AUTONOMY AND RELATEDNESS IN MARITAL FUNCTIONING

The current investigation expands the focus of cognitive behavioral formulations of marriage by exploring the constructs of autonomy and relatendness in marriage. One hundred forty-one married couples matched to the 1990 U.S. census data on age, race, and income completed a number of self-report marital inventories including the Autonomy and Relatendness Inventory (Schaefer, Edgerton, & Burnett, 1991). Autonomy was measured by evaluating spouses' perceptions of the extent to which partners encouraged a sense of independence and individuality for the spouses. Relatedness was measured by evaluating spouses' perceptions of the amount of closeness that partners provided. It was found that autonomy and relatedness were significantly positively correlated with each other, as well as with marital adjustment for both males and females. It was found that for females, the provision of relatedness (as reported by their husbands) was significantly related to the standards that they held for the relationship. In addition, it was found that for females, the provision of relatedness (as reported by their husbands) was significantly related to the standards that husbands held for the relationship. However, no significant relationships were found between husbands' standards and relatedness (either as reported by wives or husbands). It was concluded that it is appropriate to help couples think of autonomy and relatedness as being tow important aspects of marriage that can exist together and are related to a satisfying marriage. Implications of the findings suggest that marital therapists could expand the conceptualization of marital therapy beyond being primarily relationship focused to include attention to individual needs of the spouses. Relatedness was measured by evaluating spouses' perception of the amount of closeness that partners privided. It was found that autonomy and relatedness were significantly positively correlated with each other as well as with marital adjustment for both males and females. It was found that for females, the prpvision of relatedness(as reported by their husbands) was significantly related to the srandards that they held for the relationship. In addition, it was found that for females, the provision of relatedness(as reported by their husbands)was significantly related to the standards that husbands held for the relatinship. How-ever, no significant relationships were found between husbands' standards and     

Frailty in self-neglecting older adults: A secondary analysis

ABSTRACT

Self-neglect (SN) and frailty in older adults is associated with increased disability and mortality. Despite these commonalities, there have been no studies objectively assessing frailty in older adults who SN. This secondary analysis classified frailty in N = 37 older adults with Adult Protective Services validated SN using the Fried Frailty Phenotype (FFP) of weight loss, weakness, exhaustion, activity level, and walking speed. Overall, 3% were classified as robust, 62% as prefrail, and 35% as frail. Most (72%) were overweight/obese, with clinically significant decreases in activity level (60%) and walking speed (97%). Compared to the original FFP population, older adults who SN exhibit important differences in frailty phenotypes, and finding that the largest percentage of older adults who SN were prefrail may indicate a critical opportunity for intervening in this population to reduce future functional decline and mortality.     

Family size and child mental disorders in Bahia,Brazil

The relationship between family size and child mental disorders was assessed through a prevalence study conducted in an urban neighborhood of Salvador, Brazil. From a representative sample of 828 children aged between 5 and 14 years, 23.3% were diagnosed as exhibiting varying degrees of mental disorders. Diagnoses were based on psychiatric interviews, following screening using the QMPI (a Portuguese-language screening questionnaire). Results supported the hypotheses that: (1) children from smaller families would exhibit higher prevalence of mental disorders than those from larger families; and (2) prevalence of neurotic and psychosomatic disorders would be lower for children from larger families than from smaller ones. Significant associations were also found between family size and diagnosis and severity of child mental disorders. Controlled analyses indicated that these relationships were not confounded by age or sex of the child, family social class, or family type.     

