Although previous research on emotion recognition ability (ERA) has found consistent evidence for a female advantage, the explanation for this sex difference remains incompletely understood. This study compared males and females on four emotion recognition tasks, using a community sample of 379 adults drawn from two regions of the United States (stratified with respect to age, sex, and socioeconomic status). Participants also completed the Levels of Emotional Awareness Scale (LEAS), a measure of trait emotional awareness (EA) thought to primarily reflect individual differences in emotion concept learning. We observed that individual differences in LEAS scores mediated the relationship between sex and ERA; in addition, we observed that ERA distributions were noticeably non-normal, and that—similar to findings with other cognitive performance measures—males had more variability in ERA than females. These results further characterize sex differences in ERA and suggest that these differences may be explained by differences in EA—a trait variable linked primarily to early learning.

AbstractTrained as a social psychologist, Donald Campbell (1916–96) became the premier research methodologist of the social sciences and a proponent of social reform through the mechanism of “experimenting societies.” He was in particular responsible for detailing and rationalizing a wide range of quasi‐experimental designs in terms of their robustness against “threats to validity,” having formulated highly useful notions of types of experimental validity. Campbell also developed the important ideas of nonreactive measurement and unobtrusive measures. Most importantly, perhaps, Campbell had great influence on many scientific fields and, ultimately, on philosophy of science by way of his innovative thinking that came to be labeledevolutionary epistemology.

BACKGROUND:Fatigue is one of the most distressing symptoms experienced by people with cancer receiving radiation therapy.OBJECTIVES:The goal of this study is to evaluate clinical predictors of worsening fatigue during external beam radiation therapy (EBRT) in men with non-metastatic prostate cancer.METHODS:Thirty-five men with non-metastatic prostate cancer scheduled for EBRT were followed at baseline, midpoint, and completion of EBRT. The Functional Assessment of Cancer Therapy-Fatigue scale was administered. Demographic and clinical data were obtained by chart review. Paired t-tests, correlations, general linear models, and logistic regressions were used to determine associations between fatigue scores and clinical data.FINDINGS:Red blood cells, hemoglobin, and hematocrit levels were highly intercorrelated and, therefore, were grouped as one composite variable termed heme. Heme levels at baseline and androgen-deprivation therapy (ADT) were significantly correlated with worsening of fatigue symptoms from baseline to midpoint and endpoint. ADT alone did not have a significant correlation with fatigue, but it indirectly affected fatigue levels by influencing heme markers as treatment progressed. These findings provide evidence that hematologic markers and the use of ADT assist in predicting radiation therapy-related fatigue and guide symptom management.

Integrative medicine (IM) is a clinical paradigm of whole person healthcare that combines appropriate conventional and complementary medicine (CM) treatments. Studies of integrative healthcare systems and theory-driven evaluations of IM practice models need to be undertaken. Two health services research methods can strengthen the validity of IM healthcare studies, practice theory, and fidelity evaluation. The University of Arizona Integrative Health Center (UAIHC) is a membership-supported integrative primary care clinic in Phoenix, AZ. A comparative effectiveness evaluation is being conducted to assess its clinical and cost outcomes. A process evaluation of the clinic's practice theory components assesses model fidelity for four purposes: (1) as a measure of intervention integrity to determine whether the practice model was delivered as intended; (2) to describe an integrative primary care clinic model as it is being developed and refined; (3) as potential covariates in the outcomes analyses, to assist in interpretation of findings, and for external validity and replication; and (4) to provide feedback for needed corrections and improvements of clinic operations over time. This paper provides a rationale for the use of practice theory and fidelity evaluation in studies of integrative practices and describes the approach and protocol used in fidelity evaluation of the UAIHC.

Growth curve analysis provides important informational benefits regarding intervention outcomes over time. Rarely, however, should outcome trajectories be assumed to be linear. Instead, both the shape and the slope of the growth curve can be estimated. Non-linear growth curves are usually modeled by including either higher-order time variables or orthogonal polynomial contrast codes. Each has limitations (multicollinearity with the first, a lack of coefficient interpretability with the second, and a loss of degrees of freedom with both) and neither encourages direct testing of alternative hypothesized curve shapes. Especially in studies with relatively small samples it is likely to be useful to preserve as much information as possible at the individual level. This article presents a step-by-step example of the use and testing of hypothesized curve shapes in the estimation of growth curves using hierarchical linear modeling for a small intervention study. DOI:10.2458/azu_jmmss_v3i2_herman

