International note: Prediction of mathematics work ethic and performance from behavioral,normative, and control beliefs among Qatari adolescents

Over half-a-million adolescents take part in each cycle of the Program for International Student Assessment (PISA). Yet often, researchers and policy makers across the globe tend to focus their attention primarily on the academic trajectories of adolescents hailing from highly successful education systems. Hence, a vast majority of the adolescent population who regionally and globally constitute the ‘long tail of underachievement’ often remain unnoticed and underrepresented in the growing literature on adolescents' academic trajectories. The present study, therefore, explored the relations of dispositions toward mathematics, subjective norms in mathematics, and perceived control of success in mathematics to mathematics work ethic as well as mathematics performance; and the mediational role of mathematics work ethic in the association between dispositional, normative, and control beliefs and mathematics performance among adolescents in one of the lowest performing education systems, Qatar. Structural equation modeling (SEM) analyses revealed that Qatari adolescents' dispositional, normative, and control beliefs about mathematics were significantly associated with their mathematics work ethic and mathematics performance, and mathematics work ethic significantly mediated the relationship between dispositional, normative, and control beliefs about mathematics and mathematics performance. However, multi-group SEM analyses indicated that these relationships were not invariant across the gender and the SES groups.     

Rationalizing self-defeating behaviors: Theory and evidence

Why do individuals engage in self-defeating behaviors like self-harm, addiction, and risky sexual behaviors? Why do they experience the apathy of depression or inaction when trapped by multiple competing problems? We propose a framework for explaining these and other related behaviors based on the insight that individuals can only experience a limited number of latent stimuli to which they are exposed. We conduct an experiment to test this model and find that more than two thirds of the subjects behave consistent with our theoretical framework.     

Effect of change in coding rules on recording diabetes in hospital administrative datasets

AimDuring 2008–2011 Australian Coding Standards mandated a causal relationship between diabetes and inpatient care as a criterion for recording diabetes as a comorbidity in hospital administrative datasets. We aim to measure the effect of the causality mandate on recorded diabetes and associated inter-hospital variations.MethodFor patients with diabetes, all admissions between 2004 and 2013 to all New South Wales acute public hospitals were investigated. Poisson mixed models were employed to derive adjusted rates and variations.ResultsThe non-recorded diabetes incidence rate was 20.7%. The causality mandate increased the incidence rate four fold during the change period, 2008–2011, compared to the pre- or post-change periods (32.5% vs 8.4% and 6.9%). The inter-hospital variation was also higher, with twice the difference in the non-recorded rate between hospitals with the highest and lowest rates (50% vs 24% and 27% risk gap). The variation decreased during the change period (29%), while the rate continued to rise (53%). Admission characteristics accounted for over 44% of the variation compared with at most two per cent attributable to patient or hospital characteristics. Contributing characteristics explained less of the variation within the change period compared to pre- or post-change (46% vs 58% and 53%). Hospital relative performance was not constant over time.ConclusionThe causality mandate substantially increased the non-recorded diabetes rate and associated inter-hospital variation. Longitudinal accumulation of clinical information at the patient level, and the development of appropriate adoption protocols to achieve comprehensive and timely implementation of coding changes are essential to supporting the integrity of hospital administrative datasets.     

Capacities for theory of mind,metacognition, and neurocognitive function are independently related to emotional recognition in schizophrenia

While many with schizophrenia spectrum disorders experience difficulties understanding the feelings of others, little is known about the psychological antecedents of these deficits. To explore these issues we examined whether deficits in mental state decoding, mental state reasoning and metacognitive capacity predict performance on an emotion recognition task. Participants were 115 adults with a schizophrenia spectrum disorder and 58 adults with substance use disorders but no history of a diagnosis of psychosis who completed the Eyes and Hinting Test. Metacognitive capacity was assessed using the Metacognitive Assessment Scale Abbreviated and emotion recognition was assessed using the Bell Lysaker Emotion Recognition Test. Results revealed that the schizophrenia patients performed more poorly than controls on tests of emotion recognition, mental state decoding, mental state reasoning and metacognition. Lesser capacities for mental state decoding, mental state reasoning and metacognition were all uniquely related emotion recognition within the schizophrenia group even after controlling for neurocognition and symptoms in a stepwise multiple regression. Results suggest that deficits in emotion recognition in schizophrenia may partly result from a combination of impairments in the ability to judge the cognitive and affective states of others and difficulties forming complex representations of self and others.     

A Complex Negotiation: Women's Experiences of Naming and Not Naming Premenstrual Distress in Couple Relationships

ABSTRACT

Recent research has demonstrated the importance of family relationships in women's experience of premenstrual changes, their construction of these changes as “PMS.” However, the discursive process by which women take up the subject position of “PMS” sufferer through the explicit naming of “PMS” to an intimate partner has received little research attention. Drawing on 60 individual interviews with Australian women, conducted between 2004 and 2006, we examined accounts of naming “PMS” in intimate relationships, women's explanations for naming or not naming, their experiences of their partner naming them as premenstrual. The analysis process identified an overarching theme of naming “PMS,” which was made up of three themes: naming to explain; “PMS” becoming the only explanation for distress; “PMS” as not a legitimate explanation for distress. The findings suggest that clinicians need to be aware of women's complex, often ambivalent, experiences of naming “PMS” within their relationships, when working with women, couples, seeking treatment or support for premenstrual distress.     

Validation of the Reading the Mind in the Eyes Test in a healthy Spanish sample and women with anorexia nervosa

Introduction: The aim of this study was to build a Spanish version of the Reading the Mind in the Eyes Test (RMET) including limited time of response and an integrated glossary, and to test its validity.

