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.     

Work patterns and marital status change

The impact of marital status changes on the lives of adults and children has increased importance as marriage, divorce, and remarriage have become more frequent patterns of family composition change. These events can often be predicted by the family members involved so that they may be accompanied by changes in labor market activity prior to the events themselves. The study reported here uses panel data to examine the labor market activity changes that precede marital status changes. Women who become divorced increase hours of work in the year or two before the divorce occurs, and women who become remarried decrease hours of work in the year of the remarriage and thereafter. For men there seems to be little change in labor supply during these years. However, hours of housework for men do seem to change.This research has been supported by the United States Department of Agriculture through the New York Agricultural Experiment Station under Southern Regional Project S-206. The data utilized in this work were made available in part by the Inter-University Consortium for Political and Social Research. The data were originally collected by James N. Morgan, et al. The contents of this article do not necessarily reflect the view of the Inter-University Consortium or the institutions with which the researchers are affiliated. We wish to especially thank Robert Avery for his helpful comments throughout this research and Veronica Abel for her able research assistance.Jennifer L. Gerner is Associate Professor, Department of Consumer Economics and Housing, 137 Martha Van Rensselaer Hall, Cornell University, Ithaca, NY 14853. Her research interests include the economics of the family and family organization. She received her Ph.D. from the University of Wisconsin. Catherine Phillips Montalto is a Ph.D. candidate in the Department of Consumer Economics and Housing, Cornell University, Ithaca, NY 14853. Her research interests include the economic behavior of households. W. Keith Bryant is Professor and Chair of the Department of Consumer Economics and Housing, 117D Martha Van Rensselaer, Cornell University, Ithaca, NY 14853. He received his Ph.D. from Michigan State University.     

The Best Years of Their Lives: A Portrait of a Residential Home for People With AIDS

The article results from 18 months of ethnographic fieldwork conducted at the “Tahitian Islander,” an apartment building in Florida for people with AIDs. This essay offers stories of three longtime residents as a way of describing and interpreting discourse that creates and maintains a sense of self and place. By using a narrative form that is built around dialogue, the author offers examples of how people with AIDS (PWAs) talk about themselves and talk to each other. Through the particulars of daily practice and conversation, this essay shows us that PWAs are actively and continually engaged in the production of identity and community.     

A Bayesian approach to Markov modelling in cost-effectiveness analyses: application to taxane use in advanced breast cancer

Summary. The paper demonstrates how cost-effectiveness decision analysis may be implemented from a Bayesian perspective, using Markov chain Monte Carlo simulation methods for both the synthesis of relevant evidence input into the model and the evaluation of the model itself. The desirable aspects of a Bayesian approach for this type of analysis include the incorporation of full parameter uncertainty, the ability to perform all the analysis, including each meta-analysis, in a single coherent model and the incorporation of expert opinion either directly or regarding the relative credibility of different data sources. The method is described, and its ease of implementation demonstrated, through a practical example to evaluate the cost-effectiveness of using taxanes for the second-line treatment of advanced breast cancer compared with conventional treatment. For completeness, the results from the Markov chain Monte Carlo simulation model are compared and contrasted with those from a classical Monte Carlo simulation model.     

Not in my backyard: Las Vegas residents protest casinos

Casino gambling is becoming increasingly attractive to jurisdictions facing severe fiscal crises. Evidence suggests that casinos bring jobs and increased government revenues. However, attitudes and concerns of local residents regarding the location of casinos in their community should be considered in decisions regarding casino legalization. This paper analyzes the importance of factors associated with the selection of homes by persons living in the Las Vegas metropolitan area. A random survey of 967 recent home purchasers was analyzed. Proximity to a casino is of some importance to home purchasers. As expected, purchasers of more expensive homes and those with children in the household were more concerned about casino locations than others. But casinos were not the only concern of purchasers. Crime, industrial plants, and potential nuclear waste route locations were of greater concern than casino proximity. On the other hand, casino locations were of greater concern than shopping centers and fast food restaurant locations.This research project was supported in part by funds from Clark County through U.S. Department of Energy project grant # DE-FG08-89NV10819, and the College of Business and Economics (U.N.L.V.) Faculty Research Fund of the First Interstate Bank of Nevada.     

Understanding the impact of early-life trauma in nursing home residents

Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.     

The effects of child health on marital status and family structure

The purpose of this paper is to provide evidence on the effect of child health on marital stability and family structure in an economic framework. We use the 1988 National Health Interview Survey's Child Health Supplement, with a sample of about 9,000 families, to test whether having an unhealthy child decreases the mother's chance of being married and whether it increases her chance of living in an extended family. Using two different measures of child health, we find that having an unhealthy child decreases the mother's likelihood of being married. Our results imply that children in poor health are more likely to face obstacles beyond their illness because they also are more likely to suffer the consequences of poverty and the poor schooling outcomes that result from being raised in a female-headed household. The only mitigating factor is that unhealthy white children are more likely than their healthy counterparts to be living in an extended family.     

Policy Stable States in the Graph Model for Conflict Resolution

A new approach to policy analysis is formulated within the framework of the graph model for conflict resolution. A policy is defined as a plan of action for a decision maker (DM) that specifies the DM’s intended action starting at every possible state in a graph model of a conflict. Given a profile of policies, a Policy Stable State (PSS) is a state that no DM moves away from (according to its policy), and such that no DM would prefer to change its policy given the policies of the other DMs. The profile of policies associated to a PSS is called a Policy Equilibrium. Properties of PSSs are developed, and a refinement is suggested that restricts DMs to policies that are credible in that they are in the DM’s immediate interest. Relationships with existing stability definitions in the graph model for conflict resolution are then explored.