How does Sexual Orientation Affect Perceptions of Single People?
- Past research has found that single people are perceived more negatively than coupled people. However, in past research, the target’s sexual orientation was not explicitly mentioned. The current experiment manipulated the sexual orientation of targets and also measured the sexual orientation of participants to test whether the relatively negative perceptions of single people are held about people and believed by people regardless of their sexual orientation. Three hundred ninety heterosexual and 226 gay and lesbian participants from Israel and the United States read descriptions of target people. Targets were described as heterosexual, gay, or lesbian; single or in a long-term relationship; and men or women. Although single people were consistently perceived more negatively than coupled people, F(1, 600) = 130.78, p < .001, η2 = .18, participants perceived the differences between coupled and single targets as being largest when they rated targets of the same sexual orientation as themselves, F(1, 600) = 10.38, p =.001, η2 = 0.02. Furthermore, regardless of their own sexual orientation, participants who expressed a stronger desire for a long-term romantic relationship held more negative views of single people compared to coupled people, r = .10, p < .01.
ELUSIVE MIGRATION SYSTEMS. LESSONS FROM EUROPE’S NEW MIGRATORY MAP
- Europe is facing a new era of migration. During the last decades, the European migration system underwent several shifts due to different reasons. A basic observation is that general changes, on the political map for example, do not necessarily have the same consequences in European regions, even in seemingly similar contexts. The major changes started in 1990 accelerated with the enlargement of the European Union in 2004 and found its continuation by crisis-driven migration from south European countries into Western European labour markets after 2008. All of these "migration waves" have been topped by a massive inflow of refugees in 2015 creating new migratory map of Europe.
Thus, important stages of contemporary and present European migration history are interpreted as indicators for a surplus in diversity, flexibility and spontaneity and will serve for formulating the hypothesis of Elusive Migration Systems as an analytical framework and a kind of hypothesis to study new features of migrants’ trajectories, which became more and more variable.. Being grounded may be the wish of the majority of Europeans and, in effect, the global population, but being on the move, voluntarily or forced, is reality for a certain number of migrants inside and heading towards Europe.
Treatment of subclinical depression with a CBT program (DIAMOS): Results of a prospective randomized, controlled study
- Depression without meeting the criteria of a major depression. However,
elevated depressive symptoms are associated with a reduced quality of
life, lower self-care activities, and a higher mortality. To target this large
group of people, a diabetes-specific treatment program (DIAMOS) was
developed and evaluated in a randomized controlled trial with a 12-month
DIAMOS is a group program based on cognitive-behavioral-therapy
(CBT). It consists of 5 group sessions which lasts for 90 minutes each. 214
inpatients with subclinical depression were randomized either to DIAMOS
or to a control group receiving diabetes education. Depression, diabetesrelated
distress, and quality of life were assessed via questionnaires (CES-D,
PAID, WHO-5 respectively). HbA1c was analyzed in a central laboratory.
181 patients (age: 45±14 yrs.; 57% female; 63% Type 1 DM; diabetes
duration 15±11 yrs.; 95% with insulin; 51% with late complications; HbA1c
8.8±1.7%; CES-D 23.3±8.1; PAID 39.5±18.4; WHO-5 8.9±4.5) were available
at the 12-month follow-up (drop-out rate: 15%). Compared to the control
group, patients treated with DIAMOS showed a significantly greater reduction of depressive symptoms (- 7.4 ± 11.4 vs. - 2.7 ± 11.7; p < .01), and
diabetes-related distress (- 13.0 ± 18.9 vs. - 4.2 ± 16.9; p < .01), as well as a
significantly greater improvement of quality of life (+ 4.5 ± 6.1 vs. + 2.5 ± 6.3;
p = .03). HbA1c improvement was comparable in both groups.
The results demonstrate that DIAMOS is an effective tool for the
treatment of subclinical depression in people with diabetes. In addition,
DIAMOS positively affects diabetes-related distress and quality of life.
Interestingly, the reduction of depressive symptoms and distress was not
associated with an improvement of glycemic control. DIAMOS proofs to be
an innovative tool for routine care to improve the situation of people with
diabetes and subclinical depression.
The effect of a diabetes-specific cognitive behavioural treatment programme (DIAMOS) for people with diabetes and subthreshold depression
- Background and aims: Subthreshold depression is one of the most frequent
mental comorbidities in people with diabetes and is associated with a poorer
long-term prognosis. Since specific intervention concepts are missing a new
self-management oriented group programme (DIAMOS) was developed for
this patient group and evaluated in a randomised trial.
Materials and methods: The active control group (CG) received diabetes education.
DIAMOS consisted of cognitive behavioural interventions aiming at
the reduction of diabetes distress. Patients completed several questionnaires
at baseline and follow-up: The Center of Epidemiological Studies-Depression
Scale (CES-D), the Patient Health Questionnaire (PHQ 9), the Problem Areas
in Diabetes Questionnaire (PAID) and the Diabetes Distress Scale (DDS).
