<p>Background: Type 2 diabetes is a complex chronic condition. To achieve positive outcomes patients must have an understanding of diabetes and self-efficacy to carry out self-management. Studies have shown that diabetes self-management education interventions positively affect physical and mental health outcomes, thereby improving the patient?s diabetes self-management. Purpose: The purpose of this article was to determine if four diabetes self-management programs (DSMP) on the Island of Hawaii are providing competent care based on national standards of curriculum components, addressing mental health concerns affecting diabetes self-management, and providing culturally adapted care. Methods: This study was carried out in three stages: 1) selecting programs for analysis; 2) comparing evaluated programs based on American Association of Diabetes Educators Self-care behaviors through the review of program manuals and supplemental materials; and 3) interviewing program directors. Results: A review of community-based, self-management programs on Hawaii Island reveals that they provide competent care based on national Diabetes Self-Management Education standards. The reviewed programs appear to be successful and include culturally adapted education. However, assessments for mental health are not currently being used to assess a patient?s need for treatment of common mental health problems such as depression. Conclusion: The current evidence of a connection between diabetes and depression indicates that DSMPs should assess for depression and provide effective treatment, especially for ethnic groups that have a high prevalence of diabetes and diabetes-related hospitalizations. More research is needed to determine how programs could better address culture and mental health concerns related to diabetes self-management education.

<p> Patients diagnosed with cancer often require interventions for the accompanying mental health distress of their diagnosis; patients&rsquo; mental distress can lead to hopelessness and noncompliance. Improvements for assessment and interventions are needed. This project provides recommendations for improving oncological nursing knowledge by implementing competencies for nurses through educational modules, focusing on nursing approach, confidence, and interventions necessary for understanding methods of treatment and the measurement of distress in oncology and oncological treatment. Using established standards and competencies will improve knowledge and skill in inpatient settings. Current established nursing standards from the American Nursing Association, Institute Of Medicine/National Comprehensive Cancer Network, C-Change, and Public Mental Health Essentials were explored in order to identify gaps and create a list of recommended competencies for oncology nursing. Six associated adaptable educational modules were developed based on the adult education framework of Knowles, and participant training entailed proper use and comprehension of the Distress Thermometer for measurement of distress. The C-Change observation displayed participant (<i>n</i> = 102) results of approximately 119% improvement, which was observed in knowledge, communication, and confidence. Participants used the resources to reduce distress levels by initiating the selected established interventions for management, all of which was made evident in patient self-reported outcomes, using resources from published, established, standardized competencies. Having such training will allow for improved care for patients with cancer, thus having an influence on positive social change. </p>

<p> This research explored the topic of team building for a multicultural team and investigated the impact on group cohesion. The participants were members of a work group, each of a different nationality. Review of existing literature revealed a list of team building elements most suited for the multicultural context. A team building program incorporating those elements and customized for the participant group was designed and implemented. Pre and post survey data showed no significant difference in group cohesion, although there was a slight increase in the score for task cohesion. Qualitative interview data, however, suggested a positive impact on group cohesion, with the impact perceived to be greater on task cohesion than social cohesion. Elements of the team building program that were found to be the most impactful were: it provided an opportunity to generate a deeper awareness of others, it provided an opportunity to generate deeper self-awareness, it provided a platform for team collaboration, and it contained fun and interesting activities.</p>

<p> As a disengaged and underutilized community resource, young people have the potential to develop leadership skills and express themselves in community action. For this study, the researcher interviewed 13 young adults from rural areas of Alabama. These 18- to 20-year-olds had taken part in community leadership skills programs during their high school years. In this qualitative investigation, the researcher used a multiple case study model that included in depth, one on one interviews and personal observations. Analysis of the data revealed three themes for civic engagement: (a) the participants expressed their ideas and feelings, orally and in their writings; (b) they discussed their leadership skills; and (c) they applied their leadership skills. These results further suggested to the researcher that motivation, confidence, self esteem, and relationship building skills were reinforced by the leadership skills programs, and those factors were applied within the participants' communities. Based on the evidence derived from this study, the ideas and leadership skills of young people have value and strength, especially for rural communities.</p>

<p> Previous research indicates that ecstasy use is positively associated with higher levels of impulsivity and risky sexual behaviors. In addition, methamphetamine use, which is chemically related to ecstasy, has been associated with higher levels of adult Attention Deficit Hyperactivity Disorder (ADHD) symptoms. This study adds to the existing literature by investigating the relationship between adult ADHD symptoms, impulsivity, ecstasy use, and unprotected anal sex. Participants were recruited from the Center for Behavioral Research and Services in Long Beach, California. Adult ADHD symptoms were associated with unprotected anal sex among women, but not for men. Furthermore, ecstasy use was found to be associated with unprotected anal sex among men who have sex with men (MSM) but not for women or men who have sex with women (MSW). In addition, higher levels of impulsivity were associated with both ecstasy use and unprotected anal sex among women, MSM, and MSW.</p>

<p>This thesis uses a heuristic research methodology to investigate the patterns of cognition and emotion that are present when one practices self-discipline. A sample of several studies on the subject are presented, compared, and analyzed via a personal experience. The theories presented include ego depletion theory, self-determination theory, organismic integration theory, cognitive evaluation theory, self-control failure, goal setting, and goal visualization. The analysis herein suggests the clinical and counseling applications of incorporating self-discipline techniques into psychotherapy. </p>

