Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

Decision analysis for practical negotiation application

The family of decision analysis techniques can be applied effectively to support practical negotiators in international settings. These techniques are most appropriate in support of the prenegotiation phase, when parties are diagnosing the situation, assessing their own plans and strategies, and evaluating likely reactions and outcomes. The paper identifies how these approaches have and can be used to assist negotiation practitioners, offers a rationale for the application of decision analytic approaches in terms of the particular analytical requirements of the prenegotiation period, suggests how these process-oriented tools can be integrated with substantive tools, and discusses ways in which these tools can be presented and delivered to practitioners in a practical and confidence-building manner.     

Student perceptions of the danger of drug use: a factor analysis.

Australian secondary school students from three Year levels were asked to rate the danger involved in various uses of alcohol, tobacco, inhalants, marijuana and other illicit drugs. These ratings were then factor analyzed for each Year level. The results showed a more refined discrimination among the older students, with type of drug and frequency of use being important considerations. Familiarity was a major consideration for the younger students. The cognitive factors derived from the data are consistent with expectations based on the gateway theory of drug use.     

Medicine on the line? Computer‐mediated social support and advice for people with diabetes

The advent of thousands of Usenet groups on the Internet, covering a vast range of medical and welfare issues and ostensibly devoted to the mutual social support of participating members, has raised the potential for the development of new forms of 'virtual' health care. This article critically analyses the use by people with diabetes of one such Usenet group. It seeks to establish, first, the extent to which such a site provides some demonstrable measure of social support to its participants. This is approached by undertaking a structural analysis of the site to identify the extent of usage, and the nature of supporting interventions using a fivefold classification (instrumental, informational, esteem and social companionship and other). Second, the article attempts to identify any disparity between the lay health-knowledge in evidence and biomedical opinions proffered by the use of a panel of consultant diabetiologists. The results of the analysis suggest that the diabetes newsgroup provides an example of an active forum for largely well-informed participants who routinely use the media as an aid to the reflexive management of their medical condition. It also raises the prospect of a renegotiated relationship between medical knowledge and lay experience based upon shared learning     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

Mapping Gender and Migration in Sociological Scholarship: Is It Segregation or Integration?

A review of the sociological research about gender and migration shows the substantial ways in which gender fundamentally organizes the social relations and structures influencing the causes and consequences of migration. Yet, although a significant sociological research has emerged on gender and migration in the last three decades, studies are not evenly distributed across the discipline. In this article, we map the recent intellectual history of gender and migration in the field of sociology and then systematically assess the extent to which studies on engendering migration have appeared in four widely read journals of sociology (American Journal of Sociology, American Sociological Review, Demography, and Social Forces). We follow with a discussion of these studies, and in our conclusions, we consider how future gender and migration scholarship in sociology might evolve more equitably.     

Constructivist self-development theory: a theoretical framework for assessing and treating traumatized college students.

The authors present a new conceptual framework for assessing and treating traumatized college students. The framework, constructivist self-development theory (CSDT), blends object relations, self-psychology, and social cognition theories. It is founded upon a constructivist view of trauma in which the individual's unique history shapes his or her experience of traumatic events and defines the adaptation to trauma. Within this theory, the authors suggest approaches to setting the frame for trauma therapy, including stabilizing acute symptoms and setting appropriate expectations for treatment. CSDT provides a framework for the systematic assessment and practical treatment of three aspects of the self that are affected by trauma. These include self-capacities, or the ability to tolerate strong affect and regulate self-esteem; cognitive schemas, or beliefs and expectations about self and others in the areas of frame of reference (or identity and world view), safety, trust, esteem, intimacy, power, and independence; and intrusive trauma memories and related distressing affect. Finally, the authors provide guidelines for assessing the need for longer term treatment.     

Membranes, mitochondria and amoebae: shape models

Most real-world shapes and images are characterized by high variability- they are not rigid, like crystals, for example—but they are strongly structured. Therefore, a fundamental task in the understanding and analysis of such image ensembles is the construction of models that incorporate both variability and structure in a mathematically precise way. The global shape models introduced in Grenander's general pattern theory are intended to do this. In this paper, we describe the representation of two-dimensional mitochondria and membranes in electron microscope photographs, and three-dimensional amoebae in optical sectioning microscopy. There are three kinds of variability to all of these patterns, which these representations accommodate. The first is the variability in shape and viewing orientation. For this, the typical structure is represented via linear, circular and spherical templates, with the variability accomodated via the application of transformations applied to the templates. The transformations form groups: scale, rotation and translation. They are locally applied throughout the continuum and of high dimension. The second is the textural variability; the inside and outside of these basic shapes are subject to random variation, as well as sensor noise. For this, statistical sensor models and Markov random field texture models are used to connect the constituent structures of the shapes to the measured data. The third variability type is associated with the fact that each scene is made up of a variable number of shapes; this number is not assumed to be known a priori. Each scene has a variable number of parameters encoding the transformations of the templates appropriate for that scene. For this, a single posterior distribution is defined over the countable union of spaces representing models of varying numbers of shapes. Bayesian inference is performed via computation of the conditional expectation of the parametrically defined shapes under the posterior. These conditional mean estimates are generated using jump-diffusion processes. Results for membranes, mitochondria and amoebae are shown.