Primary outcome was the reduction of depressive symptoms. Secondary outcomes
were diabetes distress, well-being, self-care behaviour, diabetes acceptance,
diabetes treatment satisfaction, HbA1c and inflammatory markers. 214
participants were randomised.
Results: Baseline characteristics (age 43.3 ±13.3 yrs., female gender 56.5%,
diabetes duration 14.2 ±10.5 yrs., type 2 diabetes 34.1%, BMI 28.7 ±71 kg/m²)
were comparable between both interventions groups except BMI and diabetes
type. At 12-month follow-up there was a significant greater reduction
of the CESD- and PHQ 9-scores in DIAMOS compared to the CG (Δ -3.7,
95%-CI 0.57 to 6.85 p=.021 respectively Δ -1.49, 95%-CI 0.08 to 2.90; p=.039
). The risk of incident major depression was reduced (OR 0.63, 95%-CI 0.42
to 0.96, p=.028) Also PAID-scores (Δ -8.3 95%-CI 3.33 to 12.72, p=.001) and
DDS-scores (Δ -0.22 95%-CI 0.02 to 0.42, p=.042) were significantly reduced.
C-reactive protein was significantly more lowered (Δ -0.25 95%-CI 0.02 to
0.48 p=.035). No effect of the intervention was observed in other inflammatory
markers (IL1RA, IL6 and adiponectin).
Conclusion: DIAMOS is more effective in lowering depressive symptoms
and diabetes related distress in diabetic patients with subthreshold depression.
DIAMOS also has a preventive effect regarding the incidence of major
The Diabetes Self-Management Questionnaire (DSMQ) can detect inadequate self-care behaviour and help identify patients at risk of a negative diabetes prognosis
- Background and aims: Existing psychometric instruments to assess diabetes
self-management often reveal weak or inconsistent associations with ‚hard
data‘ such as medical outcomes and HbA1c. To fill this gap, the Diabetes SelfManagement
Questionnaire (DSMQ) was developed, focussing on self-care
activities which directly impact medical diabetes outcomes. This study evaluates
the questionnaire’s practical utility in detecting high-risk patients at a
tertiary diabetes centre.
Materials and methods: 226 people with diabetes (age 43 ± 15 y.; 55% female;
BMI 29 ± 7; 70% type 1 diabetes; illness duration 15 ± 10 y.; 92% treated
with insulin; HbA1c 8.9 ± 1.6%) were assessed with the DSMQ and further
questionnaires regarding diabetes acceptance (AADQ), coping with illness
(FQCI), treatment satisfaction (DTSQ), diabetes distress (PAID), and depressive
symptoms (CES-D); additional data (demographic variables, self-monitoring
of blood glucose, HbA1c, and long-term complications) were gained
from electronic patient records. People were then categorized by a median
split of the DSMQ total score into groups performing ‘adequate’ (n = 107)
versus ‘inadequate’ diabetes self-care (n = 119); the groups were compared
regarding relevant outcomes using multivariate ANOVA (subsequently presented
data are M ± SD, F statistic, and effect size Cohen’s d).
Results: After adjusting for sex, age, BMI, diabetes type, diabetes duration,
and type of treatment, people performing ‘inadequate self-care’ compared to
those with ‘adequate self-care’ showed stronger diabetes non-acceptance (31
± 8 vs. 22 ± 6, F = 90.5, d = 1.24), less active coping with diabetes (2.7 ± 0.9
vs. 3.4 ± 0.8, F = 18.1, d = 0.82), lower diabetes treatment satisfaction (20 ± 7
vs. 24 ± 6, F = 21.3, d = 0.60), higher diabetes distress (43 ± 21 vs. 33 ± 19, F
= 17.0, d = 0.85), and more depressive symptoms (24 ± 11 vs. 20 ± 11, F = 4.8,
d = 0.36). Moreover, they performed fewer blood glucose self-tests (3.3 ± 3.5
vs. 5.6 ± 2.4 times per day, F = 24.7, d = 0.74), consulted their diabetologist
less often (1.9 ± 1.8 vs. 2.6 ± 2.3 times per half-year, F = 6.6, d = 0.34), had a
higher HbA1c value (9.5 ± 1.5 vs. 8.2 ± 1.4%, F = 34.6, d = 0.87), and showed
a higher prevalence of retinopathy (28% vs. 14%, F = 6.0, d = 0.35).
Conclusion: The DSMQ yields excellent distinction between people with
diabetes performing adequate versus insufficient diabetes self-care, thus enabling
detection of people at high risk of a negative diabetes prognosis. The
16-item questionnaire is an efficient tool which may be used for screening
and diagnostic purposes or clinical diabetes research.