©2011 Carden Jennings Publishing Co., Ltd. Correspondence: Adele B. Cohen, MS, Senior Vice President for Grants and Operations, Physicians’ Institute for Excellence in Medicine, 1849 The Exchange, Atlanta, GA 30339 USA; 678-303-9287; fax: 888-290-7436 (e-mail: acohen@mag.org). IntroductIon In 2009, the University of Arizona HealthCare Partnership received a grant to provide education toward improvement in the treatment of nicotine addiction through the Physicians’ Institute for Excellence in Medicine. The Physicians’ Institute (a nonprofit subsidiary of the Medical Association of Georgia) is a partner in the Cease Smoking Today (CS2Day) initiative. CS2Day is a multi-organizational education initiative designed to provide physicians and healthcare professionals with effective and clinically relevant strategies targeted to increase the smoking quit rates for patients followed in multiple practice settings. This article describes the content, delivery, and outcomes of 2 continuing medical education (CME) courses delivered in Arizona to health and human service professionals and compares the impact of longer and shorter programs.

This study focused on the quality of life experienced by persons with severe mental illness (SMI). Previous studies indicate the need for a multi-dimensional approach to the study of quality of life and its subjective indicators. For the SMI, attention should be paid not only to the direct and intentional effects of interventions, but also to the indirect and unintentional effects, both negative and positive. Hence, a global evaluation of individuals within this group is indicated. A multitrait-multimethod approach to construct validation using confirmatory factor analysis was employed. The hypothesized factors were modeled as multiple traits and the multiple perspectives of the respondents (i.e. patient, case manager, family member) were multiple methods. A total of 265 severely mentally ill adults served by a network of agencies in four cities were randomly sampled. The sample was approximately 50% male and 50% female, ages ranged from 19-78 years. DOI:10.2458/azu_jmmss_v1i2_johnson

Ethnic differences in health outcomes are assumed to reflect levels of acculturation, among other factors. Health surveys frequently include language and social interaction items taken from existing acculturation instruments. This study evaluated the dimensionality of responses to typical bilinear items in Latino youth using Rasch modeling. Two seven-item scales measuring Anglo-Hispanic orientation were adapted from Marin and Gamba (1996) and Cuellar, Arnold, and Maldonado (1995). Most of the items fit the Rasch model. However, there were gaps in both the Hispanic and Anglo scales. The Anglo items were not well targeted for the sample because most students reported they always spoke English. The lack of variability found in a heterogeneous sample of Latino youth has negative implications for the common practice of relying on language as a measure of acculturation. Acculturation instruments for youth probably need more sensitive items to discriminate linguistic differences, or to measure other factors.

OBJECTIVE:Smokers who are not ready to quit are a very difficult group to treat. Physicians, nurses, and nurse practitioners are in a unique position to encourage patients to quit smoking. However, the best approach to do so is not clear. METHODS:A two-group randomized controlled trial with 218 pack-a-day precontemplative and contemplative smokers recruited from the community. The laboratory-based study was designed to simulate outpatient visits to general practitioners. Participants were randomized to a 15-min intervention to compare the effectiveness of brief motivational or prescriptive counseling by a health professional. Thirteen outcome variables included intentions to quit and verbal reports at 1 and 6 months with biological verification. A composite outcome measure was constructed to provide greater power to detect study differences. RESULTS:Approximately 33% of the sample reported at least one 24-h quit period during the 6 months they were followed after the trial. Results suggest that while neither treatment was superior, there were subgroup differences. Participants in the motivational condition were also more likely to respond to follow-up calls. CONCLUSIONS AND PRACTICE IMPLICATIONS:Motivational interviewing and prescriptive advice were equally effective for precontemplative and contemplative smokers. Practitioners should use the method that appeals to them.

stimuli.’ 1 Alas, if that statement were only regularly honoured. Instead, as LaPierre goes on to note, ‘But by derivation social attitudes are seldom more than a verbal response to a symbolic situation’. Let us note that LaPierre was writing those statements 75 years ago. Nothing has changed, and social psychologists continue to observe and fret about the fact that ‘attitudes’ do not necessarily relate to ‘behaviour’. As LaPierre’s opening statement makes clear that that idea is nonsense because attitudes are behaviour. Or, perhaps a bit more accurately, attitudes are inferred from behaviour, and only from behaviour. The whole issue hinges on one’s ideas about just what constitutes ‘behaviour’ and whether one wants to divide behaviour into the two categories of ‘what people

