Self and other: The importance of social interaction and social relationships in shaping the experience of early-stage Alzheimer's disease

Various factors influence how individuals experience illness. Especially important, however, is the reaction of others whose response shapes the meaning of the illness for the person who is ill, and the impact it will have on her or his sense of self. Adopting a symbolic interactionist perspective, and drawing on data obtained from in-depth interviews conducted with nine individuals living with early-stage Alzheimer's disease, this paper examines how others’ reactions to and treatment of persons living with the condition can influence how they experience dementia. The findings reveal that the majority of the participants did not believe others’ treatment of them had substantially changed, nor did most express the level of concern about the possible negative response of others reported in other studies. Within their relationships and social interactions participants received the essential support, cooperation, and encouragement that enabled them to create meaning in life and sustain identity.     

The genetic connections of Alzheimer's disease: An emerging source of caregiver stress

The purpose of this study was to expand and refine current theoretical conceptualization of dementia caregiving by identifying and analyzing new potential sources of stress. A qualitative analysis of unsolicited letters (N=51) written by family caregivers of persons diagnosed with Alzheimer's disease (AD) was conducted. Content analysis of the data confirmed that providing care for persons diagnosed with AD could impart emotional, physiological, and financial stress on caregivers. The data also revealed an emerging source of stress for family caregivers—fears and uncertainties regarding possible genetic connections between family caregivers and relatives suffering from AD. These results strongly suggest that concerns with genetic connections should be included in theoretical models of stress and dementia caregiving. Implications include the need for increased dissemination of information regarding genetic connections and AD, as well as increased support for family members if and when genetic connections are discovered.     

In their voices: Identity preservation and experiences of Alzheimer's disease

Although much research pertaining to Alzheimer's disease (AD) explores the impact on caregivers, there is a general paucity of data on experiences of living with the condition. Contemporary medical initiatives to diagnose people earlier in the illness trajectory make it increasingly possible to hear the voice of people with memory loss, which can improve both public perception and policy. This study examined the impact of being diagnosed with early AD on identity construction. Respondents highlighted aspects of being diagnosed that were instrumental in making sense of changes in their lives and identities, including defining moments, to tell or not to tell, and preservation. Findings suggest that understanding how to identify memory deficits, the context of diagnosis, and the techniques employed for managing illness are crucial to subjective experiences. Despite normative expectations and the rhetoric of loss, respondents deliberately manage their interactions to make sense of their lives and preserve themselves.     

The controversial promises of cholinesterase inhibitors for Alzheimer's disease and related dementias: A qualitative study of caregivers' experiences

Since their introduction, clinicians have been engaging in debates over the therapeutic benefits of cholinesterase inhibitors (ChEIs) in Alzheimer's disease and related dementias (ADRD). Against this backdrop of controversy, caregivers' views and experiences have been largely ignored. This has occurred despite the fact that this group may provide insights into these drugs in ways not captured by clinical research. To address this gap in knowledge, the current study examines 25 caregivers' narratives about the treatment of relatives diagnosed with mild to moderate ADRD and treated with ChEIs. The findings reveal an appraisal of cholinergic effects whereby caregivers question the benefits of the drugs, generally not knowing whether to attribute stabilization or improvements to them or not but also fearing termination of the drug ‘just in case’ there is some benefit. Caregivers justify their belief in ChEIs' long-term effectiveness primarily by invoking non-medicated prognostic scenarios of more rapid decline and loss of self. In addition, the study explores the meaning caregivers attribute to ChEI effects vis-à-vis a pharmaceutical discourse which frames these drugs as a source of hope.     

The norm and the text: Denzin and Lincoln's handbooks of qualitative method

Qualitative methods have lately enjoyed enhanced legitimacy and are increasingly used in academic and applied social research. Yet the field is marked by controversy about virtually every key tenet of qualitative inquiry, from matters of epistemology to purely practical matters of relations with research subjects. Not only is the practice of qualitative research hotly contested, consensus is lacking about the purpose of qualitative research and whether it has a distinctive role to play relative to other approaches to the study of social phenomena. Against this context, the handbooks of qualitative method edited by Norman Denzin and Yvonna Lincoln represent a significant attempt to capture the breadth of contemporary approaches to qualitative method. The article examines key contributions from the handbooks, drawing on these to develop a view of qualitative method from a pragmatic, realist perspective. Among the issues considered are the significance of relativism, subjectivity, post-modernism and feminist method, the politicization of the purposes of qualitative research, the debate over criteria of validity, and the move to treat qualitative research as an entertainment rather than a scientific practice.     

