Using focus groups to identify diabetes care and education issues for Latinos with diabetes

The purpose of this study was to identify diabetes care and education issues for Latinos with diabetes. Four focus groups of Latinos with diabetes were held in the Detroit area; these sessions were audiotaped. An expert panel of bilingual health professionals from the United States and Mexico reviewed the audiotapes and identified and prioritized 47 issues using a modified Delphi technique. The highest priority issue identified by a wide margin was the difficulty many Latina women with diabetes have with self-care because of other family responsibilities. Universal diabetes care issues have a specific cultural expression which, when identified, can be incorporated into diabetes care and education programs for a particular cultural group. Focus groups are a useful means for identifying and illuminating such issues.     

Using focus group interviews to identify salient issues concerning college students' alcohol abuse

Despite extensive efforts to decrease alcohol abuse among college students, prevention approaches have had limited success. This study attempted to clarify reasons for this limited success and to identify directions for future interventions by directly interviewing college students on this topic. Five issues were discussed in the focus group interviews: (1) reasons for drinking alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender differences in drinking patterns. The focus group interviews were found to be a valid tool for elucidating sensitive aspects of these issues and the relative importance of these issues to each other. The students revealed how susceptible they are to societal pressures to drink alcohol and how the limitations of their intrapersonal skills affect their alcohol consumption, most notably regarding sexuality issues. The authors contend that improving intrapersonal skills should be a major focus of programs to prevent alcohol abuse.     

Diabetes in urban African Americans. V. Use of discussion groups to identify barriers to dietary therapy among low-income individuals with non-insulin-dependent diabetes mellitus

The purpose of the present study is the presentation of the available literature on obesity in Greece. The heterogeneity of design, small sample size and limited number of studies conducted, complicates the delineation of definite trends. Nevertheless, the existing literature appears to point at a high prevalence of obesity among Greek children. Childhood obesity, may partly be accounted for by the over-protection and forced feeding by Greek parents. With regard to the incidence of obesity among Greek adolescents, studies have yielded controversial results. On the other hand, the existing evidence appears to indicate a high prevalence of obesity among Greek adults and the elderly, particularly those above 30 years of age. In contrast to the females, males appear to be characterised by central obesity. These observations highlight a need for primary prevention measures.     

Using visual assessment to identify a client's needs

Assessing the eyesight of people with learning disabilities may involve some ingenuity to get an accurate result. This paper describes a project to explore the role of the RNMH is assessing such patients' visual acuity.     

Current issues relating to psychosocial job strain and cardiovascular disease research.

[Correction Notice: An erratum for this article was reported in Vol 3(4) of Journal of Occupational Health Psychology (see record 2008-09594-001). On p. 12, in the caption to Figure 2, the copyright statement is missing. The caption should have read "The environment, the worker, and illness: Dynamic associations linking environmental strain and learning to evolution of personality. From Healthy Work: Stress, Productivity, and the Reconstruction of Working Life (p. 99), by R. A. Karasek and T. Theorell, 1990, New York: Basic Books. Copyright 1990 by Basic Books. Used with permission."] Examines recent reviews of cardiovascular (CV) job strain (JS) research by P. L. Schnall and P. A. Landsbergis (1994) and T. S. Kristensen (see record 1995-39109-001), which conclude that JS as defined by the demand–control model (the combination of contributions of low job decision latitudes and high psychological job demands) is confirmed as a risk factor for CV mortality in a large majority of studies. Lack of social support at work appears to increase this risk. Several still-unresolved issues are discussed in light of recent research. Methodological issues related to the use of occupational & career aggregate estimates, use of standard scales for job analysis, and recall bias in issues of self-reporting are examined. Confounding factors and differential strengths of associations by subgroups in JS–CV disease analyses with respect to social class, gender, and working hours are addressed. A review of results of monitoring JS–blood pressure associations and associated methodological issues is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research of psychosocial issues of children with craniofacial anomalies: progress and challenges

Benign intracranial hypertension and communicating hydrocephalus are uncommon but important disorders that affect cerebrospinal fluid dynamics. They have clinical similarities but their management is usually different. The factors determining which of the two disorders will develop include brain compliance, the state of the cranial sutures, the nature of the insult and its magnitude. I propose that the time course of the pathological events leading to presentation may be a further factor to consider in the pathogenesis and management of these disorders.     

Using clinically significant change to identify premature termination.

Research examining treatment dropout is hindered by the inconsistencies in the methods used to operationalize the construct. In this article an operationalization based on the criteria of attaining clinically significant change prior to treatment discontinuation is reintroduced and compared with other existing dropout classification systems. A dropout rate of 77% was found in a university-based training clinic sample by using the clinically significant change (CSC) definition. This classification showed little agreement to classifications made by other popularly used definitions of dropout (median split, intake only, missed appointment, and therapist judgment). Further analysis indicated that the other popularly used definitions frequently classified clients as treatment dropouts when recovery had occurred or as treatment completers when recovery had not occurred. Uses and limitations of the CSC method and other popular definitions of treatment dropout are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing for the 21st century. Planning with focus groups

The job market for nursing graduates is changing, and nursing schools must respond to the changes. The author describes the process of using focus groups to facilitate a constructive dialogue between nurse administrators, clinicians, educators, and students. The groups focused on adapting the curriculum to changing market conditions. Recommendations and outcomes are highlighted. Nursing educators are encouraged to critically examine their own programs in preparation for the 21st century.     

