Gastrostomy and children: a review of the literature in learning disabilities

Children with developmental delays often suffer feeding difficulties. It has become common for those with a severe likelihood of malnutrition to be considered for alternative methods of nutritional intake, often a gastrostomy. As part of a pilot study investigating the effects of gastrostomy on the child and their family, we conducted a literature review in order to establish the current areas of research, progress and concern. This paper describes the method and findings of the literature review and concludes with a discussion of the topics raised. The main conclusion is that although the need for gastrostomy in this group of children has been shown to be effective in maintaining adequate weight gain and nutritional intake, the support given to the family prior to, and after the operation is inadequate. Greater emphasis needs to be placed on detailed family assessment as part of the early intervention package. Copyright © 2001 John Wiley & Sons, Ltd.     

Promising research and methodological approaches for health behavior research with homeless persons

High-risk health behaviors have high prevalence among homeless persons prompting substantial research on health behavior and behavior change strategies within the population. Previously, much of this research focused solely on the target behavior without consideration of contextual factors that may contribute to the behavior or that may inhibit behavior change. We describe three overlapping trends in homeless health behavior research – longitudinal, qualitative, and participatory – which consider the link between the context of homelessness and health behavior. These approaches contribute to the understanding of the social determinants of health behavior and health and demonstrate opportunities for intervention beyond the individual level.     

Intention or Attention Before Pointing: Do Infants’ Early Holdout Gestures Reflect Evidence of a Declarative Motive?

Gestures are the first signs of intentional communication within prelinguistic infants and can reflect various motives, including a declarative motive to share attention and interest. The ability to use gestures declaratively has been linked to later language development; therefore, it is important to understand the origins of this motive. Previous research has focused on the use of declarative pointing at around 12 months; however, other potential forms of declarative communication, such as holdout gestures, are yet to be studied in detail. The purpose of this study was to examine whether from 10 months, infants use holdouts declaratively. We elicited holdouts from 36 infants and then reacted to these gestures in four different conditions: (1) joint attention: shared interest; (2) infant attention: attended to infant; (3) toy attention: attended to toy; (4) ignore: gesture was not attended to. Infants’ behavioral responses were recorded. When the experimenter engaged in joint attention, infants were significantly more likely to display a positive attitude and produced fewer re‐engagement attempts. In contrast, the three non‐joint attention conditions displayed significantly higher negative attitudes and attempts to re‐engage the experimenter. We conclude that infants display declarative communication prior to 12 months, resetting the age at which these more complex skills emerge.     

Lessons from stochastic small-area population projections: the case of Waikato subregions in New Zealand

Subnational population projections in New Zealand by means of the conventional deterministic cohort-component method have had a tendency to be conservative: underprojecting fast-growing populations and overprojecting slow-growing ones. In this paper we use a stochastic population projection method as an alternative. We generate population projections for five demographically distinct administrative areas within the Waikato region of New Zealand: Hamilton City, Franklin District, Thames-Coromandel District, Otorohanga District and South Waikato District. The results are compared to official subnational deterministic projections. The accuracy of subnational population projections in New Zealand is strongly affected by the instability of migration as a component of population change. Differently from the standard cohort-component method, in which net migration levels are projected, the key parameters of our method are age-gender-area specific probabilistic net migration rates. Generally, the identified and modelled uncertainty makes the traditional ‘mid-range’ scenario of subnational deterministic projections of limited use for policy analysis or planning beyond a relatively short projection horizon. We find that the projected range of rates of population growth is wider for smaller regions and/or regions more strongly affected by net migration. Directions for further development of the methodology are suggested.     

The Role of Social Networks in Getting a Job

This article reviews recent research on the effect s of social networks on access to job information and getting a job in the United States. Drawing on network ties from friends, family members, acquaintances, employers, or coworkers can improve the job search because individuals gain access to and make use of their network’s social capital. While this job searching strategy can result in a successful job search for some, not all job seekers benefit from reliance on social networks. We spotlight research that documents how reliance on social networks as a means to find work can actually maintain sex and racial/ethnic inequality at work. We discuss research documenting the important role social networks play in the job acquisition process. The last half of this review focuses on several new developments in the literature that promise to further our understanding of social networks’ lasting effects on employment outcomes.     

