MS,exercise, and the potential for older adults

Multiple Sclerosis (MS) is an autoimmune disorder of the central nervous system. The average onset of the disease is 30 years of age, and it afflicts women more often than men (ratio of approximately 2:1). The symptoms of the disease include fatigue, motor weakness, heat sensitivity, reduced mobility, abnormal gait mechanics, and poor balance. These symptoms decrease cognitive and physical functional capacity of an individual and tend to result in sedentary lifestyle behaviors. A sedentary lifestyle among individuals with MS increases the risk of secondary diseases such as coronary heart disease and obesity, particularly as one ages. The effect of exercise in treating symptoms of MS has been under explored, perhaps due to the fact that exercise was thought to magnify MS-related fatigue and other symptoms. Recent research has challenged this notion, advocating exercise as an effective therapy for the management of MS, as well as maintaining overall fitness and improving quality-of-life measures. While the research shows clear benefits, the barriers to exercise participation among MS patients are significant. Recommendations for various forms of exercise are provided, along with strategies for overcoming barriers to participation.     

Specification analysis in mixed hazard models and a test of crossing survival functions

The paper investigates diagnostic procedures for the specification of common hazard models in duration analysis. It is shown that under mixed hazard specifications the survival functions of different subgroups cannot cross. A nonparametric test for the crossing of two survival functions is provided and its applications in duration analysis are discussed. In particular, the proportional hazard model with unobserved heterogeneity (PHU) is investigated, and procedures are developed to test whether given data are consistent with the PHU model and whether they contain unobserved heterogeneity within the PHU specification. Examples in which crossing survivals are of substantive concern are discussed, including the dynamics of infectious diseases and the demand for vaccination.     

Choice under complete uncertainty when outcome spaces are state dependent

One central objection to the maximin payoff criterion is that it focuses on the state that yields the lowest payoffs regardless of how low these are. We allow different states to have different sets of possible outcomes and show that the original axioms of Milnor (1954) continue to characterize the maximin payoff criterion, provided that the sets of payoffs achievable across states overlap. If instead payoffs in some states are always lower than in all others then ignoring the “bad” states is no longer inconsistent with these axioms. Similar dependence on overlap of outcome spaces across states holds for the minimax regret and maximin joy criteria.      

Individual status at the start of rehabilitation: Implications for vocational rehabilitation programs

This research investigated the situation of 143 unemployed sick leavers at the start of vocational rehabilitation in Sweden. It is argued in this paper that in order to gain a meaningful picture of the vocational rehabilitation process it is necessary to know and understand something of individual differences and status at the onset. In doing so, assessment was carried out of the possible influence of one contextual factor and five individual factors on health, duration of sick leave and unemployment. Findings suggest that individual differences exist in health status, length of sick leave and unemployment, at the upstart of vocational rehabilitating. Locus of control was found to exert important influence on the differences between the individuals in the study sample, with persons of external locus of control having a less favourable point of departure at the start of vocational rehabilitation compared to other groups. It is therefore assumed that these persons will be in greater need of support during the vocational rehabilitation process. The level of unemployment within a geographical area was also found to influence the length of sick leave. CONCLUSIONS: Our suggestion is for rehabilitation programs to be developed and selected to match the special needs and differences whether they are of individual or of social nature.     

The prevalence of dental anxiety in patients of a university dental clinic

Dental anxiety remains a pervasive barrier to dental treatment for many individuals, including college-age patients. In this article, the author reviews dental anxiety and examines the usefulness of assessment instruments for identifying dental anxiety. Using 2 unique assessment instruments, he examines the prevalence of dental anxiety in his university dental clinic's patient population. The 2 assessment instruments were determined to be equally effective in identifying anxious dental patients. Both instruments revealed that the average patient surveyed had low-to-mild dental anxiety. The results of this survey concur with those of previous studies of college-populations.     

Marriage and Family Counselor Licensure: Special Reference to Nevada*

The background of licensure-certification of marriage and family counselors is briefly sketched and major provisions of California compared. Special attention is given to the Nevada law. (Editor.)     

Weighing the success of a national Alzheimer's disease service demonstration

As the need for long-term care services within the United States has grown dramatically, Congress has consistently deflected the primary responsibility for such care to state governments, local organizations, and, ultimately, the family. This paper examines the impact of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program, a small federally funded initiative within the context of this trend. Although the demonstration can be deemed a huge success relative to the goals of creating new services for an underserved target population, questions are raised about the merits of the program relative to the exploding need for an effective network of long-term care services.     

Do maternal health problems influence child's worrying status? Evidence from the British Cohort Study

Conventional methods apply symmetric prior distributions such as a normal distribution or a Laplace distribution for regression coefficients, which may be suitable for median regression and exhibit no robustness to outliers. This work develops a quantile regression on linear panel data model without heterogeneity from a Bayesian point of view, i.e. upon a location-scale mixture representation of the asymmetric Laplace error distribution, and provides how the posterior distribution is summarized using Markov chain Monte Carlo methods. Applying this approach to the 1970 British Cohort Study (BCS) data, it finds that a different maternal health problem has different influence on child's worrying status at different quantiles. In addition, applying stochastic search variable selection for maternal health problems to the 1970 BCS data, it finds that maternal nervous breakdown, among the 25 maternal health problems, contributes most to influence the child's worrying status.