A new assessment tool to measure the ability of Bolus Calculation and Carbohydrate Estimation (SMART) in people with diabetes performing an intensive insulin therapy
- Background and aims: Intensive insulin therapy relies on correct prandial
insulin dose adaptation dependent from current glucose level, amount of
planned carbohydrate intake and the consideration of other situational factors
like physical activity or circadian fluctuation of insulin sensitivity. People
with diabetes and intensive insulin therapy should be able to estimate carbohydrates
and calculate insulin bolus correctly, while regarding the factors
mentioned above. An assessment tool for the measurement of the ability of
carbohydrate estimation and bolus calculation is missing. The objective of
this study was the development and psychometric evaluation of an assessment
tool for carbohydrate estimation and bolus calculation (“aSsessMent of
the Ability of Bolus Calculation and CaRbohydrate esTimation” SMART). Of
special interest were the associations of both abilities with glycaemic control.
Materials and methods: The SMART consisted of one scale for the assessment
of bolus calculation (BOLUS) with 10 items and a scale for carbohydrate
estimation (CARB) with 12 items. People with type 1 or type 2 diabetes
on an intensive insulin regimen were invited to participate. HbA1c and stored
data of blood glucose meters were used to determine glycaemic control.
Results: 411 patients participated (age 42.9 ±15.7, 58% female, HbA1c 8.6
±1.8%, 28% with CSII-treatment) and approx. 56,000 blood glucose meter
readings could be obtained. The reliability of both scales was sufficient (Cron-bachs alpha for BOLUS r= 0.78 and the CARB r = 0.67). Better bolus calculation
was associated with a higher level of education (r = 0.24, p<.05), lower
HbA1c (r = -0.27, p<.05), lower mean blood glucose (r = -0.29, p<.05), and
a lower standard deviation of blood glucose values (r = -0.43, p<.05). Better
carbohydrate estimation was associated with a lower body mass index (r =
-0.2, p<.05), lower mean blood glucose (r = -0.3, p<.05), a lower frequency of
hyperglycaemia (r = -0.27, p<.05), and a higher frequency of euglycaemia (r
= 0.26, p<.05). Patients with an insulin pump were better on both scales than
patients with multiple daily insulin injections (BOLUS: 7.2 ± 2.4 vs. 6.4 ± 2.7,
p<.01; CARB: 7.8 ± 2.1 vs. 7.1 ± 2.6, p<.01). Patients with previous diabetes
education performed significantly better on both scales (BOLUS: 6.8 ± 2.5 vs.
5.7 ± 2.8, p<.01; CARB: 7.4 ± 2.4 vs. 6.5 ± 2.6, p<.01).
Conclusion: SMART provides a reliable and valid assessment of the ability to
estimate the correct amount of carbohydrates and to calculate the appropriate
prandial insulin dose. SMART is also sensitive to depict effects of diabetes
education and of CSII treatment in comparison to multiple daily insulin
injections. In summary SMART can assist the identification of people with
diabetes on an intensive insulin regimen, who are in need for improvements
in carbohydrate estimation and/or calculation of prandial insulin dose
The Influence of Diabetes-related Distress on Depression
- Depressive disorders in diabetic patients are nearly twice as likely
compared to the non-diabetic population. There is evidence that patients’
perception of diabetes is a decisive aspect of this association. Therefore this
study prospectively investigates the role of patients’ perceived diabetesrelated
distress on incidence depression and recovery.
343 patients with type 1 diabetes completed the CES-D and the Problem
Areas in Diabetes Scale (PAID) at baseline and at the 6-month follow-up. A
CES-D score of ≥16 indicated elevated depressive symptoms. A PAID score
of ≥30 indicated elevated diabetes-related distress. Logistic regression
analyses were performed with recovery from and incidence of depressive
symptoms as dependent variables. Independent variable was diabetesrelated
distress adjusted for possible demographic (age, gender, BMI) and
medical confounders (diabetes duration, HbA1c, insulin pump therapy, and
At baseline 130 patients (37.9%) reported elevated depressive symptoms
and 40 of these patients (30.8%) recovered 6 months later. Of the 213 patients
without elevated depressive symptoms, 27 (12.7%) had elevated depressive
symptoms 6 months later. Diabetes-related distress at baseline diminished
the chance to recover from elevated depressive symptoms by 64% (OR =
0.36, p<.05). In addition, the chance for incident depressive symptoms if
diabetes-related distress was present at baseline is 2.5 times more likely in
contrast to no diabetes-related distress at baseline (OR=2.5; p<.05). In both
analyses, no other variables reached a signifi cant infl uence.
It could be demonstrated that preventing diabetes-related distress is a
protective factor regarding the incidence of elevated depressive symptoms.
