Using a predictive model of clinician intention to improve continuing health professional education on cancer survivorship.

INTRODUCTION: Cancer survivorship is a chronic disease that places patients in limbo between oncologists and primary care clinicians. Strategies have been proposed to ease the shift in coordination of care, including broad-based educational outreach to primary care providers. METHODS: Guided by the theory of planned behavior (TPB), predictors of intention to provide survivorship care, including credentials, experience, perception of barriers, and personal survivorship status, were evaluated using logistic regression with a cohort of physicians, nurse practitioners, and registered nurses participating in an unprecedented online continuing medical education/continuing education survivorship care course. RESULTS: Results showed that physicians were significantly less likely to express intent to provide survivorship care (odds ratio [OR] = .237, p = .0001) compared to the other groups. Overall, clinicians with 6-10 years of experience were 3 times more likely to express intent to provide survivorship care (OR = 2.86, p = .045) than those with less or more experience. When clinicians perceived the presence of a barrier, they were nearly twice as likely to have diminished intent (OR = 1.89, p = .035). Most participants (66%; n = 1185) selected two barriers: lack of survivorship care plans and treatment summaries (45.4%; n = 821) and lack of education (20.1%; n = 364). DISCUSSION: Barriers to the delivery of survivorship care can influence clinicians' intention to provide survivorship care, which varied by years of experience in this study. Interdisciplinary educational strategies featuring midcareer provider champions who have successfully incorporated survivorship care and can offer specific solutions to these barriers are recommended for future interventions.

Working memory capacity accounts for the ability to switch between object-based and location-based allocation of visual attention.

Bleckley, Durso, Crutchfield, Engle, and Khanna (Psychonomic Bulletin & Review, 10, 884-889, 2003) found that visual attention allocation differed between groups high or low in working memory capacity (WMC). High-span, but not low-span, subjects showed an invalid-cue cost during a letter localization task in which the letter appeared closer to fixation than the cue, but not when the letter appeared farther from fixation than the cue. This suggests that low-spans allocated attention as a spotlight, whereas high-spans allocated their attention to objects. In this study, we tested whether utilizing object-based visual attention is a resource-limited process that is difficult for low-span individuals. In the first experiment, we tested the uses of object versus location-based attention with high and low-span subjects, with half of the subjects completing a demanding secondary load task. Under load, high-spans were no longer able to use object-based visual attention. A second experiment supported the hypothesis that these differences in allocation were due to high-spans using object-based allocation, whereas low-spans used location-based allocation.

Comorbidity between depression and disordered eating in adolescents.

Depression is one of the most common mental health disorders seen in adolescence. Low self-esteem, lack of social support and poor body image have been found to be risk factors for depression. However, these risk factors have not adequately explained why adolescent female rates of depressive episodes rise to almost twice that of males. This study had three purposes. The first is to identify the prevalence and comorbidity of depressive and disordered eating symptoms in a sample of high school students. The second is to examine predictors of depressive and disordered eating symptoms. Finally, a model predicting depressive symptoms is examined. Significant depressive and disordered eating symptomatology and a high level of comorbidity were observed in this sample. Predictors of depressive and disordered eating symptoms were similar for both genders. Finally, a model predicting depressive symptoms, via body image factors, was found to be supported in both boys and girls. The results of this study suggest that males and females are more similar than different, regarding predictors of depressive symptoms and disordered eating symptoms.

Does situation awareness add to the validity of cognitive tests?

OBJECTIVE: Does adding situation awareness (SA) to a battery of cognitive tests improve prediction? BACKGROUND: Identifying variables that predict skilled performance in a complex task aids in understanding the nature of skill and also aids in the selection of operators to perform that task. SA is thought to be an important predictor of performance. SA is often thought to be based on underlying cognitive mechanisms. METHOD: Three performance measures taken from the Federal Aviation Administration's (FAA's) Air Traffic Scenarios Test, the low-fidelity simulation component of the FAA's controller selection battery, were used as criterion variables in a hierarchical regression. After predicting performance based on a battery of cognitive (e.g., intelligence, working memory, spatial memory) and noncognitive tests (e.g., cognitive style, personality, demographics), we added measures of SA. RESULTS: SA did provide increases in prediction, but only when measured with the Situation Present Assessment Method, an on-line query method. When the same questions were asked off line, SA did not enter the model in two cases and improved prediction by only 2% in the third. CONCLUSION: Thus, some measures of SA do show incremental validity, even against a backdrop of a large number of cognitive variables. APPLICATION: On-line measures of SA can be a worthwhile addition to standard batteries of tests used to predict performance in cognitively oriented industrial tasks.

Perfectionism, low self-esteem, and family factors as predictors of bulimic behavior.

A previous study found that self-reported body dissatisfaction, depression, and peer pressure to maintain a thin body shape were significant predictors of bulimic behavior in college women, but that family functioning was not a significant predictor [Eat. Behav. 2 (2001) 323]. The current study examined whether perfectionism, low self-esteem, and a more specific family variable--perceived pressure from the family to be thin--predicted any additional variance in eating-disordered behavior after significant variables from the previous study had been taken into account. As in the previous study, self-reported body dissatisfaction, depression, and peer pressure to maintain a thin body shape were significant predictors of bulimic behavior. Perceived weight-related pressure from the family was also a significant predictor. In contrast, high parental expectations were found to predict lower levels of bulimic behavior and to moderate the effects of peer influence on bulimic behavior. The variables found in this study to be related to bulimic behavior may be useful targets for clinical intervention for women with disturbed eating patterns.

Individual differences in working memory capacity predict visual attention allocation.

To the extent that individual differences in working memory capacity (WMC) reflect differences in attention (Baddeley, 1993; Engle, Kane, & Tuholski, 1999), differences in WMC should predict performance on visual attention tasks. Individuals who scored in the upper and lower quartiles on the OSPAN working memory test performed a modification of Egly and Homa's (1984) selective attention task. In this task, the participants identified a central letter and localized a displaced letter flashed somewhere on one of three concentric rings. When the displaced letter occurred closer to fixation than the cue implied, high-WMC, but not low-WMC, individuals showed a cost in the letter localization task. This suggests that low-WMC participants allocated attention as a spotlight, whereas those with high WMC showed flexible allocation.