A longitudinal investigation of cognitive function in children and adolescents with type 1 diabetes mellitus.

OBJECTIVE: Cross-sectional studies find altered cognition in youth with type 1 diabetes mellitus (T1DM). However, few longitudinal studies have examined the trajectories of their cognitive performance over time. The aims of this study were to explore longitudinal change in cognitive function in youth with T1DM as compared with nondiabetic sibling controls, and how glycemic control and age of onset influence cognitive performance over time. METHODS: We assessed crystallized intelligence, visual-spatial ability, delayed memory, and processing speed at 3 time points using the same cognitive tasks in youth with T1DM and sibling controls. Hierarchical linear modeling examined relationships between diabetes, hyperglycemia (HbA1c values), age of onset, and cognition over 5.5 y. RESULTS: Youth with diabetes performed worse than controls on visual-spatial ability and memory tasks over time, and did not improve as much in processing speed. Greater hyperglycemia was associated with lower crystallized intelligence and slower processing speed but better memory across all time points. There was a stronger negative relationship between hyperglycemia and visual-spatial ability for youth with earlier compared with later onset diabetes. Importantly, within-person decreases in hyperglycemia between time points were associated with improved visual-spatial ability and faster processing speed. CONCLUSIONS: On average, differences in cognitive function between youth with T1DM and nondiabetic relatives are maintained or increase during childhood and adolescence. Hyperglycemia and age of onset can have negative effects on the developmental trajectories of cognitive processes in youth with T1DM. However, treatments that lower hyperglycemia may lead to improved cognitive function in youth with T1DM.

The effects of power, leadership and psychological safety on resident event reporting.

CONTEXT: Although the reporting of adverse events is a necessary first step in identifying and addressing lapses in patient safety, such events are under-reported, especially by frontline providers such as resident physicians. OBJECTIVES: This study describes and tests relationships between power distance and leader inclusiveness on psychological safety and the willingness of residents to report adverse events. METHODS: A total of 106 resident physicians from the departments of neurosurgery, orthopaedic surgery, emergency medicine, otolaryngology, neurology, obstetrics and gynaecology, paediatrics and general surgery in a mid-Atlantic teaching hospital were asked to complete a survey on psychological safety, perceived power distance, leader inclusiveness and intention to report adverse events. RESULTS: Perceived power distance (ß = -0.26, standard error [SE] 0.06, 95% confidence interval [CI] -0.37 to 0.15; p < 0.001) and leader inclusiveness (ß = 0.51; SE 0.07, 95% CI 0.38-0.65; p < 0.001) both significantly predicted psychological safety, which, in turn, significantly predicted intention to report adverse events (ß = 0.34; SE 0.08, 95% CI 0.18-0.49; p < 0.001). Psychological safety significantly mediated the direct relationship between power distance and intention to report adverse events (indirect effect: -0.09; SE 0.02, 95% CI -0.13 to 0.04; p < 0.001). Psychological safety also significantly mediated the direct relationship between leader inclusiveness and intention to report adverse events (indirect effect: 0.17; SE 0.02, 95% CI 0.08-0.27; p = 0.001). CONCLUSIONS: Psychological safety was found to be a predictor of intention to report adverse events. Perceived power distance and leader inclusiveness both influenced the reporting of adverse events through the concept of psychological safety. Because adverse event reporting is shaped by relationships and culture external to the individual, it should be viewed as an organisational as much as a personal function. Supervisors and other leaders in health care should ensure that policies, procedures and leadership practices build psychological safety and minimise power distance between low- and high-status members in order to support greater reporting of adverse events.

Differential Reactivity and the Within-person Job Stressor-Satisfaction Relationship.

An experience sampling methodology was used to study the direct and conditional within-person relationship between job stressors and job satisfaction. One hundred and one full-time administrative staff completed momentary measures of job stressors and job satisfaction three times a day on six different workdays over a 3-week period (N = 1818 observations). Multilevel random coefficients models were specified, and the results suggest that within-person stressors are negatively related to within-person job satisfaction. These results stand when controlling for the effects of time, demographics, work characteristics, baseline levels of job stressors and satisfaction, and between-person effects of job stressors. Furthermore, consistent with the differential reactivity model, the results suggest that the observed within-person stressors-satisfaction relationship is conditional upon locus of control and positive affect. Copyright © 2015 John Wiley & Sons, Ltd.

Teams in organizations: from input-process-output models to IMOI models.

This review examines research and theory relevant to work groups and teams typically embedded in organizations and existing over time, although many studies reviewed were conducted in other settings, including the laboratory. Research was organized around a two-dimensional system based on time and the nature of explanatory mechanisms that mediated between team inputs and outcomes. These mechanisms were affective, behavioral, cognitive, or some combination of the three. Recent theoretical and methodological work is discussed that has advanced our understanding of teams as complex, multilevel systems that function over time, tasks, and contexts. The state of both the empirical and theoretical work is compared as to its impact on present knowledge and future directions.