What is the key to culturally competent care: Reducing bias or cultural tailoring?

Objective: To gain a better understanding as to whether disparities in patient–provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently.

Method: African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10.

Results: Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients’ needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians.

Conclusion: Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians’ patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.     

Illusions of integration are subjectively impenetrable: Phenomenological experience of Lag 1 percepts during dual-target RSVP

We investigated the relationship between different kinds of target reports in a rapid serial visual presentation task, and their associated perceptual experience. Participants reported the identity of two targets embedded in a stream of stimuli and their associated subjective visibility. In our task, target stimuli could be combined together to form more complex ones, thus allowing participants to report temporally integrated percepts. We found that integrated percepts were associated with high subjective visibility scores, whereas reports in which the order of targets was reversed led to a poorer perceptual experience. We also found a reciprocal relationship between the chance of the second target not being reported correctly and the perceptual experience associated with the first one. Principally, our results indicate that integrated percepts are experienced as a unique, clear perceptual event, whereas order reversals are experienced as confused, similar to cases in which an entirely wrong response was given.     

Three-component commitment and turnover: An examination of temporal aspects

SEM (N = 182) was employed to examine implied temporal aspects of three-component commitment theory as they relate to turnover. Consistent with expectations, affective commitment predicted subsequent turnover in an immediate and relatively short interval of 4 months, but failed to do in a much longer but outlying interval of 5–12 months. Side bet commitment failed to predict turnover in the short, immediate interval, but did so robustly over the longer albeit more distant interval. Normative commitment predicted turnover in neither the near term nor outmonths. Turnover rates for employees with low affective commitment were much higher than those with high affective commitment in the first quarter of a 1-year monitoring period, but subsequent turnover rates were roughly the same for the two groups. In contrast, turnover for employees with low side bet commitment was only slightly higher than the high side bet group in the first quarter, but over the remainder of the year cumulative turnover for the low side bet group exceeded that for the high side bet group by increasingly large margins. These results are consistent with theory suggesting that decrements in affective commitment (1) often occur suddenly and just prior to employees' leaving and (2) reflect general disaffection and an impetus to leave that is already exists at the point of attitude measurement. Results comport with theory describing side bet commitment as (1) an appraisal of leaving costs that, in the aggregate, are unlikely to change suddenly and (2) a relatively stable attitude that serves primarily to prevent turnover should some independent motivation to leave arise.     

From women to objects: Appearance focus, target gender, and perceptions of warmth, morality and competence

Most literally, objectification refers to perceiving a person as an object, and consequently, less than fully human. Research on perceptions of humanness and the stereotype content model suggests that humanness is linked to perceptions of warmth, morality and competence. Merging these insights with objectification theory, we hypothesized that focusing on a woman's, but not a man's, appearance should induce objectification, and thus reduce perceptions of these characteristics. In three studies, females, but not males, were perceived as less competent (Studies 2 and 3) and less warm and moral (Studies 1, 2 and 3) when participants were instructed to focus on their appearance. These findings support our position and help rule out stereotype activation as an alternative explanation to dehumanization. Further, they generalized to targets of different races, familiarity, physical attractiveness and occupational status. Implications for gender inequity and the perpetuation of objectification of women are discussed.     

Temporal preparation and inhibitory deficit in fibromyalgia syndrome

Cognitive deficits in fibromyalgia may be specifically related to controlled processes, such as those measured by working memory or executive function tasks. This hypothesis was tested here by measuring controlled temporal preparation (temporal orienting) during a response inhibition (go no-go) task. Temporal orienting effects (faster reaction times for targets appearing at temporally attended vs. unattended moments) and response inhibition were impaired in fibromyalgia compared to the control group. It is concluded that frontal networks underlying attentional control (temporal orienting and response inhibition) can be a dysfunctional neurocognitive mechanism in fibromyalgia.     

The development of temporal coordination in children

The ability to learn temporal patterns in sequenced actions was investigated in elementary-school age children. Temporal learning depends upon a process of integrating timing patterns with action sequences. Children ages 6-13 and young adults performed a serial response time task in which a response and a timing sequence were presented repeatedly in a phase-matched manner, allowing for integrative learning. The degree of integrative learning was measured as the slowing in performance that resulted when phase-shifting the sequences. Learning was similar for the children and adults on average but increased with age for the children. Executive function measured by Wisconsin Card Sorting Test (WCST) performance as well as a measure of response speed also improved with age. Finally, WCST performance and response speed predicted temporal learning. Taken together, the results indicate that temporal learning continues to develop in pre-adolescents and that maturing executive function or processing speed may play an important role in acquiring temporal patterns in sequenced actions and the development of this ability.     

Personal attitudes toward time: The relationship between temporal focus,space‐time mappings and real life experiences

What influences how people implicitly associate “past” and “future” with “front” and “back?” Whereas previous research has shown that cultural attitudes toward time play a role in modulating space‐time mappings in people's mental models (de la Fuente, Santiago, Román, Dumitrache & Casasanto, 2014), we investigated real life experiences as potential additional influences on these implicit associations. Participants within the same single culture, who are engaged in different intermediate‐term educational experiences (Study 1), long‐term living experiences (Study 2), and short‐term visiting experiences (Study 3), showed their distinct differences in temporal focus, thereby influencing their implicit spatializations of time. Results across samples suggest that personal attitudes toward time related to real life experiences may influence people's space‐time mappings. The findings we report on shed further light on the high flexibility of human conceptualization system. While culture may exert an important influence on temporal focus, a person's conceptualization of time may be attributed to a culmination of factors.     

小学生调节聚焦对生活满意度的影响:压力应对方式的中介作用

采用调节聚焦问卷、压力应对方式问卷和生活满意度问卷对北京市五所学校1174名小学生进行调查, 考察调节聚焦对小学生压力应对方式、生活满意度的影响, 并检验应对方式在调节聚焦和生活满意度之间的中介作用。结果发现:(1)促进定向对小学生生活满意度有显著正向预测作用, 预防定向对生活满意度有显著负向预测作用;(2)积极应对和促进定向更相关, 消极应对和预防定向更相关;(3)积极应对在促进定向和生活满意度之间起着完全中介的作用, 积极应对、消极应对均在预防定向和生活满意度之间起着部分中介的作用。