The changing character of stepfamilies: implications of cohabitation and nonmarital childbearing

Divorce, nonmarital childbearing, and cohabitation are reshaping family experience in the United States. Because of these changes, our traditional definitions of families decreasingly capture the social units of interest. We have noted how a significant proportion of officially defined single-parent families actually are two-parent unmarried families. The present paper expands on this perspective with respect to stepfamilies. We must broaden our definition of stepfamilies to include cohabitations involving a child of only one partner, and must recognize the large role of nonmarital childbearing in the creation of stepfamilies. We find that cohabitation and nonmarital childbearing have been important aspects of stepfamily experience for at least two decades, and that this is increasingly so. To define stepfamilies only in terms of marriage clearly underestimates both the level and the trend in stepfamily experience: when cohabitation is taken into account, about two-fifths of all women and 30% of all children are likely to spend some time in a stepfamily.     

A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia

The main objective of this article was to conduct a systematic review of the literature examining relationship adjustment and sexual satisfaction among women with provoked vestibulodynia (PVD). Although only a small number of studies have included partners, the literature regarding partner's relationship adjustment and sexual satisfaction was also examined. Relevant articles were identified by a literature search conducted between August 2008 and May 2010. Studies were included if they contained at least one group or subset of participants with PVD or dyspareunia (i.e., painful sexual intercourse), and if they assessed relationship adjustment or sexual satisfaction as a primary outcome measure. Within this review, the methodological quality of 33 studies was systematically rated, and effect sizes were calculated when possible. Methodological type and quality greatly varied across the studies, as did the pain samples included and the outcomes reported. Nevertheless, the results of controlled studies indicate that PVD is associated with decreased sexual satisfaction. The controlled results also suggest, however, that PVD is not necessarily associated with general relationship maladjustment for women and their partners. Future research, using various methodologies, is needed to further understand intimate relationships among women with PVD and the impact that this condition may have on couples.     

Simulation to enhance care of patients with psychiatric and behavioral issues: use in clinical settings

Nurses with a medical-surgical clinical focus often care for patients with psychiatric and behavioral issues in acute care hospitals. This article describes how hospital staff and nursing and theater department faculty joined forces to develop realistic simulated psychiatric scenarios for use by practicing nurses.     

Nursing home admissions and long-stay conversions among persons with and without serious mental illness

The appropriateness of nursing homes for individuals with serious mental illness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999 , which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mental illness newly admitted to nursing homes. They found that newly admitted people with serious mental illness were younger and more likely to become long-stay residents than those admitted with other conditions, despite a higher proportion of residents with serious mental illness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mental illness versus those younger than 65 without serious mental illness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mental illness and those aged 65 and older without serious mental illness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mental illness residing in nursing homes may have the functional capacity to live in less restrictive environments.     

Teaching about near-death experiences: the effectiveness of using The Day I Died

In this article, we reviewed results of research on near-death experiences (NDEs) over the past 3 decades and examined the effect of viewing the hour-long 2002 BBC documentary The Day I Died: The Mind, the Brain, and Near-Death Experiences on accurate knowledge about near-death experiences among advanced undergraduates at a southwestern university. In a quasi-experimental research design, the experimental group completed a 20-item questionnaire before and after viewing the documentary (n = 66; 45 females, 21 males), and the waitlist control group completed the questionnaire as pre- and posttest before viewing the documentary (n = 39; 36 female, 3 male). The two groups' scores at pretest were not significantly different (p > .05). Group by occasion repeated measures ANOVA revealed the experimental group's posttest scores moved significantly in the direction of correctness with a large effect size (p < .001; eta2 = .56), whereas waitlist control group posttest scores remained similar to pretest scores. We discuss two exceptions to the effectiveness of the documentary and recommendations for educators using it as well as for future research.     

Restrictiveness and guidance in support systems

Restrictiveness and guidance have been proposed as methods for improving the performance of users of support systems. In many companies computerized support systems are used in demand forecasting enabling interventions based on management judgment to be applied to statistical forecasts. However, the resulting forecasts are often ‘sub-optimal’ because many judgmental adjustments are made when they are not required. An experiment was used to investigate whether restrictiveness or guidance in a support system leads to more effective use of judgment. Users received statistical forecasts of the demand for products that were subject to promotions. In the restrictiveness mode small judgmental adjustments to these forecasts were prohibited (research indicates that these waste effort and may damage accuracy). In the guidance mode users were advised to make adjustments in promotion periods, but not to adjust in non-promotion periods. A control group of users were not subject to restrictions and received no guidance. The results showed that neither restrictiveness nor guidance led to improvements in accuracy. While restrictiveness reduced unnecessary adjustments, it deterred desirable adjustments and also encouraged over-large adjustments so that accuracy was damaged. Guidance encouraged more desirable system use, but was often ignored. Surprisingly, users indicated it was less acceptable than restrictiveness.     

Age Differences in Exposure and Reactivity to Interpersonal Tensions among Black and White Individuals across Adulthood

The present study examined age differences in exposure and reactivity to interpersonal tensions among white and black Americans. Participants from the National Study of Daily Experiences II (NSDE II, n = 1,696 white and n = 239 black; ages 34–84) reported their experiences of daily interpersonal tensions and well-being (positive and negative affect) over 8 days and provided salivary cortisol samples. A total of 40% of respondents reported having an argument and 62% reported avoiding an argument. Multilevel models estimated separately for black and white respondents revealed that older people reported fewer interpersonal tensions (i.e., less exposure) than did younger people. However, age differences in reactivity to tensions (e.g., appraisals, coping strategies, implications of tensions for affect and cortisol) varied by race. Although older black respondents reported tensions were less stressful than younger black respondents, there were fewer age difference in reactivity to tensions overall among black respondents compared with white respondents. Findings are consistent with the exposure-reactivity model and gerontological theories of emotion regulation but show that the specific age differences vary by race which may indicate unique strengths and vulnerabilities among whites and blacks.     

Understanding Mexican‐American Marriage Patterns Using a Life‐Course Approach*

Objective. Guided by a life‐course framework that incorporates the interconnection between marriage, migration, and other transitions, we critically examine the familism explanation for the earlier age at marriage among Mexican Americans. Methods. We compare the marriage patterns of Mexican immigrants derived from the National Survey of Family Growth (NSFG) to those of women living in Mexico derived from the Mexican Census. We then use data from the NSFG to estimate proportional hazard models of marriage using fixed variables such as parent's education and time‐varying variables such as school enrollment. Results. Analyses show that the Mexican immigrant population marries earlier than Mexicans who do not migrate to the United States. In addition, the U.S.‐born Mexican population has lower marriage rates than whites once family background characteristics associated with early marriage are controlled and Anglos are no less likely than Mexican Americans to marry in response to a pregnancy. Conclusion. We find reason to doubt that ethnic differentials are driven by a strong attachment to marriage, female chastity, and the “traditional” family. Although cultural factors may play an important role, researchers need to more carefully specify the aspects of Mexican culture that might encourage marriage and how these factors interrelate with economic and demographic constraints.