Acute health effects of transported air pollution: A study of children attending a residential summer camp

Sulphur dioxide was very low throughout the study period, with the highest hourly value reaching only 8.9 ppb. Sulphuric acid concentrations were usually below the detectable limit of 2 μg/m³. The highest hourly concentrations of 5 μg/m³ were attained on days of relatively low sulphur concentrations. Due to the low concentrations of SO₂ and H₂SO₄, these environmental variables will not be considered further here. The environmental factors of interest are PM_2.5, SO₄⁼, O₃ (one-hour maximum), temperature, and relative humidity, where SO₄⁼, temperature, and relative humidity are averages of continuous measurements over the sampling period. The values of these variables are listed by lung-function testing period in Table 1. Two periods of elevated pollution levels occurred during the study period, the first lasting from 30 June P. M. to 1 July P. M., and the second from 3 July P. M. to 4 July P. M. On four of the nine days, the current Ontario air-quality standard for ozone of 80 ppb (1-hour maximum) was attained or exceeded. A back-trajectory analysis conducted by Environment Canada showed air-mass transport from the Ohio valley on both 30 June and 3 July. Fifty-two campers, including 23 asthmatics (12 boys and 11 girls) and 29 nonasthmatics (16 boys and 13 girls), completed all components of the study. The mean values of the three lung-function indictors (FVC, FEV_1.0, and PEF) for asthmatics and nonasthmatics are given in Table 2 for each of 18 testing periods. The first testing period (29 June P. M.) was considered as a training session and is not included in this presentation. The three lung-function responses tend to follow a similar pattern over time, with the highest responses occurring at the beginning of the camp, followed by a steep decline for several subsequent testing periods. A gradual increase is then observed, with some stabilization occurring near the completion of the camp. The child-specific variation in lung function over time is given in Table 3. There are appreciable differences in the variance of the lung-function measurements between children, with asthmatics tending to exhibit larger variances than their nonasthmatic counterparts. Table 4 gives the frequency of a positive response to several questions concerning respiratory symptoms for each session for asthmatics and nonasthmatics respectively. Here, a positive response to Cough and Sneeze is defined as an occurrence of these symptoms five or more times since the previous lung-function testing session. The number of children using medication since the last session is also reported. The consultants were asked to explore the possibility that the environmental factors in Table 1 may affect lung-function performance as measured by the parameters in Table 2 or occurrence of the respiratory symptoms summarized in Table 4. Differences in response between asthmatics and nonasthmatics are also of interest.     

Air pollution effects on hospital admission rates: A random effects modeling approach

Statistical methods are proposed to analyze parallel time series of hospital-based health data and measurements of ambient air pollution. Specifically, associations between the number of daily health events (hospital admissions or emergency-room visits for respiratory illnesses) and daily levels of ambient air pollutants in the vicinity of several hospitals are examined. A relative-risk regression model is proposed in which the regression parameters are assumed to vary at random among hospitals. Adjustment for seasonal trends in admissions are also considered. Simple computational methods based on generalized estimating equations are explored as the basis for statistical inference. The proposed methods are illustrated on data obtained from 164 acute-care hospitals in Ontario over the May-to-August period for 1983 to 1988. These admission rates are related to ozone levels obtained from 22 monitoring stations maintained by the Ontario Ministry of the Environment.     

Including structural measurement errors in the nonlinear regression analysis of clustered data

This paper extends methods for nonlinear regression analysis that have developed for the analysis of clustered data. Its novelty lies in its dual incorporation of random cluster effects and structural error in the measurement of the explanatory variables. Moments up to second order are assumed to have been specified for the latter to enable a generalized estimating equations approach to be used for fitting and testing nonlinear models linking response to these explanatory variables and random effects. Taylor expansion methods are used, and a difficulty with earlier approaches overcome. Finally we describe an application of this methodology to indicate how it can be used. That application concerns the degree of association of hospital admissions for acute respiratory health problems and air pollution.     

(Re)Conceptualising inclusive education in New Zealand: listening to the hidden voices

This article explores the experiences of 14 students with severe and complex behaviour, their caregivers, and teachers/principals as the students transition from a disestablished residential school back to mainstream schools, with support from the Intensive Wraparound Service (IWS). Interviews were the primary source of data collection. Data were collated into 14 cases, and analysed using a general inductive approach. Two broad themes are addressed in the article: education and relationships/communication. The research found that the IWS is not living up to its rhetoric. Suggestions made for improvement are based on approaches that participants found worked for them.     

Feasibility of intervention in elder self-neglecters: Setting the stage for future research

Objectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.

Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.

Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).

Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.