Alzheimer's aggression: influences on caregiver coping and resilience

This study assessed impact of Alzheimer's patients' aggressive behavior (AD aggression) on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression-caregiver resilience relationship. Informal caregivers across Louisiana (N = 419) completed surveys with measures of demographics, AD aggression, caregiver coping strategies, and caregiver resilience. Task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. Implications for social work professionals are discussed.     

Compulsive gambling and the changing military law

Military courts have had to face the issue of compulsive gambling in criminal court-martial proceedings. The military recently switched from the liberal ALI definition of insanity to the much more stringent standards of the federal Insanity Defense Reform Act. However, military courts have not even allowed in expert testimony, holding the relevance of compulsive gambling has not been generally accepted in the scientific community. The rules involving extenuation or mitigation in sentencing allow much more leeway. Although compulsive gambling cannot be used as the basis for a defense of insanity in military courts, defense lawyers will continue to raise the issue in attempting to obtain lesser punishments for their military clients.B.S. Loyola College, J.D. Univ. of MD, Active duty Judge Advocate General's Corps, four years currently selected for promotion to Colonel, USAR. Partner, Stark and Little.B.A. 1982, Gettysburg College; J.D., 1987, Univ. of Balto.; Associate, Stark and Little, Baltimore, MD; member of the Baltimore City, Md. State, and Am. Bar Associations.     

Elders with Serious Mental Illness: Lost Opportunities and New Policy Options

This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under Medicaid.     

Alzheimer's Aggression: Influences on Caregiver Coping and Resilience

This study assessed impact of Alzheimer's patients' aggressive behavior (AD aggression) on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression–caregiver resilience relationship. Informal caregivers across Louisiana (N?=?419) completed surveys with measures of demographics, AD aggression, caregiver coping strategies, and caregiver resilience. Task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. Implications for social work professionals are discussed.     

Robust Model-Based Inference for Incomplete Data via Penalized Spline Propensity Prediction

Parametric model-based regression imputation is commonly applied to missing-data problems, but is sensitive to misspecification of the imputation model. Little and An (2004 Little , R. J. A. , An , H. ( 2004 ). Robust likelihood-based analysis of multivariate data with missing values . Statistica Sinica 14 : 949 – 968 .[Web of Science ®] , [Google Scholar]) proposed a semiparametric approach called penalized spline propensity prediction (PSPP), where the variable with missing values is modeled by a penalized spline (P-Spline) of the response propensity score, which is logit of the estimated probability of being missing given the observed variables. Variables other than the response propensity are included parametrically in the imputation model. However they only considered point estimation based on single imputation with PSPP. We consider here three approaches to standard errors estimation incorporating the uncertainty due to non response: (a) standard errors based on the asymptotic variance of the PSPP estimator, ignoring sampling error in estimating the response propensity; (b) standard errors based on the bootstrap method; and (c) multiple imputation-based standard errors using draws from the joint posterior predictive distribution of missing values under the PSPP model. Simulation studies suggest that the bootstrap and multiple imputation approaches yield good inferences under a range of simulation conditions, with multiple imputation showing some evidence of closer to nominal confidence interval coverage when the sample size is small.     

Using Probabilistic Modeling to Evaluate Human Exposure to Organotin in Drinking Water Transported by Polyvinyl Chloride Pipe

The leaching of organotin (OT) heat stabilizers from polyvinyl chloride (PVC) pipes used in residential drinking water systems may affect the quality of drinking water. These OTs, principally mono- and di-substituted species of butyltins and methyltins, are a potential health concern because they belong to a broad class of compounds that may be immune, nervous, and reproductive system toxicants. In this article, we develop probability distributions of U.S. population exposures to mixtures of OTs encountered in drinking water transported by PVC pipes. We employed a family of mathematical models to estimate OT leaching rates from PVC pipe as a function of both surface area and time. We then integrated the distribution of estimated leaching rates into an exposure model that estimated the probability distribution of OT concentrations in tap waters and the resulting potential human OT exposures via tap water consumption. Our study results suggest that human OT exposures through tap water consumption are likely to be considerably lower than the World Health Organization (WHO) "safe" long-term concentration in drinking water (150 μg/L) for dibutyltin (DBT)—the most toxic of the OT considered in this article. The 90th percentile average daily dose (ADD) estimate of 0.034 ± 2.92 × 10⁻⁴μg/kg day is approximately 120 times lower than the WHO-based ADD for DBT (4.2 μg/kg day).     

Correlational change analysis: Reliability and metric issues

Unless certain metric conditions are met, and unless reliability estimates are available, analyzing change data via correlational techniques is often inappropriate. Although these techniques are useful for problems of practical prediction, the absence of equivalent interval scales and reliability estimates may influence the value of the observed coefficient so as to misrepresent the underlying causal model. The consequences of ignoring reliability estimates and metric equivalences are discussed for each of the three most commonly used correlational techniques: (1) The correlation of crude gain scores with initial scores, (2) The correlation of crude gain scores with third variables, and (3) The correlation of residualized gain scores with third variables.     

More than just being there: balancing the participation equation

The research and evaluation evidence is mounting: out-of-school-time (OST) programs can keep young people safe, support working families, and improve academic achievement and social development. Over 6 million children are enrolled in after-school programs nationwide, but an estimated 14.3 million children still care for themselves in the nonschool hours. Because of this discrepancy, OST stakeholders need information about how to maximize participation in OST programs. The Harvard Family Research Project (HRFP) has developed a conceptual model, based on scholarly theory, empirical research, and knowledge gained from providers, that describes the characteristics that predict participation in OST programs as well as the potential benefits of that participation. In the center of the model, participation is conceived as a three-part construct of enrollment, attendance, and engagement. This equation serves as the basis for framing this issue of New Directions for Youth Development. The chapter provides an overview of why participation in OST programs matters for young people, describes some of the barriers and challenges to youth participation, teases out more precise definitions of participation, and presents HFRP's conceptual model of participation. It focuses on the participation equation and concludes by highlighting some overarching themes that recur throughout the issue and that have an impact on future directions for research and evaluation.