Centre and periphery: Two speeds for the implementation of public relations in Spain

In this qualitative study conducted at the Rovira i Virgili University we show that there are clearly two speeds for the implementation of public relations in Spain: one in the big cities (basically Madrid and Barcelona) and one in the smaller cities or regions of secondary economic importance, such as Tarragona, where the degree of professionalisation is noticeably lower.     

The place of “think family” approaches in child and family social work: Messages from a process evaluation of an English pathfinder service

Findings are reported from a process study of an English multi-disciplinary team working with families with long standing and complex problems. The approaches and methods of the team are described and placed in the context of UK policy developments and of UK and USA research on professional practice with families facing multiple difficulties. Basic data are provided on all families referred in the first year and analysed with respect to the first 100 completed cases. A broadly ethnographic research approach is used for the observational study of the team interactions and decision-making on individual cases. For a one-third sub-sample of 33 cases, process and interim outcome data are analysed from information systematically extracted from case records. These are complemented by qualitative data from interviews with managers and caseworkers and by observation of ‘team around the family’ and professionals' meetings. The researchers conclude that the service succeeds in engaging a majority of the referred families who have been hard to reach or hard to change in the past and whose children are either ‘on the edge of care’ or likely to be significantly harmed without the provision of an intensive service. The researchers concluded that improvements were made in the life chances of children in 75% of the families. Aspects of the service identified as associated with more positive outcomes are: the allocation of two key workers (one for the child/ren and one for the parent/s); the centrality of relationship-based practice and flexibility of the approach rather than strict adherence to any particular practice model; the fact that the service is firmly embedded within the statutory children's services department, allowing for continuity of relationships with team around the family members when the intensive service ends; and flexibility about case duration and intensity.     

The structure of norms and relations in patronage systems

Patronage systems are composed of a social relation (between patron and client), the norms associated with this relation (support, defend, not attack), and network-formation rules (governing the creation of patronage ties). Actors in a patronage system face moral dilemmas when they become obligated to fight on both sides of a conflict, and patronage systems are normatively consistent when these dilemmas can never arise. This paper examines the structure of normatively consistent patronage systems, exploring the logical relationships among norms and between norms and network structure. The paper illustrates how sociologically relevant concerns from deontic logic can be incorporated into network analysis using algebraic methods familiar to network analysts.     

Former system youth with mental health needs: Routes to adult mental health care, insight, emotions, and mistrust

Objective

Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care.

Methods

In-depth face-to-face interviews were conducted with 60 participants currently struggling with mental health difficulties regarding their service use experiences over the transition. Participants were recruited from one Midwestern state. Multi-phase analysis was conducted utilizing immersion/crystallization, constant comparison and concept matrices.

Results

Few participants received continuous mental health care across the transition, with the majority experiencing interruptions or discontinuation of care. Important facilitators of service use emerged, such as physicians, former caseworkers and family. Health clinics and parenting programs emerged as potential entrée points for reconnecting disengaged young adults to mental health services. Insight, mistrust, and emotions emerged as novel factors associated with service utilization among young adults.

Conclusions

Mental health service utilization remains a complicated phenomenon over the developmental transition to adulthood. Future research is needed that closely examines the associations between insight, emotion, mistrust and service use among young adults.     

The impact of newsroom changes and the rise of social media on the practice of media relations

Recent changes in American media have resulted in direct impacts on the work of PR professionals, from newsroom reductions in traditional media outlets to the rise of social media. This study examines changes in the media relations dynamic with qualitative, in-depth interviews from 12 PR professionals in a medium, eastern U.S. city. Findings include PR professionals doing less traditional media relations, mostly attributable to downsized newsrooms, and frustration with the resulting dearth of institutional knowledge, influx of young, inexperienced reporters, and shallow stories. While participants see opportunities to inject unfiltered messages in media, overall they value reporter relationships and using social media in communication with them and in their job. Although new media are seen as one more task on an already very full PR plate, participants acknowledge their importance and growing relevance. Overall, PR professionals see their and the industry's future including both traditional and new media.     

