bluuebunny/crossref_metadata_2025 huggingface dataset:
Transnational Television in Europe
Authors: Chalaby Jean K.
Published: June 2009

This article analyses the pan-European television industry in the context of the debate on globalization. Pan-European channels are a minority of transnational channels that broadcast across Europe. Their emergence over the last two decades has been made possible by a mix of commercial, regulatory and technological factors. Pan-European television channels can be distinguished by their content, type of ownership and market strategy. Since the mid-1990s, many pan-European channels have operated a shift in strategy and have begun to localize their pan-European feed. This article identifies four types of localization: local advertising, dubbing or subtitling, local programming and the local opt-out. Taking Eurosport and MTV as examples, I have illustrated the practices of localization and explain why some channels engage more in this than others. Localization can be seen as evidence of the vast differences that persist between national cultures. However, I have argued that localization facilitates the process of globalization because it allows transnational media players to overcome cultural diversity and operate efficiently in a multinational environment.
Research Note: Assessing Audience Performance of Public Service Broadcasters
Authors: Picard Robert G.
Published: June 2009

This article explores the economics of audiences and uses this aproach to explore performance of public service broadcasters (PSBs) in the European Union. It suggests and applies a method for analysing the contemporary performance of public service broadcasters using market shares. The study finds that, as a whole, public service broadcasters are performing better than statistical expectations, that public service broadcasting is generally maintaining market leadership, and that higher levels of market share performance are associated with lower levels of governmental funding.
Lifestyle Segmentation
Authors: Vyncke Patrick
Published: June 2009

Nowhere in the field of mass communication research has the concept of `lifestyle' been so prominently and fruitfully used as in the field of marketing communication, where it has been shown that lifestyles influence both consumption patterns and the processing of different forms of marketing communication. Therefore, the lifestyle concept has become the core of a special kind of segmentation research called `psychographics'. This psychographic or lifestyle research usually takes as its point of departure extensive and ad hoc AIO (activities, interests and opinions) surveys, which then lead to often very colourful and useful lifestyle typologies using the technique of cluster analysis. In this article, new approaches to constructing lifestyle typologies are developed using the more general and stable concepts of values, aesthetic styles and life visions. Their applicability, both in isolation and in combination, to form meaningful lifestyle typologies is compared to traditional demographic segmentation criteria such as gender, age, social class and stage of life. This is done in four different markets: goods (cars), services (tourism), not-forprofit (political parties) and media (television programmes, films and magazines). In each of these markets, we compare the different segmentation systems in terms of most wanted product attributes or benefits as found in a survey using a quota sample of the Flemish adult population. It is found that values, aesthetic styles and life visions — either alone or in combination — can lead to very balanced and meaningful lifestyle typologies. In all four markets studied here, these lifestyle segmentations clearly surpass classic demographic segmentations in yielding significant differences in terms of product attribute or benefit evaluation. Finally, the research results clearly demonstrate the value of a media section as an essential part of a lifestyle questionnaire.
Consumer Culture, Islam and the Politics of Lifestyle
Authors: Kılıçbay Barış , Binark Mutlu
Published: June 2009

This article traces the growth of the `fashion for veiling' which has grown in Turkey since the early 1990s, and discusses the representation of Muslim women in both the cultural and public spheres in the late 1980s. The practice of veiling has been chosen to explore how religious iconography is changing to reflect new patterns of consumption and pleasure, and the ways in which these changes are occurring. The authors focus on the shifting meanings of the practice of veiling due to the articulation of Islamic faith into consumption culture, as evidenced in advertising images and commentaries taken from Islamic women's magazines, and fashion catalogues of major Islamic clothing companies. The authors examine the problematic relationship of the fashion for veiling to two other established meanings of veiling: as a sign of adherence to the Islamic principle of covering the female body to conceal it from the male gaze, and as a sign of `political Islam'.
Women’s Views on Breast Cancer Risk and Screening Mammography
Authors: Silverman E. , Woloshin S. , Schwartz L. M. , Byram S. J. , Welch H. G. , Fischhoff B.
Published: June 2009