Furthermore, preventing diabetes-related distress supports the recovery
from already elevated depressive symptoms. This supports the notion that
diabetes per se is not a risk factor for depressive disorders but the perceived
emotional distress is.
Phonological determinants of grammatical variation in English: Chomsky’s worst possible case
- In this paper it is argued, contra Chomsky (1995), that phonological factors like the prefer-ence for alternating syllable structures (or the avoidance of hiatuses and complex consonant clusters) and the striving for an alternating rhythm (or the avoidance of stress clashes and lapses) have the potential to (co-)determine morphological and syntactic structures wherever these are variable. Empirical support for this claim comes from analyses of corpus data from present-day and earlier forms of English and includes the presence or absence of the Middle English verbal ending -n, the variants of the indefinite article a/an preceding h-initial words, the distribution of the participial forms lit and lighted, and the restrictions bearing on attribu-tive constructions and sentence adverbs negated by not. Building on the tentative assump-tion that alternating patterns are universal tendencies conditioned by neurophysiological facts, an interactive activation model of language processing is sketched out and contrasted with a possible treatment of the variation phenomena in terms of Optimality Theory
Constraints on the attributive use of 'predicative only' adjectives : A reassessment
- This paper focuses on a class of English adjectives that are subject to important restrictions on their syntactic placement. While core members of the adjective class freely occur in predicative and postnominal as well as in attributive positions, the group of a-adjectives has been claimed to be virtually barred from attributive uses (cf. Biber & al. 1999: 508; Huddleston & Pullum 2002: 559). For some members of this group, their etymological origin as prepositional phrases goes some way towards explaining their limitation to predicative and postnominal uses (e.g. afloat, alive, aloof, asleep, awake and many more; cf. Bolinger 1967: 12; Markus 1997: 490). For those adjectives that derive from ancient participles formed with the Old English ge-prefix (e.g. aghast, afraid, ashamed) and for those originating in adjectives prefixed by ge- (e.g. alike, aware), no similar historical explanation is available.
The literature on the so-called ‘predicative-only’ adjectives yields two fundamentally different approaches to explaining their distributional restrictions, one semantic and one phonological. On the semantic side, the temporary, transitory meaning of typical a-adjectives weighs against their occurrence in attributive position, which is more appropriate for characterizing or habitual meanings (cf. Bolinger 1952: 1133-1137; 1967: 3-4; Jacobsson 1996: 218). On the phonological side, their stress contour creates an obstacle to prenominal occurrence: since all disyllabic a-adjectives have final stress, and the majority of English nouns are initially stressed, their juxtaposition in attributive structures leads to a high potential for stress clashes, which in turn gives rise to substantial avoidance effects (cf. Bolinger 1965: 143; Minkova 1990: 327). In the most detailed study of a-adjectives published to date, Jacobsson (1996: 217) comes to the conclusion that the semantic effects outweigh the phonological ones.
It is the aim of the present study to arrive at a detailed reassessment of the positional restrictions bearing on a-adjectives and of the explanatory potential of semantic and phonological factors, respectively. For this purpose, an extensive corpus is used, which consists of 40 years of British newspapers totalling almost one and a half billion words.
On the basis of the corpus data, a-adjectives can be grouped according to their ability to occur in attributive position. The groups that emerge show only a minimal overlap with Jacobsson’s (1996: 218) division. In addition to this descriptive readjustment, a revision of the explanation favoured by Jacobsson suggests itself. It is argued that premodification plays a prominent role in licensing a-adjectives in attributive position since its semantic as well as rhythmic effects contribute to the acceptability of these structures. Contra Jacobsson (1996: 211), for some a-adjectives in particular, the avoidance of stress clashes, secured by premodification, turns out to be a more incontrovertible requirement than the semantic specification.
Early Modern English: Phonology
- In the Early Modern English period, English underwent a number of substantial
changes in all phonological subsystems, which transformed the Middle English
system into a distinctly modern one. The present chapter highlights in turn changes in
lexical stress patterns, the reduction of unstressed syllables, changes in the
distribution of certain consonants and their allophones (in particular /h/, [ç], [x], /r/),
the reduction of consonant clusters (including the emergence of the novel /ʒ/ and /ŋ/
phonemes) and changes in the vowel system. A large part of the chapter is devoted to
the important shifts undergone by the latter category of sounds in the Early Modern
era; yet it excludes the massive turnover known as the Great Vowel Shift (which is
treated in a separate chapter of the present handbook). The vowel changes are, for
expository purposes, subdivided into unconditioned and conditioned changes; the
subsystems of long vowels, diphthongs and short vowels are treated separately. The
chapter describes the most important qualitative changes in long vowels (beyond the
Great Vowel Shift), the monophthongization of many ME diphthongs, the
development of some of the short vowels, and the interfering effect of certain
consonantal environments, partly leading to phonemic splits.