Having good intentions to engage in healthy behaviours, to change our lives in a positive direction and make substantial, lasting changes may not always translate into actions or behaviour that is ...maintained. Motivational Interviewing is a directive person‐centred approach designed to explore ambivalence and activate motivation for change Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviour. London: Guilford Press, 1991. A key component of a motivational interviewing conversation is to acknowledge that clients have every right to make no change. It uses a guiding communication style which invites people to consider their own situation and find their own solutions to situations that they identify as problematic that are preventing change. Motivational Interviewing was first introduced in adult health addiction services in the early 1980s. It has developed in the physical health specialties, and in the last 20 years or so attention has turned to the potential of Motivational Interviewing in the paediatric setting and the challenges of using it in families with children at differing ages and developmental stages. This article summarizes studies published from 2006 to 2011 of Motivational Interviewing in individuals across the lifespan with type 1 and type 2 diabetes and obesity.
•The cost of balancing a parabolic trough concentrated solar power (CSP) plant is investigated.•A new CSP dispatch model using a dynamic programming algorithm presented.•The cost of balancing ...increases with solar multiple and number of hours of storage.•The cost of balancing is typically 2.2–9.5% of plant gross income.
This study presents a new dispatch model (SCSP) for a CSP plant based on a dynamic programing algorithm. The purpose is to investigate the cost of balancing a CSP plant in the Spanish electricity market. Results are presented for a parabolic plant in the Spanish market for years 2009, 2010 and 2011 using solar availability data at the Plataforma Solar, Andalucia, Spain. The variation of balancing cost with solar multiple (SM) and number of storage hours (Nh) is analysed and results for two different optimisation cases presented. The first uses day-ahead forecasts for both solar availability and market prices. The second uses day-ahead solar availability and within-day market price forecasts. Both cases are settled in the balancing market. Key results include that the balancing cost decreases with increased SM and Nh and that balancing costs can be 2.2% to 9.5% of the plants gross income. For all SM and Nh, balancing costs are a function of season, being lower in summer than winter driven by increased load-factor in summer. During the year Quarter 3 has a lower balancing cost than Quarter 2 due to a closer match between forecast and actual solar availability. Optimising against within-day prices costs more than with day-ahead prices resulting from more balancing energy traded at a less favourable price than day-ahead. It is envisaged that the numbers presented in this study will provide an aid to policy makers when constructing tariffs to support future CSP development.
In the 70 years since E. Franklin Frazier published The Negro Family in the United States (1948), black communities have witnessed the arrival of black immigrants in unprecedented numbers. Literature ...on this population suggests that, although African American, African, and Afro-Caribbean families are similarly marginalized by the resuscitation of antiblack practices, they fail to locate refuge in one another. Racial stereotypes work internally to distort and degrade their perception of the “other.” African Americans doubt the authenticity of the foreign-born families that move into their neighborhoods or purchase local businesses, while black immigrants conceive of native-born parents as unmotivated and their children as self-destructive.
Diabet. Med. 28, 994–1000 (2011)
Aims To explore the experiences of young people and their carers during the transition from child to adult diabetes services.
Methods Longitudinal qualitative case ...studies of young people and carers undergoing transition in five different diabetes services in the UK.
Results When young people make the transition from child to adult diabetes services, it is assumed that they will also undergo a parallel transition away from dependence on parents to independent diabetes management. However, the lives of young people are characterized by interdependencies, which are facilitative of their diabetes management and which are not always reflected in healthcare policy and practice. This can lead to discontinuities of information and undermine mothers’ ability to continue to support their child into young adulthood. Mothers also lose contact with the service at a time when they are undergoing developmental challenges of their own and need support in adjusting to a new existence.
Conclusions There is a clear need to develop service structures that recognize the continuing role played by mothers in the diabetes care of young adults.
Group work forms the foundation for much of student learning within higher education, and has many educational, social and professional benefits. This study aimed to explore the determinants of ...success or failure for undergraduate student teams and to define a ‘good group’ through considering three aspects of group success: the task, the individuals, and the team. We employed a mixed methodology, combining demographic data with qualitative observations and task and peer evaluation scores. We determined associations between group dynamic and behaviour, demographic composition, member personalities and attitudes towards one another, and task success. We also employed a cluster analysis to create a model outlining the attributes of a good small group learning team in veterinary education. This model highlights that student groups differ in measures of their effectiveness as teams, independent of their task performance. On the basis of this, we suggest that groups who achieve high marks in tasks cannot be assumed to have acquired team working skills, and therefore if these are important as a learning outcome, they must be assessed directly alongside the task output.
