Measurement of cumulative physiological dysregulation in an older population

The allostatic load framework postulates that an important pathway connecting the social environment with health involves biological responses to stressful stimuli and the subsequent dysregulation of interrelated physiological systems. We formulate a new measure for cumulative physiological dysregulation using a grade of membership model estimated with biodemographic data from a national sample of older Taiwanese persons. We investigate associations between the measure and physical, psychological, and cognitive function. The results provide insights into the relationships between a set of biological profiles and various health outcomes, identify limitations of earlier approaches, and underscore next steps in the development of improved for mulations of physiological dysregulation.     

Gender Differences in Adult Children's Support of Their Parents in Taiwan

This paper examines the patterns and determinants of four types of support provided by adult children to their parents, with particular attention to differences in the helping behaviors of sons and daughters. The data come from the 1989 wave of the Survey of Health and Living Status of the Elderly in Taiwan. The analysis is based on 12,166 adult children from 2,527 families. We find that usually only one child in a family provides help with activities of daily living (ADLs) or instrumental activities of daily living (IADLs), but for financial or material support the responsibility is likely to be shared among siblings. Sons generally carry the major responsibility for taking care of their older parents, and daughters fulfill the son's roles when sons are not available.     

Risk Factors,Parental Communication,Self and Peers’ Beliefs as Predictors of Condom Use Among Female Adolescents Attending Family Planning Clinics

This study examined the impact of risk factors, self and peers’ beliefs, and parental communication on condom use among 290 female adolescents who attended family planning clinics. The major findings showed that in addition to risk factors, self and peer beliefs about condom use and parental communication about birth control predicted actual condom use. Implications for social workers about the importance of encouraging communication between adolescents and their parents are discussed.     

Smoothing for small samples with model misspecification: nonparametric and semiparametric concerns

Our goal is to find a regression technique that can be used in a small-sample situation with possible model misspecification. The development of a new bandwidth selector allows nonparametric regression (in conjunction with least squares) to be used in this small-sample problem, where nonparametric procedures have previously proven to be inadequate. Considered here are two new semiparametric (model-robust) regression techniques that combine parametric and nonparametric techniques when there is partial information present about the underlying model. A general overview is given of how typical concerns for bandwidth selection in nonparametric regression extend to the model-robust procedures. A new penalized PRESS criterion (with a graphical selection strategy for applications) is developed that overcomes these concerns and is able to maintain the beneficial mean squared error properties of the new model-robust methods. It is shown that this new selector outperforms standard and recently improved bandwidth selectors. Comparisons of the selectors are made via numerous generated data examples and a small simulation study.     

A Multistate model of fecundability and sterility

This paper develops a multistate hazards model for estimating fecundability and sterility from data on waiting times to conception. Important features of the model include separate sterile and nonsterile states, a distinction between preexisting sterility and sterility that begins after initiation of exposure, and log-normally distributed fecundability among nonsterile couples. Application of the model to data on first birth intervals from Taiwan, Sri Lanka, and the Amish shows that heterogeneity in fecundability is statistically significant at most ages, but that preexisting sterility and new sterility are unimportant before age 40. These results suggest that sterility may not be an important determinant of natural fertility until later reproductive ages.     

Development and validation of a tool to improve physician identification of elder abuse: the Elder Abuse Suspicion Index (EASI)

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

The association between aging inmate housing management models and non-geriatric health services in state correctional institutions

One of the current debates in the literature on aging inmates asks, what is the most efficient housing/health care model for this "special needs" population? State and federal correctional systems place elderly inmates either in specialized segregated housing units away from the general inmate population, consolidate elderly inmates in housing units within the prison, or provide a combination of both models. In general, proponents of the segregated housing model argue that aging inmates will receive specialized medical services in geriatric units. However, proponents of consolidated housing model argue that aging inmates will have the benefit of both geriatric and non-geriatric health services. This paper examines the association between the type of housing management model for aging inmates and the availability of non-geriatric physical and mental health services. Data for the analysis come from the 2000 Bureau of Justice Statistics Census of State and Federal Adult Correctional Facilities. The results suggest that institutions offering consolidated geriatric care provide more mental health services and that these effects are independent of the characteristics of prison facility.     

Parental Divorce and First-Year Students' Transition to University: The Need to Include Baseline Data and Gender

This research examines parental divorce and first-year students' transition to university. Incoming students (N = 2,724) to six diverse universities completed questionnaires in August, before university, and again in November and March. Initial baseline measures indicated that females of divorced parents reported more depressive symptoms than females of intact families, whereas males of divorced parents reported lower levels of perceived stress than those of intact families. These findings remained over the first year. Regarding adjustment to university, males with divorced parents reported the best academic adjustment, and females with divorced parents were most vulnerable regarding personal-emotional adjustment.     

Ethnic and Marital Differences in Family Structure,Risk Behaviors,and Service Requests Among Young Minority Fathers

The purpose of this study was to examine ethnic and marital status differences in family structure, risk behaviors and service requests among African American and Hispanic adolescent fathers participating in a community-based fatherhood program. Demographic factors, risk behaviors, and service requests were gathered at program entry. The results indicated that each group demonstrated distinct patterns associated with family structure, sexual risk behaviors, substance use, and criminal behavior. In comparison to African American fathers, Hispanic fathers were younger and were more likely to be married and present at the delivery of their child. African American fathers reported having more children than Hispanic fathers. Disparities in school-related measures were also found, with African American fathers having higher high school graduation rates than Hispanic fathers. The impact of marriage on risk behaviors had mixed results. Services requests were similar for both groups. The finding that different ethnic groups have specific patterns of risk behaviors highlights the importance of considering the ethnic composition of a population when developing future research and interventions.