Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults

The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T.H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents.     

The difference engine: A model of diversity in speeded cognition

A theory of diversity in speeded cognition, the difference engine, is proposed, in which information processing is represented as a series of generic computational steps. Some individuals tend to perform all of these computations relatively quickly and other individuals tend to perform them all relatively slowly, reflecting the existence of a general cognitive speed factor, but the time required for response selection and execution is assumed to be independent of cognitive speed. The difference engine correctly predicts the positively accelerated form of the relation between diversity of performance, as measured by the standard deviation for the group, and task difficulty, as indexed by the mean response time (RT) for the group. In addition, the difference engine correctly predicts approximately linear relations between the RTs of any individual and average performance for the group, with the regression lines for fast individuals having slopes less than 1.0 (and positive intercepts) and the regression lines for slow individuals having slopes greater than 1.0 (and negative intercepts). Similar predictions are made for comparisons of slow, average, and fast subgroups, regardless of whether those subgroups are formed on the basis of differences in ability, age, or health status. These predictions are consistent with evidence from studies of healthy young and older adults as well as from studies of depressed and age-matched control groups.     

A longitudinal study of psychosocial distress in breast cancer: prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Trends in Telehealth versus On-site Clinical Genetics Appointments in Manitoba: A Comparative Study

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.     

Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis

We describe the association between postpartum depression and the quantity and content of infant media use. Households with depressed mothers viewed twice as much television as households with non-depressed mothers did, and depressed mothers appeared to derive comparatively greater pleasure from television viewing. Maternal depression was associated with an increased exposure to child-directed content by 6–9-month-old infants, although it was not associated with an increased exposure to adult-directed programming. Depressed mothers also reported being less likely to sit and talk with their children during television use or to consult outside sources of information about media. This increase in television exposure without corresponding parental involvement could negatively affect developmental outcomes.     

Improving the quality of medical care: the normativity of evidence-based performance standards

Poor quality medical care is sometimes attributed to physicians?? unwillingness to act on evidence about what works best. Evidence-based performance standards (EBPSs) are one response to this problem, and they are increasingly employed by health care regulators and payers. Evidence in this instance is judged according to the precepts of evidence-based medicine (EBM); it is probabilistic, and the randomized controlled trial (RCT) is the gold standard. This means that EBPSs suffer all the infirmities of EBM generally??well rehearsed problems with the external validity of research findings as well as the inferential leap from study results in the aggregate to individual patient care. These theoretical weaknesses promise to have a practical impact on the care of patients. To avoid this, EBPSs should be understood as guidelines indicative of average effectiveness rather than standards to be applied in every case.