The present study examined the cognitive performance and ratings of subjective fatigue in people with advanced MS and matched healthy control participants. A continuous n-back task, involving ...attention (0-back), was performed at the beginning and end of one testing session; a task involving working memory (1-back) was performed at the beginning and end of another testing session. Subjective fatigue was rated at regular intervals during each session. Overall, there was limited evidence of objective cognitive fatigue in the MS group, as assessed by the change in n-back performance during the sessions. The MS group did report a greater increase, than the control group, in the level of subjective fatigue during the 1-back testing session, but change in subjective fatigue did not correlate significantly with change in cognitive performance. The implications of these findings for our understanding of cognitive fatigue in MS are discussed.
ABSTRACT
Aims Alcoholism is associated with cognitive deficits, which have been interpreted in terms of a specific vulnerability of the frontal lobes to the toxic effects of alcohol. While executive ...functions in alcoholism have been investigated extensively, only little work has been carried out on social cognition. The aim of the present study was to investigate the association between executive functions, theory of mind and humour processing in alcoholism.
Design, setting, participants and measurements A comprehensive neuropsychological test battery was administered to 29 alcoholic patients (Alc) and 29 healthy controls (HC). The test battery included measurements of affect, general intellectual abilities, executive functions, humour processing and theory of mind. The two groups were comparable with respect to affective variables, IQ, gender and age.
Findings and conclusions Group comparisons revealed cognitive as well as affective humour processing deficits of alcoholics in comparison with HC. The observed impairments were related to theory of mind and executive functions. The deficits may contribute to interpersonal problems and are thus of relevance to rehabilitation.
Major depression is associated with cognitive deficits including memory, executive functions, and affect perception, which have been linked to dysfunction of fronto-subcortical networks. However, ...little is known about social cognition on more complex socially relevant tasks, such as humor processing. In this investigation a computerized humor-processing task was administered to 27 patients with a diagnosis of major depression (Dep) and 27 healthy controls (HC). Theory of mind (mentalizing) and executive functions were also assessed. Both groups were similar in IQ, age, and gender. Depressed patients performed below the control group with respect to both affective and cognitive aspects of humor processing, and these were related to mentalizing and executive performance. Our findings suggest social cognition deficits in major depression. Ability to process humor and appreciate mentalistic perspectives may in turn influence social interactions and should be given consideration in therapeutic approaches to depression.
Aims
A diagnosis of Type 1 diabetes in childhood can be a difficult life event for children and families. For children who are not severely ill, initial home rather than hospital‐based care at ...diagnosis is an option although there is little research on which is preferable. Practice varies widely, with long hospital stays in some countries and predominantly home‐based care in others. This article reports on the comparative acceptability and experience of children with Type 1 diabetes and their parents taking part in the DECIDE study evaluating outcomes of home or hospital‐based treatment from diagnosis in the UK.
Methods
Semi‐structured interviews with 11 (pairs of) parents and seven children were conducted between 15 and 20 months post diagnosis. Interviewees were asked about adaptation to, management and impact of the diabetes diagnosis, and their experience of initial post‐diagnosis treatment.
Results
There were no differences between trial arms in adaptation to, management of or impact of diabetes. Most interviewees wanted to be randomized to the ‘home’ arm initially but expressed a retrospective preference for whichever trial arm they had been in, and cited benefits relating to learning about diabetes management.
Conclusions
The setting for early treatment did not appear to have a differential impact on families in the long term. However, the data presented here describe different experiences of early treatment settings from the perspective of children and their families, and factors that influenced how families felt initially about treatment setting. Further research could investigate the short‐term benefits of both settings.
What's new?
Home or hospital treatment settings for children newly diagnosed with diabetes vary widely but little is known about the impact of early treatment settings on children and their families.
Treatment setting was found to have no long‐term impact on adaptation to, management of or impact of diabetes on children and their families.
Families tended to express a preference for home treatment when offered an option at diagnosis.
Retrospectively, families tended to prefer whichever treatment setting, home or hospital, they experienced and identified benefits in terms of learning about diabetes.
Diabet. Med. 28, 1103–1108 (2011)
Aims The aims of this study were to describe users’ experience of paediatric diabetes services to inform development of an intervention to improve communication ...between staff and patients in secondary care within a wider study (the DEPICTED Study).
Methods Methods adapted for paediatric settings were used to set up six audio‐recorded focus discussion groups with a total of 32 participants. Transcriptions and notes were coded thematically (supported by NVivo software) and analytic themes developed with discussion between researchers.
Results Three main themes developed: the lack of two‐way conversation about glycaemic control in clinic settings; the restricting experience of living with diabetes; and the difficult interactions around diabetes the children had with their schools. Doctors in particular were seen as struggling to link these themes of everyday life in their consultations with children and their parents. Children felt marginalized in clinics, despite active involvement in their own blood glucose management at home.
Conclusions Health professionals need to balance a requirement for good glycaemic control with realism and appreciation of their patients’ efforts. There is a need for a systematic approach to consulting, in particular using agenda setting to ensure that the issues of both the patient and the professional are addressed. A framework for a conceptual approach is discussed. How a patient is involved is as important as what is communicated during a consultation.
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