Motivations to identify with social groups: A look at their positive and negative consequences.

Social identity is considered a key social psychological variable to understanding intergroup behaviors. Given that social identity has been associated with both positive (e.g., well-being, helping behaviors) and negative consequences (e.g., ingroup bias, nationalism), it remains to be explained which dimensions of social identification yield these divergent consequences. To this aim, these studies apply self-determination theory to understanding the reasons why group members identify with their ingroup. We hypothesized that when group members identify with their ingroup for self-determined reasons, this should predict more positive consequences. In contrast, identifying with one's ingroup for non–self-determined reasons should predict more negative consequences. Three studies tested these hypotheses among members of different social groups, namely, University of Queensland students (n = 272), residents of Québec (n = 196), and members of an online community (n = 278). Controlling for degree of identification, these hypotheses were supported when predicting the positive consequences, and mostly supported for the negative consequences. Results are interpreted in light of social identity theory and self-determination theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The development of an empirical psychosocial taxonomy for patients with diabetes.

The main purpose of this study was to develop and to cross-validate an empirically derived psychosocial taxonomy of patients with diabetes. In the first study, 101 patients with Type I or Type II diabetes completed the Multidimensional Diabetes Questionnaire. Cluster analysis identified three clusters, labeled adaptive copers, low support-low involvement, and spousal overinvolvement. In the second study, the taxonomy was cross-validated using an independent sample of 132 patients with long-standing Type II diabetes. The results confirmed that the multivariate classification system was unique and highly accurate. External validation, using general psychological as well as diabetes-specific measures, supported the validity and distinctiveness of the patients' profiles. These findings help establish a multiaxial psychosocial taxonomy of diabetes and may have significant implications for the management of patients with diabetes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Insulin-resistant diabetes mellitus in a black woman with ataxia-telangiectasia

A 24-year-old woman with ataxia-telangiectasia had traumatic arthritis, elevated serum transaminase values, polyuria, polydipsia, and a serum glucose level of 575 mg/dL. A relatively high daily dose of insulin (2.8 U/kg) was required to achieve near normoglycemia. The fasting insulin concentration was elevated. During an insulin-modified frequently sampled intravenous glucose tolerance test, the first phase of insulin release in response to the administration of glucose was blunted. The insulin sensitivity was similar to that found in individuals with non-insulin-dependent diabetes mellitus. Insulin receptor antibodies were not detected in the serum. We conclude that insulin resistance and islet beta-cell dysfunction are characteristics of diabetes mellitus in ataxia-telangiectasia. Contrary to a previous report, our findings do not support a cause-and-effect relationship between insulin receptor antibodies and insulin resistance in this disorder.     

Legal issues in the assessment and treatment of individuals with dual diagnoses.

The difficult legal, ethical, and professional issues confronting psychologists who work with people with dual diagnoses are discussed here. Applicable constitutional principles are outlined in the context of discussing the right to institutional services and to refuse treatment, statutes that go beyond constitutional protections are described, issues that people with dual diagnoses face in the criminal and civil justice systems are highlighted, and some recommendations that psychologists should consider when providing services to this population are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lifestyle intervention in overweight individuals with a family history of diabetes

OBJECTIVE: To assess the effect of lifestyle intervention over 2 years on changes in weight, coronary heart disease (CHD) risk factors, and incidence of diabetes in overweight individuals with a parental history of diabetes. RESEARCH DESIGN AND METHODS: Participants (n = 154), who were 30-100% over ideal body weight, had one or both parents with diabetes, and were currently nondiabetic, were randomly assigned to 2-year treatments focused on diet (decreasing calories and fat intake), exercise (goal of 1,500 kcal/week of moderate activity), or the combination of diet plus exercise or to a no-treatment control group. Subjects were reassessed at 6 months, 1 year, and 2 years. RESULTS: At 6 months, the groups differed significantly on measures of eating, exercise, and fitness; weight losses in the diet and diet-plus-exercise groups were significantly greater than in the exercise and control conditions. Weight losses were associated with positive changes in CHD risk factors. After 6 months, there was gradual deterioration of behavioral and physiological changes, so that at 2 years, almost no between-group differences were maintained. Differences between groups in risk of developing diabetes were of borderline significance (P = 0.08). Strongest predictors were impaired glucose tolerance at baseline, which was positively related to risk of developing diabetes, and weight loss from baseline to 2 years, which was negatively related; in all treatment groups, a modest weight loss of 4.5 kg reduced the risk of type 2 diabetes by approximately 30% compared with no weight loss. CONCLUSIONS: Although initially successful, the interventions studied here were not effective in producing long-term changes in behavior, weight, or physiological parameters. However, weight loss from 0 to 2 years reduced the risk of developing type 2 diabetes. Since modest weight loss significantly reduced risk of type 2 diabetes, further research is needed to determine how best to increase the percentage of subjects achieving at least a modest weight loss.     