Summarizing Risk Using Risk Measures and Risk Indices

Our society is fascinated with risk in many different areas and disciplines. One of the main ways to describe and communicate the level of risk is through risk indices, which summarize risk using numbers or categories such as words, letters, or colors. These indices are used to communicate risks to the public, understand how risk is changing over time, compare among different risks, and support decision making. Given the different methods to construct risk indices, including flawed methods such as risk matrices, this article develops specific steps that analysts can follow to create a risk index. This article emphasizes the importance of describing risk with a probability distribution, developing a numerical risk measure that summarizes the probability distribution, and finally translating the risk measure to an index. Measuring the risk is the most difficult part and requires the analyst to summarize a probability distribution into one or possibly a few numbers. The risk measure can then be transformed to a numerical or categorical index. I apply the method outlined in this article to construct a risk index that compares the risk of fatalities in aviation and highway transportation.     

Productive Activities And Subjective Well-Being Among Older Adults: The Influence Of Number Of Activities And Time Commitment

This study examines relationships among three measures of subjective well-being (life satisfaction, happiness and depressive symptoms), and two global measures of productive activity (number of activities and time commitment). We argue that participation in multiple productive activities should increase subjective well-being because these behaviors increase social integration and provide meaningful social roles. Using the first two waves of the Americans’ Changing Lives survey, we estimate a series of OLS and ordered logistic regression models to examine this issue among a sample of respondents 60 years old and older. Our multivariate regression results show that as time committed to productive activities increases, life satisfaction increases. Both increasing numbers of productive activities and increasing time commitment predict higher levels of happiness. Also, we find only modest support for a relationship between productive activities and the number of and changes in depressive symptoms. Our results provide support for the idea that engaging in productive activities is beneficial to older persons’ well-being, implying confirmation of the role enhancement hypothesis and demonstrating the importance of social integration.This research was partially supported by a grant from the National Institute on Aging (R03 AG018910). We thank Jan Mutchler for helpful comments on an earlier version of this paper.     

Perceived Stigma and Depression among Black Adolescents in Outpatient Treatment

Despite the high prevalence of depression among children and adolescents, most that need mental health treatment do not seek care. This is especially true for ethnic minority adolescents. Prior research has shown that perceived stigma may act as a barrier to the initiation of and adherence to depression treatment, yet few studies have examined the relationship between stigma and depression among Black adolescents. This exploratory study examined the relationship between Black adolescents' depression severity and their current level of perceived stigma in an outpatient sample. Face-to-face interviews were conducted with a clinical sample of adolescents referred for mental health services at a community-based outpatient clinic (n =108), participating in a prospective pilot study on adolescents' patterns of mental health service use. The analyses revealed that greater depression severity was significantly associated with higher perceived stigma (p < .05), particularly among females. The results also suggest that Black adolescents appear to exhibit an appropriate level of self-assessment regarding their need for mental health services. These results are interpreted in relation to previous literature, and limitations and directions for future research are discussed.     

Envisioning emerging nanotechnologies: a three-year panel study of South Carolina citizens

This article reports results from a three-year panel study of a nonrandom sample of 76 South Carolina citizens, recruited from a variety of walks of life, and their impressions of emerging nanotechnology. This discussion focuses on material from depth interviews conducted alongside a baseline opinion and awareness inventory at the beginning of the study, the most intensive data-gathering phase. These results are placed in the context of data from three additional surveys conducted at about equal intervals over the three years, plus exit interviews from 21 of the 34 individuals who completed the entire study. The results give insight into popular thinking about technology but little indication of strong emerging concerns, a trajectory of amplification of those concerns, or opinion polarization over time, despite some awareness of risks and potential ethical dimensions. Nanotechnology may stand out more as an example of risk attenuation than of risk amplification, consistent with most results from national surveys.