State of the art: understanding and integration of the social context in diabetes care

We review the past 25 years of research addressing challenges people living with diabetes experience in their daily lives related to social contexts, i.e. in their family, at work and in society at large, and identify research gaps. We found that young people with diabetes, as they develop through to adulthood, are exposed to considerable risks to their physical and mental health. Family-system interventions have had mixed outcomes. Research in this area would benefit from attention to ethnic/cultural diversity, and involving fathers and other family members. In adults with diabetes, social support relates to better diabetes outcomes. While family member involvement in care is likely to affect health and psychosocial outcomes of the person with diabetes, key elements and mediators of effective family interventions need to be identified. The challenges of diabetes management at work are under-researched; distress and intentional hyperglycaemia are common. When depression is comorbid with diabetes, there are increased work-related risks, e.g. unemployment, sickness absence and reduced income. Research to support people with diabetes at work should involve colleagues and employers to raise awareness and create supportive environments. Stigma and discrimination have been found to be more common than previously acknowledged, affecting self-care, well-being and access to health services. Guidance on stigma-reducing choice of language has been published recently. Resilience, defined as successful adaptation to adversity such as stigma and discrimination, requires studies relevant to the specific challenges of diabetes, whether at diagnosis or subsequently. The importance of the social context for living well with diabetes is now fully recognized, but understanding of many of the challenges, whether at home or work, is still limited, with much work needed to develop successful interventions.

An explanation for enhanced perceptions of attractiveness after alcohol consumption

Acute alcohol consumption increases ratings of attractiveness to faces. This may help to explain increased frequencies of sexual encounters during periods of alcohol intoxication. At least in part, such increased attraction may be the result of alcohol consumption decreasing ability to detect bilateral asymmetry, presumably because of the reductions in the levels of visual function. We tested the hypotheses that acute alcohol consumption decreases ability to detect asymmetry in faces and reduces preference for symmetrical faces over asymmetrical faces. Twenty images of a pair of faces and then 20 images of a single face were displayed on a computer, one at a time. Participants were instructed to state which face of each of the face pairs displayed was most attractive and then whether the single face being displayed was symmetrical or not. Data were collected near campus bars at Roehampton University. Sixty-four self-selecting students who undertook the study were classified as either sober (control) or intoxicated with alcohol. For each face pair or single face displayed, participant response was recorded and details of the alcohol consumption of participants that day were also obtained. Sober participants had a greater preference for symmetrical faces and were better at detecting whether a face was symmetrical or otherwise, supporting the hypotheses. A further, unexpected finding was that males made fewer mistakes than did females when determining whether individual faces were asymmetrical. The reduced ability of inebriated people to perceive asymmetry may be an important mechanism underlying the higher ratings of facial attractiveness they give for members of the opposite sex and hence their increased frequency of mate choice.

Perception of Slope in Photographs

Perceptions of characteristics of space such as slope, distance, and depth are frequently inaccurate, both in the real world and in pictures. We carried out experiments to study factors that influence the accuracy of perceived slope in photographs. Slopes varied in angle from 5° to 45° inclinations against the horizontal, and in the information available to the observer (outline shape and texture characteristics). We found that perceived slope is correlated with real slope ( r=0.99), but that observers consistently overestimate slope. The latter depends not only on the available information, but also on the focal length of the lens with which slopes were photographed. Overestimation is less pronounced for the wide-angle lens compared to the standard lens. A comparison of free viewing and viewing from the correct station-point showed that the latter leads to less overestimation of slope. Since the viewing distance was too far under free viewing, the results are compatible with geometrical optics. In a further experiment the effects of magnification and minification were studied by deliberately viewing the photographs from fixed points closer or further away than the station-point; this led to an increase and decrease in overestimation, respectively. Finally, results are frequently dependent on task characteristics: magnitude judgements of photographs without an anchoring point can only be accurate to a level of scale. Thus using an action-based matching task may lead to more accurate slope perception. We therefore carried out a comparison experiment using a matching task to check for the generality and action-dependence of our results. Practical implications for the use of photographs as surrogates for natural viewing are discussed.

Self help programme for anxiety in general practice: controlled trial of an anxiety management booklet

Behavioural methods of treating anxiety have been shown to be highly effective but are not widely available in general practice where most people suffering from anxiety are treated. This study reports a development in service delivery which is simple, inexpensive and does not make great time demands on general practitioners or require them to extend their training and expertise. The study shows that for patients suffering from panic disorder or generalized anxiety disorder the use of an anxiety management booklet in addition to their usual treatment from their general practitioner produces clinically and statistically significant improvements. Of particular importance is the speed of response to the booklet. Within the first two weeks those patients who received the booklet were significantly less anxious than the controls. The booklet was acceptable to patients and recommendations are made about how to incorporate it into clinical practice.

Additional conclusions on diazepam injectable precipitate: GC-MS confirmation

The precipitate which forms upon dilution of diazepam injection with aqueous vehicles is shown conclusively to be diazepam and not benzoates. The results are based on GC-MS analysis of the precipitate as compared with a synthetic mixture of benzoic acid-diazepam.