The perceived benefits of the chronic disease self-management program among participants with stroke: A qualitative study

Despite the expense associated with rehabilitation following stroke, dissatisfaction with psychosocial outcomes is common (Thomas & Parry, 1996). The rehabilitation system has been critiqued as lacking a theoretical base for psychosocial interventions (Goldberg, Segal, Berk, Schall, & Gershkoff, 1997). The current paper examines the possible role of the Chronic Disease Self-Management Program ([CDSMP] Lorig, 1996) in contributing to the psychosocial rehabilitation of people with stroke. This paper focuses on the analysis of incidental comments made by participants about a version of the CDSMP, tailored for people with stroke. These comments, collected over an 18-month follow-up period, provide interesting insights into the key aspects of the program. Six informative themes emerged from the more specific comments, namely (1) the importance of social contact and comparison, (2) increased awareness and knowledge about stroke, (3) motivation to pursue goals and activities, (4) a sense of achievement, (5) maintenance of gains, and (6) the paradoxical nature of social support. According to participants, the program was associated with enhanced self-efficacy. Other reported benefits (such as social support and enhanced knowledge) were indirectly associated with the program and appeared to reflect social aspects of the group and its stroke-specific focus. Maintenance of gains made by participants was seen as a crucial issue.

Being stoned: A review of self-reported cannabis effects

Although there has been considerable research into the adverse effects of cannabis, less attention has been directed toward subjective effects that may be associated with ongoing cannabis use. Examination of self-reported cannabis effects is an important issue in understanding the widespread use of cannabis. While reviews have identified euphoria as a primary factor in maintaining cannabis use, relaxation is the effect reported most commonly in naturalistic studies of cannabis users, irrespective of the method used. Self-reported effects in 12 naturalistic and 18 laboratory studies were compared. Regardless of methodology there was considerable variation in the effects experienced. Variation has been reported in terms of opposite effects being experienced by different individuals, variation of effects by individuals within a single occasion and between occasions of use. Factors that might explain this variation are outlined. Limitations of the available literature and suggested directions for future research are discussed.

Self-help organisations: A qualitative study of successful collaboration with general practice

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

Development of a controlled drinking self-efficacy scale and appraising its relation to alcohol dependence

There is no specific self-efficacy measure that has been developed primarily for problem drinkers seeking a moderation drinking goal. In this article, we report the factor structure of a 20-item Controlled Drinking Self-Efficacy Scale (CDSES Sitharthan et al., 1996; Sitharthan et al., 1997). The results indicate that the CDSES is highly reliable, and the factor analysis using the full sample identified four factors: negative affect, positive mood/social context, frequency of drinking, and consumption quantity. A similar factor structure was obtained for the subsample of men. In contrast, only three factors emerged in the analysis of data on female participants. Compared to women, men had low self-efficacy to control their drinking in situations relating to positive mood/social context, and subjects with high alcohol dependence had low self-efficacy for situations relating to negative affect, social situations, and drinking less frequently. The CDSES can be a useful measure in treatment programs providing a moderation drinking goal. (C) 2003 Wiley Periodicals, Inc.

Nanostructures, Semicrytalline Morphology, and Nanoscale Confinement Effect on the Crystallization Kinetics in Self-Organized Block Copolymer/Thermoset Blends

This work reports the first instance of self-organized thermoset blends containing diblock copolymers with a crystallizable thermoset-immiscible block. Nanostructured thermoset blends of bisphenol A-type epoxy resin (ER) and a low-molecular-weight (M-n = 1400) amphiphilic polyethylene-block-poly(ethylene oxide) (EEO) symmetric diblock copolymer were prepared using 4,4'-methylenedianiline (MDA) as curing agent and were characterized by transmission electron microscopy (TEM), atomic force microscopy (AFM), small-angle X-ray scattering (SAXS), and differential scanning calorimetry (DSC). All the MDA-cured ER/EEO blends do not show macroscopic phase separation but exhibit microstructures. The ER selectively mixes with the epoxy-miscible PEO block in the EEO diblock copolymer whereas the crystallizable PE blocks that are immiscible with ER form separate microdomains at nanoscales in the blends. The PE crystals with size on nanoscales are formed and restricted within the individual spherical micelles in the nanostructured ER/EEO blends with EEO content up to 30 wt %. The spherical micelles are highly aggregated in the blends containing 40 and 50 wt % EEO. The PE dentritic crystallites exist in the blend containing 50 wt % EEO whereas the blends with even higher EEO content are completely volume-filled with PE spherulites. The semicrystalline microphase-separated lamellae in the symmetric EEO diblock copolymer are swollen in the blend with decreasing EEO content, followed by a structural transition to aggregated spherical micellar phase morphology and, eventually, spherical micellar phase morphology at the lowest EEO contents. Three morphological regimes are identified, corresponding precisely to the three regimes of crystallization kinetics of the PE blocks. The nanoscale confinement effect on the crystallization kinetics in nanostructured thermoset blends is revealed for the first time. This new phenomenon is explained on the basis of homogeneous nucleation controlled crystallization within nanoscale confined environments in the block copolymer/thermoset blends.