The history of academic research in public relations: Tracking research trends over nearly four decades

This study analyzed the history of public relations scholarship over 39 years of research published in two journals: the Journal of Public Relations Research and the Public Relations Review. By examining the topical, theoretical, and methodological themes, this study found new research topics, theoretical and methodological trends. These revealing themes provided a comprehensive picture of research trends and patterns of public relations scholarship, thus providing insights for future research agendas aimed at improving the breadth and depth in public relations.     

The experiences of children living with and caring for parents with mental illness

This research provides a three‐way perspective on the experiences and needs of children who are living with and caring for parents with severe and enduring mental illness. The views of children, parents and key workers were sought in order to provide deeper insight into the needs of families and the nature of interfamilial relationships, as well as the relationships between service users and providers. Child protection and medical research has long proposed a link between parental mental illness and the risk to children of abuse, neglect and developmental delay. The inevitability of risk associations is challenged by the research described here and outcomes for children of caring for parents with mental illness are discussed not simply in terms of risk to children but more broadly in respect of, for example, positive parent–child relationships. Copyright © 2006 John Wiley & Sons, Ltd.     

The origins of distant voicing: Examining relational dimensions in public diplomacy and their effects on megaphoning

Extant literature has discussed the similarities between public relations and public diplomacy. This study seeks to contribute to existing research on the application of organization–public relationships (OPR) to public diplomacy by further exploring relational dimensions in public diplomacy and empirically testing them based on a model consisting of antecedents (i.e., political, economic, interpersonal, cultural and corporate interactions), relational dimensions (i.e., interactional bilateralism, power mutuality, trust, empathy, relational satisfaction, relational continuation, relational attentiveness and relational curiosity), and consequences (i.e., positive and negative megaphoning). A total of 490 respondents from the United States were recruited on Amazon M-Turk to respond to survey items regarding China and Mexico. Confirmatory factor analysis and regression analysis were conducted. The findings indicate: (a) positive associations between the antecedents and the relational dimensions, (b) positive associations between the relational dimensions and positive megaphoning, and (c) negative associations between the relational dimensions and negative megaphoning. (148 words)     

Blessed assurance: The role of religion and spirituality in Alzheimer's disease caregiving and other significant life events

Increasing attention in the scientific literature is being given to the relationships among religion, spirituality, and overall well-being. Moreover, research has repeatedly identified religion and spirituality as significant coping resources throughout the life course. For this study, a group of 20 Catholic and Protestant older adults were interviewed; half were caregivers of a spouse with Alzheimer's disease and half were noncaregivers. The informants were asked about their views on religion, spirituality, and how they integrated their faith into their lives. Qualitative analysis identified several themes reinforcing previous work that has shown religion and spirituality are important dimensions to the human experience. All of the informants had integrated religious and spiritual beliefs and practices into their lives to help make sense out of stressful situations. The findings underscore the need for further scientific inquiry that examines how religion and spirituality promote healthy adaptation to significant life events.     

Cognitive function in toddlers with congenital heart disease: The impact of a stimulating home environment

Infants born with congenital heart disease (CHD) are at increased risk of neurodevelopmental difficulties in childhood. The extent to which perioperative factors, cardiac physiology, brain injury severity, socioeconomic status, and home environment influence early neurodevelopment is not clear. Sixty-nine newborns with CHD were recruited from St Thomas’ Hospital. Infants underwent presurgical magnetic resonance imaging on a 3-Tesla scanner situated on the neonatal unit. At 22 months, children completed the Bayley Scales of Infant and Toddler Development-3rd edition and parents completed the cognitively stimulating parenting scale to assess cognitive stimulation at home. Level of maternal education and total annual household income were also collected. Hospital records were reviewed to calculate days on the intensive care unit post-surgery, time on bypass during surgery, and days to corrective or definitive palliative surgical intervention. In the final analysis of 56 infants, higher scores on the cognitively stimulating parenting scale were associated with higher cognitive scores at age 22 months, correcting for gestational age at birth, sex, and maternal education. There were no relationships between outcome scores and clinical factors; socioeconomic status; or brain injury severity. Supporting parents to provide a stimulating home environment for children may promote cognitive development in this high-risk population.     