Using the media to foster self-help groups.

Describes a project that consisted of putting ongoing self-help groups on the radio for 1 hr a week. The 1st half hour each week involved an actual session of a self-help group; during the 2nd half hour, calls from the audience were taken and answered by members of the group. The groups were directed at helping women cope wth motherhood, at men who abused their wives or children, and at parents of children with behavior problems. Increases in referral calls to each group were found after the self-help groups went on the air. Process recordings of the shows were useful in documenting the communication patterns employed during the shows. A panel of 12 mental health professionals judged that the programs did not provide unethical, harmful, or inaccurate information. The present project provided a demonstration of how researchers can work collaboratively with media and self-help groups in monitoring change in community-level types of interventions. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of health, environmental, and socio-psychological variables on fear of crime and its consequences among urban black elderly individuals

Despite extensive research on fear of crime among elder members of the population, little attention has been paid to the fear of crime among Black urban elderly individuals. Using a sample of 372 low income urban Black persons aged sixty-two and over the causes and consequences of such fear were investigated. Fear of crime reduces subjective well-being of these older adults and limits their mobility. Age, gender, education, marital status, loneliness, self-reported health status, previous victimization experience, media exposure, trust of neighbors, length of residence, and type of housing were tested to identify significant predictors of fear of crime. Some of these variables had a diverse impact on fear of crime at home versus outside of the home. For example, while gender was the strongest predictor of fear of crime outside the home, it was not significantly associated with fear inside the home. Surprisingly, self-reported health status was not related to fear of crime among this sample of urban Black elderly individuals.     

Structural equation modeling of the relationship between caregiver psychosocial variables and functioning of individuals with stroke.

Purpose/Objective: Stroke is a leading cause of disability worldwide. Informal caregivers are essential in the survival of most individuals with stroke and may even aid in their recovery. Yet caregivers experience high levels of burnout, depression, burden, and physical illness. Research Method/Design: With structural equation modeling and canonical correlation analysis, links were identified between caregiver psychosocial variables and specific aspects of the functioning of individuals with stroke in 135 care recipient-caregiver dyads. Results: Initial analyses uncovered a medium-sized correlation between caregiver variables and care recipients' functioning. Follow-up analyses pinpointed specific links between caregivers' sense of coherence and care recipients' basic engagement with life and between caregivers' levels of burden and depression and care recipients' cognitive deficits and depression. Conclusions/Implications: On the basis of these findings, the authors propose a feedback loop wherein caregivers' psychosocial functioning, their quality of caregiving, and stroke severity and recovery are causally interconnected. Findings are consistent with the use of cognitive-behavioral interventions for caregivers, which may improve caregivers' sense of coherence, reducing their levels of burden and depression and leading to improved informal care and better recovery from stroke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obesity-independent hyperinsulinemia in nondiabetic first-degree relatives of individuals with type 2 diabetes

An increased incidence of systemic cancers has been described in some reports of familial atypical multiple mole-melanoma kindreds. If the gene defect underlying the familial atypical multiple mole-melanoma syndrome is not only important for the development of melanoma of the skin, the impact of the defect on life expectancy may be much higher than previously thought. We investigated all-cause mortality from 1830 to the present and causes of death from 1941 to 1994 in proven, obligate, and potential CDKN2 mutation carriers to obtain an estimate of the impact of a hereditary defect of the CDKN2 gene on mortality. From 1830 to 1994 there were 65 deaths, although only 42 deaths were expected [standardized mortality ratio (SMR) 1.6, 95% confidence interval (CI) 1.2-2.0] and the SMR doubled with calendar time. Excess mortality was shown in most of the families, but was confined to ages 35-70 y (SMR 2.1, 95%CI 1.5-2.9). Excess mortality could be fully attributed to cancer mortality, especially to pancreatic carcinoma and melanoma of the skin. There appeared to be some heterogeneity among the families, especially due to the specific cancer pattern within a family. The impact of the defect of the CDKN2 gene is rising over calendar time, mainly because the mortality in the general population has been falling. Excess mortality was not only due to melanoma, but also to pancreatic carcinoma. Therefore, follow-up programs of affected family members should not be confined to a regular check of the atypical nevi.     

Effects of focus of attention on anxiety levels and social performance of individuals with social phobia.

Self-focused attention has been linked to social anxiety and poor social performance, but the causal direction of this relationship has not been established. For this study, focus of attention was manipulated during a speech task, conducted in pairs for 38 individuals with generalized social phobia. Results indicated that intensifying self-focused attention increased anticipated anxiety and anxious appearance, regardless of whether the individual was giving a speech or passively standing before the audience. The self-focus manipulation also increased self-reported anxiety during the task, but only for individuals assigned to a passive role. Contrary to expectation, self-focused attention did not affect any measure of social performance. These results indicate that self-focused attention may play a causal role in exacerbating social anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)