Moving Beyond Basic Emotions in Aging Research

There is consistent evidence that older adults have difficulties in perceiving emotions. However, emotion perception measures to date have focused on one particular type of assessment: using standard photographs of facial expressions posing six basic emotions. We argue that it is important in future research to explore adult age differences in understanding more complex, social and blended emotions. Using stimuli which are dynamic records of the emotions expressed by people of all ages, and the use of genuine rather than posed emotions, would also improve the ecological validity of future research into age differences in emotion perception. Important questions remain about possible links between difficulties in perceiving emotional signals and the implications that this has for the everyday interpersonal functioning of older adults.     

Human Interindividual Variability in Susceptibility to Airborne Particles

Part of the explanation for the persistent epidemiological findings of associations between mortality and morbidity with relatively modest ambient exposures to airborne particles may be that some people are much more susceptible to particle-induced responses than others. This study assembled a database of quantitative observations of interindividual variability in pharmacokinetic and pharmacodynamic parameters likely to affect particle response. The pharmacodynamic responses studied included data drawn from epidemiologic studies of doses of methacholine, flour dust, and other agents that induce acute changes in lung function. In general, the amount of interindividual variability in several of these pharmacodynamic response parameters was greater than the variability in pharmacokinetic (breathing rate, deposition, and clearance) parameters. Quantitatively the results indicated that human interindividual variability of breathing rates and major pharmacokinetic parameters-total deposition and tracheobronchial clearance-were in the region of Log(GSD) = 0.1 to 0.2 (corresponding to geometric standard deviations of 10(.1)-10(.2) or 1.26-1.58). Deposition to the deep lung (alveolar region) appeared to be somewhat more variable: Log(GSD) of about 0.3 (GSD of about 2). Among pharmacodynamic parameters, changes in FEV1 in response to ozone and metabisulfite (an agent that is said to act primarily on neural receptors in the lung) were in the region of Log(GSD) of 0.2 to 0.4. However, similar responses to methacholine, an agent that acts on smooth muscle, seemed to have still more variability (0.4 to somewhat over 1.0, depending on the type of population studied). Similarly high values were suggested for particulate allergens. Central estimates of this kind of variability, and the close correspondence of the data to lognormal distributions, indicate that 99.9th percentile individuals are likely to respond at doses that are 150 to 450-fold less than would be needed in median individuals. It seems plausible that acute responses with this amount of variability could form part of the mechanistic basis for epidemiological observations of enhanced mortality in relation to ambient exposures to fine particles.     

Relationships,Reconciliation and Children: Giving Young People a Say

I have realised how central my therapy background and skills have been in my current job. Without being conscious of it, I use much of my background as a therapist in my role as Commissioner for Children and Young People. I probably spend more of my time advocating for children and young people as a group because they are excluded or disregarded on the basis of their status as children.     

Hardship Among Older Adults in the HRS: Exploring Measurement Differences Across Socio-Demographic Characteristics

Measures of hardship have been proffered as better indicators of economic well-being than traditional measures of socioeconomic status (SES). However, there is a dearth of research on latent factor structures and measurement bias in items assessing hardship across socio-demographic characteristics, especially among older adults. As such, the purpose of this study was to determine the factor structure of items measuring hardship in the Health and Retirement Study (HRS) and to determine measurement bias across socio-demographic groups (i.e., race/ethnicity, gender, and age). The participants were HRS subjects who completed an additional psychosocial survey (N = 3074). The results revealed a single latent factor for hardship (comparative fit index = 0.99, root mean square error of approximation = 0.02) using confirmatory factor analysis on eight items in the HRS. The multiple indicator, multiple causes (MIMIC) model was used to determine measurement bias in the items due to socio-demographic characteristics. Compared to white respondents, black respondents were more likely to endorse items of financial dissatisfaction (Odds Ratio (OR) = 2.19, 95 % Confidence Interval (CI) = 1.43, 3.35), while Latino respondents were more likely to endorse food insecurity (OR = 2.78, 95 % CI = 1.60, 4.83); and older individuals (age 65 and older) were less likely to endorse having moved to a worse residence/neighborhood (OR = 0.32, CI = 0.18, 0.57) and being unemployed (OR = 0.28, CI = 0.20, 0.38). These results indicate that there is differential item functioning for specific measures of hardship suggesting that there are differences observed for the measurement of hardship for these items across racial/ethnic and age groups.     

Negotiating Compliance: The Case of Autonomous Hospitals in Vietnam

Maternal death is one of the highest causes of global mortality. Governments have long used regulation to improve maternal health but concurrent fiscal‐decentralisation reforms can undermine clinical performance. This article focuses on public Vietnamese hospitals to explore how regulatory compliance is pursued in decentralised health facilities, since Vietnam has seen increasing autonomisation of public hospitals in the last decade while simultaneously experiencing marked reductions in the maternal mortality ratio. Our analysis suggests that autonomisation has allowed regional regulatory regimes to emerge and that regulatory compliance must compete with other priorities. Compliance can therefore be rethought as a negotiation having implications for how government and maternal health advocates persuade self‐sufficient hospitals to take on wider health‐system goals.     

New-dialect formation and Southern Hemisphere English: The New Zealand short front vowels

There are two conflicting hypotheses concerning the nature of the New Zealand English short vowel system. One is that this system is conservative and that it is distinguished from the system of English English by changes which have taken place in the latter. The other hypothesis is that New Zealand English is, on the contrary, innovative, and that it is English English which has remained conservative. Drawing on hitherto unavailable data and on recent empirical studies in New Zealand, this paper concludes that both of these hypotheses are to a certain extent wrong and to a certain extent correct.     

ESTIMATING THE NUMBER OF VISITS TO THE DOCTOR

The frequency of doctor consultations has direct consequences for health care budgets, yet little statistical analysis of the determinants of doctor visits has been reported. We consider the distribution of the number of visits to the doctor and, in particular, we model its dependence on a number of demographic factors. Examination of the Australian 1995 National Health Survey data reveals that generalized linear Poisson or negative binomial models are inadequate for modelling the mean as a function of covariates, because of excessive zero counts, and a mean‐variance relationship that varies enormously over covariate values. A negative binomial model is used, with parameter values estimated in subgroups according to the discrete combinations of the covariate values. Smoothing splines are then used to smooth and interpolate the parameter values. In effect the mean and the shape parameters are each modelled as (different) functions of gender, age and geographical factors. The estimated regressions for the mean have simple and intuitive interpretations. However, the dependence of the (negative binomial) shape parameter on the covariates is more difficult to interpret and is subject to influence by extreme observations. We illustrate the use of the model by estimating the distribution of the number of doctor consultations in the Statistical Local Area of Ryde, based on population numbers from the 1996 census.