The public relations paradox of erasure: Damnatio memoriae as public relations strategy and tactic

Public relations scholars study how organizations co-create meaning with engaged stakeholders. Not well understood is how and why such co-creation modifies shared meaning, amplifies change, and even “erases” some piece of memory from the public record with the purpose of redirecting and redefining societal narratives. To help establish erasure as a concept for studying public relations, we draw from Freud’s theory of memory to establish a foundation upon which to critique strategic erasure. We adapt Freud’s theory of memory into the intersecting critique of visual rhetoric as public relations by analyzing, via narrative inquiry, remnants of Imperial Rome that have been modified, amplified, but even erased to present Rome’s modern identity. For centuries, even during Imperial Rome, leaders practiced damnatio memoriae —a modern Latin phrase that means “condemnation of memory.” We use this concept to interrogate the public relations identity process Rome’s leaders have used to modify for emphasis and even obliterate Roman elites’ names and images from the texts of public records by destroying, mutilating and modifying statues and monuments as a means for co-creating new public memory. Such analysis reveals how damnatio memoriae helps elites to redefine the “memory” of the Eternal City.     

Adolescent aggression: The role of peer group status motives,peer aggression,and group characteristics

Recent studies of youth aggression have emphasized the role of network-based peer influence processes. Other scholars have suggested that aggression is often motivated by status concerns. We integrate these two veins of research by considering the effects of peer status motivations on subsequent adolescent aggression, net of their own status motivations, prior aggression, and peer behavior. We also explore different levels at which peer effects may occur, considering the effects of reciprocated and unreciprocated friendships as well as larger, meso-level peer groups. We anticipate that peer group effects are magnified by both size and boundedness as measured by Freeman's (1972) segregation index. We find that, net of the adolescent's aggression at time 1, both the aggressive behaviors and the status valuations of friends independently increase the likelihood of aggression at time 2, 6 months later. The aggressive behavior of friends who do not reciprocate the adolescent's friendship nomination has particular impact. The average status valuation of peer groups increases their members’ likelihood of aggression, even after controlling for their own attitudes about status, their friends’ attitudes, and their friends’ aggressive behavior. This effect is magnified in large groups and groups with high Freeman segregation scores.     

The state of Australian public relations: Professionalisation and paradox

It is almost a decade since the last empirical study of Australian public relations appeared in the academic literature. This paper reports on a survey conducted immediately prior to the onset of the global financial crisis aimed at revealing the state of public relations in Australia. In particular, the study investigated levels of professionalisation in terms of such criteria as the strategic orientation of public relations, its position within organisational hierarchies, and the importance placed on ethics and professional development. The findings show Australian PR professionals to be highly educated, comparatively well paid and frequently in positions of influence with their CEOs. Paradoxically despite these strengths, the profession in Australia does not seem to have outgrown public relations’ pervasive identity crisis.     

The Social Construction of Deviant Behavior in Homeless and Runaway Youth: Implications for Practice

This study examined the social construction of deviance in a sample of homeless and/or runaway youth in metropolitan Phoenix. In depth semi-structured interviews with 14 youth were conducted, and the data were transcribed and analyzed using a qualitative research computer program. The findings from the study point to an emerging theory, which suggests that ambiguous local policies relevant to homeless youth (e.g., trespassing, loitering) resulted in their selective enforcement by local security and police. Respondents described the ways that they adapted their behaviors to the environmental stressors resulting from these policies. Implications for practice are discussed.

Choice and caring: The experiences of parents supporting young people with Autistic Spectrum Conditions as they move into adulthood

This paper reports findings about parents' experiences of caring for young people with Autistic Spectrum Conditions (ASCs) moving into adulthood. In‐depth interviews were conducted with 38 parents of young people (15–21 years) with ASCs. Data were analysed thematically. In the perceived absence of service support, parents' acted as ‘care‐coordinators’ and ‘life‐supporters’ for their child as they moved into adulthood. These roles came with little choice, emotional demands and personal restrictions. Being supported was important for parents, but preferences differed regarding what this should look like. Implications for policy are discussed.