Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

Locus of control,choice, and satisfaction with an assigned task

P. E. Spector's (1982, Psychological Bulletin, 91, 482–497) hypothesis that under conditions of freedom of choice persons characterized by an internal locus of control will experience greater satisfaction with an undesirable task than persons characterized by an external locus of control is considered in light of distinctions between perceived control and perceived choice. Perceived choice is proposed as an intervening variable implicit in Spector's argument. This reasoning was tested with 46 male and female college student participants in a 2 (Choice) × 2 (Locus of Control) factorial design experiment. An interaction of Choice × Locus of Control on task satisfaction was obtained such that internals tended to be more satisfied when given a choice while externals experienced greater satisfaction when not given a choice. The implications of this result for Spector' hypothesis and for the manner in which undesirable work is assigned are discussed.     

Susceptibility to prosocial and antisocial influence in adolescence following mindfulness training

Mindfulness training programmes have shown to encourage prosocial behaviours and reduce antisocial tendencies in adolescents. However, less is known about whether training affects susceptibility to prosocial and antisocial influence. The current study investigated the effect of mindfulness training (compared with an active control) on self-reported prosocial and antisocial tendencies and susceptibility to prosocial and antisocial influence. 465 adolescents aged 11–16 years were randomly allocated to one of two training programmes. Pre- and post-training, participants completed a social influence task. Self-reported likelihood of engaging in prosocial and antisocial behaviours did not change post-training, and regardless of training group, participants showed a higher propensity for prosocial influence than for antisocial influence. Finally, participants were less influenced by antisocial ratings following both training programmes.     

SLOTE'S SATISFICING CONSEQUENTIALISM

The article discusses Michael Slote's Satisficing Consequentialism, which is the view that moral agents are not required to maximise the good, but merely to produce a sufficient amount of good. It is argued that Satisficing Consequentialism is not an acceptable alternative to Maximising Consequentialism. In particular, it is argued that Satisficing Consequentialism cannot be less demanding in practice than Maximising Consequentialism without also endorsing a wide range of clearly unacceptable actions. It is then argued that Slote's inability to provide adequate reasons for moral satisficing stems from a mistaken analogy between rationality and morals. The sense of ‘good enough’ which is relevant to morality is one which focusses on the effort an agent puts in, rather than on the outcome she produces. However, replacing outcomes with efforts would undermine Slote's Consequentialist project. Finally, it is suggested that similar problems will be faced by others who seek to construct essentially Consequentialist theories which are not unduly demanding.     

Computerized fuzzy ratings: The concept of a fuzzy class

In this paper, we outline the concept of a fuzzy class used in programs for eliciting computerized fuzzy ratings. Fuzzy ratings allow respondents to provide symmetrical or asymmetrical latitudes of acceptance around a preferred point. These ratings have been used in research testing career theories and person-environment fit models. The variables defining the fuzzy class and the various functions that can be performed by it are described in the paper. The idea of a fuzzy class may be of interest to those involved in expert systems, knowledge engineering, or in fuzzy classification and measurement in general. A program, FUZRATE, written in object-oriented C++ code that uses the concept of a fuzzy class, is available on request. Both source code and a binary (executable) file are available.     

Classroom effects on student motivation: Goal structures, social relationships, and competence beliefs

Psychologists and educators have often conceptualized motivation as an individual difference variable, something that some students simply have more of than other students. This view of motivation can underestimate contextual influences. In this article we consider how characteristics of the school and classroom may influence student motivation, as well as the role of educators in shaping school and classroom climate. We describe three motivational perspectives: achievement goal theory, self-determination theory, and social-cognitive theory. The effects on motivation of social relationships with teachers and peers are also considered.     

Stressors, quality of the child-caregiver relationship, and children's mental health problems after parental death: the mediating role of self-system beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver-child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7-16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver-child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.     

A single instrument: Engineering and engineering technology students demonstrating competence in ethics and professional standards

This paper details efforts by the Purdue School of Engineering and Technology at Indiana University Purdue University Indianapolis (IUPUI) to create a single instrument for honors science, technology, engineering and mathematics (STEM) students wishing to demonstrate competence in the IUPUI Principles of Undergraduate Learning (PUL’s) and Accreditation Board for Engineering and Technology (ABET) Engineering Accreditation Criterion (EAC) and Technology Accreditation Criterion (TAC) 2, a through k. Honors courses in Human Behavior, Ethical Decision-Making, Applied Leadership, International Issues and Leadership Theories and Processes were created along with a specific menu of activities and an assessment rubric based on PUL’s and ABET criteria to evaluate student performance in the aforementioned courses. Students who complete the series of 18 Honors Credit hours are eligible for an Honors Certificate in Leadership Studies from the Department of Organizational Leadership and Supervision. Finally, an accounting of how various university assessment criteria, in this case the IUPUI Principles of Undergraduate Learning, can be linked to ABET outcomes and prove student competence in both, using the aforementioned courses, menu of items, and assessment rubrics; these will be analyzed and discussed. An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, California, 9–10 June 2005. Timothy Diemer is a visiting assistant professor in the Dept. of Organizational Leadership and Supervision and director of international services in the Purdue School of Engineering and Technology at IUPUI. Stephen P. Hundley is an Associate Professor of Organizational Leadership and Supervision in the Purdue School of Engineering and Technology at IUPUI. Robert M. Wolter is a lecturer in the Dept. of Organizational Leadership and Supervision at IUPUI and teaches ‘Human Behavior in Organizations’ and ‘Applied Leadership’.     

Personal goals and psychological growth: testing an intervention to enhance goal attainment and personality integration

We hypothesized that semester goal attainment provides a route to short-term psychological growth. In an attempt to enhance this process, we randomly assigned participants to either a goal-training program or to a control condition. Although there were no main effects of program participation on later goal attainment, important interactions were found. Consistent with a "prepared to benefit" model, participants already high in goal-based measures of personality integration perceived the program as most useful and benefited the most from the program in terms of goal attainment. As a result, they became even more integrated and also increased in their levels of psychosocial well-being and vitality. Implications for theories of short-term growth and positive change are discussed, as is the unanswered question of how to help less-integrated persons grow.