating investigators. The resultant set of projects includes a variety of research methodologies and study populations and will serve to significantly enhance understanding of the mental health sequelae of such disasters.