Objective. Bilingual and bicultural occupational health and safety interventions for Hispanic farmworkers are extremely rare and, because of language barriers and cultural differences, issues important to their health and safety on the job remain unaddressed. We designed, conducted, and assessed the first bilingual occupational health and safety education program for farmworkers attending High School Equivalency Programs (HEPs). Methods. We took an interdisciplinary participatory approach by integrating educators and researchers with a community advisory board to guide development, evaluation, and implementation of Work Safely–Trabaje con Cuidado Curriculum (Curriculum), a bilingual occupational health and safety curriculum. We created a quasi-experimental design using mixed-method evaluation (quantitative and qualitative elements) via pre- and posttest comparisons, follow-up surveys, and focus groups assessing the Curriculum effect on knowledge, safety risk perception (SRP), and safety behavior. Focus groups and follow-up surveys reflected success and acceptance of the Curriculum among participating farmworkers under the study's logic model. Results. Completion of the Curriculum resulted in statistically significant improvements in the combined score of knowledge and SRP at the posttest ( p=0.001) and follow-up survey ( p=0.02) in the intervention group. After completing this study, the Curriculum was permanently adopted by the two high school equivalency sites involved. Conclusion. The participatory approach resulted in integration of community and applied research partnership. The potential to expand use of this Curriculum by other HEP sites can further assess effectiveness and external validity among underserved minority groups.

BACKGROUND:This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures.METHODS:The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83%) completed the survey.RESULTS:The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers.CONCLUSION:Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco Education and Prevention has included the goal of identifying and eliminating tobacco related disparities for special populations, including low-income groups. Of importance, in 2008 the Arizona Health Care Cost Containment System was authorized to provide tobacco cessation pharmacotherapy as a covered benefit for its members.

The promotores de salud (community health worker) model takes important steps toward addressing the lack of culturally competent health care services for U.S. Hispanics. The purpose of this pilot study was to evaluate eLearning as a technique to instruct promotores in evidence-based intervention strategies for tobacco dependence treatment. Nineteen promotores serving Spanish-speaking populations in southeastern Arizona were certified to deliver tobacco dependence treatment interventions through a culturally and linguistically competent online program. Pretest, posttest, and 3-month follow-up data were analyzed to measure knowledge, skills, self-efficacy, behavior change, and satisfaction with eLearning. Analysis indicated high satisfaction with eLearning as well as significant gains in knowledge, skills, self-efficacy, and provision of interventions. Findings support successful outcomes using eLearning and the need for further research on computer-based learning for promotores.

Age differences in emotion recognition from lexical stimuli and facial expressions were examined in a cross-sectional sample of adults aged 18 to 85 (N = 357). Emotion-specific response biases differed by age: Older adults were disproportionately more likely to incorrectly label lexical stimuli as happiness, sadness, and surprise and to incorrectly label facial stimuli as disgust and fear. After these biases were controlled, findings suggested that older adults were less accurate at identifying emotions than were young adults, but the pattern differed across emotions and task types. The lexical task showed stronger age differences than the facial task, and for lexical stimuli, age groups differed in accuracy for all emotional states except fear. For facial stimuli, in contrast, age groups differed only in accuracy for anger, disgust, fear, and happiness. Implications for age-related changes in different types of emotional processing are discussed.

The Smoking Hazards Scale (SHS) is a 12-item questionnaire with four scales designed to assess respondent perceptions of obvious health risks due to smoking, subtle health risks due to smoking, health risks not associated with smoking, and risks for stressful life events. The SHS focuses on risk perceptions for objective consequences and can be used to test causal pathways in behavioral treatment programs for smoking cessation. Reliability and validity information are presented from a sample of 215 smokers in the precontemplative and contemplative stages of change. While these smokers see themselves at an increased risk for the obvious health risks due to smoking, they are unaware of the subtle risks of smoking.

Since at the time of graduation from medical school physicians are expected to demonstrate adequate professional competence including mastery of critical appraisal skills, we conducted a preliminary, cross-sectional, web-based study to examine the extent to which fourth year medical students in the US are competent in core areas of evidence-based medicine (EBM). Using self-assessment instruments, subjects (n = 150) were asked to demonstrate their ability to understand the practical meaning of key methodological and data analysis constructs as they relate to patient care, to rate their perceived competence in core areas of EBM and to disclose their attitudes toward critical appraisal of the literature and EBM. The mean score in our cohort was 55% suggesting that students may have knowledge gaps that interfere with their ability to critically appraise the medical literature. There was an apparent chasm between subjects' perceived competence and their actual performance on the assessment instrument. These findings, if corroborated in larger studies, (1) suggest that better education in EBM is needed so as to avoid the possibility that patient care may inadvertently be jeopardized; and (2) cast doubt on the use of self-assessed knowledge as a proxy for actual skills with respect to EBM and medical decision-making.