Methods: A total of 433 university students (121 men and 350 women) and 38 anorexic women completed the RMET and other related measures of empathy and alexithymia. The results of the Parallel Analysis suggested a unidimensional structure for 19 items, which was verified through a Confirmatory Factor Analysis.

Results: Similarly to other research, this factor had a low reliability (α?=?.56, ρ?=?.59); however, regarding validity, the total score of the instrument showed positive correlations with empathy and negatives with alexithymia. Furthermore, healthy females were superior to males in RMET, and to anorexic women; but no significant differences appeared between healthy men and the anorexic group.

Conclusion: This study confirms the validity of the test and permits a relatively short and inexpensive means of administration in large samples of adults. Besides, it suggests the necessity of assessing and treating the theory of mind in anorexic women.     

Patient assessment within the context of healthcare delivery packages: A comparative analysis

BackgroundDue to an increased focus on productivity and cost-effectiveness, many countries across the world have implemented a variety of tools for standardizing diagnostics and treatment. In Denmark, healthcare delivery packages are increasingly used for assessment of patients. A package is a tool for creating coordination, continuity and efficient pathways; each step is pre-booked, and the package has a well-defined content within a predefined category of diseases. The aim of this study was to investigate how assessment processes took place within the context of healthcare delivery packages.MethodsThe study used a constructivist Grounded Theory approach. Ethnographic fieldwork was carried out in three specialized units: a mental health unit and two multiple sclerosis clinics in Southern Denmark, which all used assessment packages. Several types of data were sampled through theoretical sampling. Participant observation was conducted for a total of 126 h. Formal and informal interviews were conducted with 12 healthcare professionals and 13 patients. Furthermore, audio recordings were made of 9 final consultations between physicians and patients; 193 min of recorded consultations all in all. Lastly, the medical records of 13 patients and written information about packages were collected. The comparative, abductive analysis focused on the process of assessment and the work made by all the actors involved. In this paper, we emphasized the work of healthcare professionals.ResultsWe constructed five interrelated categories: 1. “Standardized assessing”, 2. “Flexibility”, which has two sub-categories, 2.1. “Diagnostic options” and 2.2. “Time and organization”, and, finally, 3. “Resisting the frames”. The process of assessment required all participants to perform the predefined work in the specified way at the specified time. Multidisciplinary teamwork was essential for the success of the process. The local organization of the packages influenced the assessment process, most notably the pre-defined scope of relevant diseases targeted by the package. The inflexible frames of the assessment package could cause resistance among clinicians. Moreover, expert knowledge was an important factor for the efficiency of the process. Some types of organizational work processes resulted in many patients being assessed, but without being diagnosed with at package-relevant disease.ConclusionLimiting the grounds for using specialist knowledge in structured health care delivery may affect specialists’ sense of professional autonomy and can result in professionals employing strategies to resist the frames of the packages. Finally, when organizing healthcare delivery packages, it seems important to consider how to make the optimal use of specialist knowledge.     

What (or who) causes health inequalities: Theories,evidence and implications?

Health inequalities are the unjust differences in health between groups of people occupying different positions in society. Since the Black Report of 1980 there has been considerable effort to understand what causes them, so as to be able to identify actions to reduce them. This paper revisits and updates the proposed theories, evaluates the evidence in light of subsequent epidemiological research, and underlines the political and policy ramifications.     

Evaluating provider communication in pediatric chronic kidney disease care using a global coding system

ObjectiveAmong adolescents and young adults (AYAs) with chronic illness, effective provider communication is essential for patient-centered care during a sensitive developmental period. However, communication in chronic illness care for AYAs is not well studied. Our objectives were to describe the provider communication skills in pediatric chronic kidney disease (CKD) care visits; and determine if communication skills differ by AYA characteristics.MethodsWe adapted a global consultation rating system for pediatric subspecialty care using audiotaped clinic encounters of 18 pediatric nephrologists with 99 AYAs (age M(SD) = 14.9(2.6)) with CKD stages 1–5 and 96 caregivers. We hypothesized that provider communication skills would differ by AYA characteristics (age, gender, and race).ResultsThe strongest provider skills included initiating the session and developing rapport; lowest rated skills were asking patient’s perspective and checking understanding. Communication scores did not consistently differ by AYA age or race, but were rated higher with female AYAs in several domains (ps<0.05).ConclusionsPediatric providers generally had adequate or good communication scores with AYAs, but improvement in certain skills, particularly with male AYAs, may further support patient-centered care.Practice implicationsTo achieve consistent, patient-centered communication with AYAs, an observation-based global assessment may identify areas for provider improvement.     

Impaired Theory of Mind and psychosocial functioning among pediatric patients with Type I versus Type II bipolar disorder

Deficits in Theory of Mind (ToM) have been documented among pediatric patients with Bipolar Disorder (BD). However, fewer studies have directly examined differences between type I and type II patients and whether or not ToM deficits are related to psychosocial difficulties. Therefore, the aim of this study was to compare type I versus type II pediatric bipolar patients and matched Healthy Controls (HC) on ToM and interpersonal functioning tasks. All participants completed the Revised Mind in the Eyes Task (MET), the Cognitive and Emotional Perspective Taking Task (CEPTT), and the Index of Peer Relations (IPR). Type I BD patients reported greater peer difficulties on the IPR compared to HC, and also performed more poorly on the MET and the cognitive condition of the CEPTT, but did not differ significantly on the emotional condition. There were no significant group differences between type II BD patients and HC. More impaired ToM performance was associated with poorer interpersonal functioning. Type I BD patients show deficits in the ability to understand another's mental state, irrespective of emotional valence. Deficits in understanding others' mental states could be an important treatment target for type I pediatric patients with BD.