Efficacy of a new self-supporting low-profile bednet for personal protection against Anopheles farauti (Diptera : Culicidae) in a village in Papua New Guinea

A new United States (U.S.) self-supporting low-profile bednet was designed by Walter Reed Army Institute of Research in collaboration with Breakthrough Technologies. The bednet incorporated permethrin-impregnated screening into a frame that erected automatically when removed from its bag. The new U.S. bednet was compared with the current Australian Defense Force (ADF) mosquito bednet at Buka Island, North Solomons Province, Papua New Guinea, in March 1999. At the time of the test, Anopheles farauti Laveran was the most abundant biting mosquito. Both bednet types provided > 97.8% protection compared with an unprotected collector. The untreated U.S. Army prototype bednet provided better protection than the untreated ADF bednet against mosquitoes entering the bednet during the night.

A longitudinal study of employee adaptation to organizational change: The role of change-related information and change-related self-efficacy

This study examined the role of information, efficacy, and 3 stressors in predicting adjustment to organizational change. Participants were 589 government employees undergoing an 18-month process of regionalization. To examine if the predictor variables had long-term effects on adjustment, the authors assessed psychological well-being, client engagement, and job satisfaction again at a 2-year follow-up. At Time 1, there was evidence to suggest that information was indirectly related to psychological well-being, client engagement, and job satisfaction, via its positive relationship to efficacy. There also was evidence to suggest that efficacy was related to reduced stress appraisals, thereby heightening client engagement. Last, there was consistent support for the stress-buffering role of Time I self-efficacy in the prediction of Time 2 job satisfaction.

The role of catastrophic misinterpretation of bodily sensations and panic self-efficacy in predicting panic severity

This study investigated the role of both negative and positive cognitions in predicting panic severity in an international sample of patients diagnosed with panic disorder (with and without agoraphobia). One hundred and fifty-nine patients were administered the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), the Self-efficacy to Control Panic Attacks Questionnaire, and the Panic and Agoraphobia Scale (PAS) prior to receiving treatment. Regression analyses indicated that both catastrophic misinterpretation of bodily sensations and panic self-efficacy independently predicted panic severity. The influence of panic self-efficacy upon panic severity remained significant even after controlling for the presence or absence of agoraphobia. There was no evidence to suggest a moderating relationship between the two cognitive factors. Results are discussed in terms of the need to consider both negative and positive cognitions in cognitive accounts of panic disorder. (C) 2002 Elsevier Science Inc. All rights reserved.

Woodrow Wilson's ''Rhetorical restructuring'': The transformation of the American self and the construction of the German enemy

From a comprehensive study of the public addresses of Woodrow Wilson in the period following the outbreak of the war in Europe in August 1914 to the war's conclusion in June 1919, this essay examines Wilson's transformation of the long-held vision of America as merely a great example of liberty to its embodiment as the self-sacrificing champion of liberty. It will demonstrate how this transformation of the American "self" was inextricably connected to a changing image of the war and the construction of an enemy image of the German government.

Initiation of evasive manoeuvres during self-motion: a test of three hypotheses

To understand performance of evasive and interceptive actions it is important to know how people decide when to initiate a movement - initiating at the 'right' moment is often essential for successful performance. It has been proposed that initiation is triggered when a perceptually derived quantity reaches an invariant criterion value. Candidate quantities include time-to-collision (TTC), distance, and rate of image expansion ( ROE), all of which have received empirical support. We studied initiation of an evasive manoeuvre in a computer-simulated steering task in which the observer was required to steer through a stationary visual environment and avoid colliding with an obstacle in their path. The results could not be explained by hypotheses which propose that evasive manoeuvre initiation is based on a fixed criterion value of TTC or distance. The overall pattern was, however, consistent with the use of a criterion ROE value. This was further tested by analyses designed to directly evaluate whether the ROE value used to initiate the response was the same across experimental conditions. Only two of the six participants showed evidence for using the ROE strategy.

Response to Orr and Siegler - collective intentionality and procreative desires: the permissible view on consent to posthumous conception

Orr and Siegler have recently defended a restrictive view concerning posthumous sperm retrieval and conception, which would limit insemination to those cases where the deceased man has provided explicit consent for such a procedure. The restrictive view dominates current law and practice. A permissible view, in contrast, would allow insemination and conception in all but those cases where the posthumous procedure has been explicitly refused, or where there is no reasonable evidence that the deceased person desired children. I describe a phenomenology of procreative desires which supports the permissible view, and which is compatible with requirements concerning the interests of the decedent, concepts of medical infertility, and the welfare of the future child. The account illustrates how our current obsession with individual rights and autonomy can be self-defeating and repressive.

Irja' ila Nafsika: Suhraward's apperception of the self in light of Avicenna

Shihāb al-Dīn Suhrawardī (d.687/1191) proposed a theory of apperception that constitutes the core of his “illuminative” epistemology. His theory of apperception purports to account for the soul’s immediate, reflexive, and unmediated knowledge of its own essence. Apperception may be defined as the direct experience the soul has of its essence. A closer examination of the Avicennan tradition (Avicenna died in 420/1037) reveals the existence of a number of arguments for the demonstration of an apperception of the self/soul similar to the arguments Suhrawardī later proposes. Contrary to admitted views, Avicenna had tackled issues related to the soul’s apperception, a type of perception distinct from the soul’s intellection of its essence. Avicenna alluded to the existence of a mode of perception specific to the soul that would guarantee both the soul’s unity and its personal identity. This apperception is defined as an unmediated presence of the soul to itself. These elements recur in Suhrawardī’s theory of apperception and numerous versions of Avicenna’s arguments for the demonstration of the presential nature of apperception