Joint Attention,Self‐Recognition,and Neurocognitive Function in Toddlers

Recent studies have attempted to understand the processes involved in joint attention because of its relevance to both atypical and normal development. Data from a recent study of young children with autism suggests that performance on a delay nonmatch to sample (DNMS) task associated with ventromedial prefrontal functions, but not an A‐not‐B/delayed response task associated with dorsolateral prefrontal cortex, was related to joint attention skills (Dawson et al., 2002). Recent research also suggests that joint attention is associated with dorsalmedial brain systems linked to self‐monitoring (Mundy, 2003). This study investigated the relations among joint attention, DNMS, and self‐recognition performance in a longitudinal study of 39 normally developing toddlers from 14 to 18 months. The results indicated that development on the DNMS and self‐recognition tasks, but not a means end task, predicted joint attention at 18 months. Further analysis showed that the model was only significant for initiating joint attention (IJA). The implications of these results for the neuro‐development of IJA are discussed.     

The Sandwich Generation: Dependency, Proximity, and Task Assistance Needs of Parents

This study was designed to determine the extent of sandwiched families and the impact of dependency and proximity to task assistance provided to parent(s). Data were collected in Idaho, Oregon, Utah, and Michigan from a random sample of 40–65-year-old respondents. Fifteen percent are sandwiched between needs of aging parents and financially dependent children. Respondents are much more likely to be providing assistance to mothers than fathers. Parents are most likely to live near, but not necessarily with, the respondent. Spouses and partners' parents, however, are likely to live farther away. Task assistance provided most often to aging parent(s) includes help with transportation and shopping; financial assistance was reported least often. Income of respondent and dependency and proximity of parents are significantly related to providing assistance to parents. This study offers a unique glimpse at the relationships between personal characteristics, dependency, proximity, and task assistance issues as they pertain to the sandwich generation.     

Graphical representation of survival curves in the presence of time-dependent categorical covariates with application to liver transplantation

Graphical representation of survival curves is often used to illustrate associations between exposures and time-to-event outcomes. However, when exposures are time-dependent, calculation of survival probabilities is not straightforward. Our aim was to develop a method to estimate time-dependent survival probabilities and represent them graphically. Cox models with time-dependent indicators to represent state changes were fitted, and survival probabilities were plotted using pre-specified times of state changes. Time-varying hazard ratios for the state change were also explored. The method was applied to data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Survival curves showing a ‘split’ at a pre-specified time t allow for the qualitative comparison of survival probabilities between patients with similar baseline covariates who do and do not experience a state change at time t. Time since state change interactions can be visually represented to reflect changing hazard ratios over time. A2ALL study results showed differences in survival probabilities among those who did not receive a transplant, received a living donor transplant, and received a deceased donor transplant. These graphical representations of survival curves with time-dependent indicators improve upon previous methods and allow for clinically meaningful interpretation.