<p>Quality of life is an important aspect of the assessment of medical and psychiatric disorders, such as eating disorders. Eating disorders affect both the emotional and physical wellbeing of individuals who suffer from them and presumably impact quality of life. The purpose of this study was to assess the quality of life of individuals seeking inpatient treatment for an eating disorder using the Quality of Life Inventory. This assessment is unique because it considers both the importance and satisfaction of life domains and it is also very comprehensive, assessing 16 life domains both quantitatively and qualitatively. This is the first study to report on the use of the Quality of Life Inventory in an eating disorder sample. It was hypothesized that patients with eating disorders would have significantly worse quality of life than non-clinical groups and similar quality of life compared to other clinically impaired groups. This hypothesis was confirmed. It was also predicted that individuals with anorexia and bulimia nervosa would have statistically equivalent quality of life global scores but differences on domain scores, and this was confirmed as well. Finally, it was hypothesized that treatment history, number of co-morbid disorders, body mass index, and eating disorder symptoms would be related to quality of life, which was not supported. These results contribute to the literature about quality of life of individuals with eating disorders by supporting existing findings based on other quality of life measures and add information about life domains not previously assessed by other measures.

<p> Diabetes is linked to behavior and requires patients to engage in complex self-management practices to attain glycemic control and prevent complications. Group medical visits (GMVs)&mdash;which are shared medical appointments used in primary care&mdash;provide a model of care to help patients adhere to self-management behaviors. Developing, implementing, and translating this model of care in a clinical setting has proven challenging, and the underlying mechanisms related to improved outcomes found in participants of GMVs are undetermined. The purpose of this study was to implement and evaluate GMVs for diabetes care in a primary-care and residency-training facility and explore changes in behavioral intentions, self-management behaviors, and blood HbA_1c levels. The study also explored whether behavioral intentions and self-management behaviors functioned as mediators of changes in HbA_1C levels. </p><p> A repeated measures design with 37 participants examined the behavioral intentions to diet, to exercise, and to adhere to medication; self-management behaviors (i.e., diet, exercise, and adherence to medication); and HbA_1C levels of participants with Type 2 diabetes during and after the GMVs. Behavioral intentions and self-management behaviors were measured through self-report instruments at baseline, posttreatment, and 3-month follow-up; HbA_1C values were measured at baseline and 3-month follow-up. Self-reported adherence to diet changed significantly from baseline to posttreatment and remained at 3-month follow-up. </p><p> Self-reported exercise changed significantly from baseline to posttreatment; changes were not sustained at 3-month follow-up. Clinical and statically significant changes in HbA_1C levels were seen at 3-month follow-up. A reduction of 0.7% in blood glucose levels was observed; the majority of the participants (59.5%) attained diabetes control at 3-month follow-up. No mediation relationship was found between behavioral intentions, self-management behaviors, and HbA_1C levels. </p><p> This study is the first reported examination of GMVs that found significance in biophysical outcomes without research-based funding. GMVs focused on health-behavior change can be executed and sustained in primary care and residency-training facilities. This program modality is a promising model of care for motivated patients and may help patients reach self-care goals and diabetes control. Future research with a larger sample size and a control group is needed to enhance the current findings.</p>

<p> This study explored the relationships among master's level counseling trainees' level of training, ability emotional intelligence (EI), and psychophysiological correlates of emotion regulation recorded during a video-simulated client interaction. Agreement exists among counselor educators, researchers, and theorists that counselors' emotion regulation is foundational to the competent delivery of counseling treatment. The literature further suggests that counselors and trainees experience frequent emotional challenges that overwhelm emotion regulation skills, interfere with competent delivery of service, and affect client outcomes. However, little research in counseling training and supervision has investigated trainees' emotion regulation or factors that support adaptive emotion regulation while trainees interact with clients who are experiencing emotional distress. </p><p> Participants were 66 master's level counseling trainees from counseling programs accredited by the Counsel for Accreditation of Counseling and Related Educational Programs. Participants' EI was operationalized as scores on the Mayer, Salovey, and Caruso Emotional Intelligence Test (Mayer, Salovey, Caruso, &amp; Sitarenios, 2003). Emotion regulation was operationalized as electrodermal activity (EDA), high-frequency heart rate variability, and the standard deviation of normal heartbeat intervals (HRV-SDNN). Correlation and regression analyses indicated that psychophysiological correlates of trainees' emotion regulation were not significantly correlated with training. However, HRV-SDNN significantly correlated with total EI, and the EI subscale Perceiving Emotions, while EDA significantly correlated with the Managing Emotions subscale.</p>

<p> The purpose of the current study was to assess a model of college completion at a 2-year community college based on Tinto's Theory of Student Drop Out and current factors known to impact college completion. A freshman cohort (<i>n</i> = 2,846) that attended a large-urban community college was assessed. Logistic regression analysis found student age and math proficiency when entering college were significant factors in the model. The older the student was when first enrolling, the lower their likelihood of completing college. The more remediation a student needed in math skills, then the less likely she or he was in completing college. Placement into developmental (remedial) English writing courses did not seem to suppress completion, and was a non-significant finding in the model. Reading proficiency and participation in a student success course (first-year seminar) were not significant factors in the model, though estimated coefficients aligned with research literature.</p>