Background. To promote informed decision making about mammography, clinicians are urged to present women with complete, relevant information about breast cancer and screening. Understanding women’s current beliefs may help guide such efforts by uncovering misunderstandings, conceptual gaps, and areas of concern. Objective. The authors sought to learn how women view breast cancer, their personal risk of breast cancer, and how screening mammography affects that risk. Methods. Forty-one open-ended semistructured telephone interviews with women selected from a national database by quota sampling to ensure a wide range in demographics of the participants. Results. Almost all respondents viewed breast cancer as a uniformly progressive disease that begins in a silent curable form (typically found by mammograms) and, unless treated early, invariably grows, spreads, and kills. Some women felt that any abnormality found must be treated, even if it was not malignant. None had heard of potentially nonprogressive cancers, and when informed, most felt that the uncertain prognosis of such lesions reinforced the need to find and treat disease as soon as possible. Women expressed a wide range of views about their personal risk of breast cancer. Although some saw breast cancer as a central threat to their health, many others cited heart disease, other cancers, violence, and trauma as greater concerns. Most recognized the importance of “uncontrollable” factors for breast cancer such as age, sex, family history, and genetics. However, other “controllable” factors with little or no demonstrated link to breast cancer (e.g., smoking, diet, toxic exposures, “bad attitudes”) were given equal or greater prominence, suggesting that many women feel considerable personal responsibility for their level of breast cancer risk. Similarly, although women recognized that mammography was not perfect, almost all believed that failure to have mammograms put one at risk for premature and preventable death. When asked how mammography worked, almost all repeated the message that “early detection saves lives,” suggesting that advanced cancer (and perhaps most cancer deaths) reflected a failure of early detection. The belief in the benefit of early detection was so strong that some women advocated scaring other women into getting mammograms because it is “better to be safe than sorry.” Conclusions. Women view breast cancer as a uniformly progressive disease rarely curable unless caught early. The exaggerated importance many attribute to a variety of controllable factors in modifying personal risk and the “danger” seen in failing to have mammograms may lead women diagnosed with breast cancer to blame themselves.
Distributed Localization of Modular Robot Ensembles
Authors: Funiak Stanislav , Pillai Padmanabhan , Ashley-Rollman Michael P. , Campbell Jason D. , Goldstein Seth Copen
Published: June 2009

Internal localization, the problem of estimating relative pose for each module of a modular robot, is a prerequisite for many shape control, locomotion, and actuation algorithms. In this paper, we propose a robust hierarchical approach that uses normalized cut to identify dense sub-regions with small mutual localization error, then progressively merges those sub-regions to localize the entire ensemble. Our method works well in both two and three dimensions, and requires neither exact measurements nor rigid inter-module connectors. Most of the computations in our method can be distributed effectively. The result is a robust algorithm that scales to large ensembles. We evaluate our algorithm in two- and three-dimensional simulations of scenarios with up to 10,000 modules.
Creole Metaphors in Cultural Analysis
Authors: Harris Roxy , Rampton Ben
Published: June 2009

It is sometimes suggested that creole language study provides important concepts and metaphors for the analysis of cultural processes within globalization and transnational flow. This article argues, however, that although it may have served as a useful heuristic in certain cases, most of creole linguistics has been grounded in a set of assumptions and procedures that now look increasingly doubtful, both within linguistics and anthropology more generally. After some critical comments on politics and methodology within this subdisciplinary area, there is an overview of the challenge presented by a number of larger shifts in language study, and the article concludes with a socio-linguistic analysis of situated interaction which, we argue, provides a much better framework for understanding the dynamics of syncretic practice than the study of creole grammar.1
Invisible Racism
Authors: Wilson Jacqueline Zara
Published: June 2009

This article examines the uses of the term `White Trash', as a descriptor for identifiable sectors in the United States and Australia. Through consideration of those sectors' history, status and culture, questions of race are addressed with a view to determining to what extent and in what way(s) the term stands as a form of racism. An anecdotal Australian example is employed to introduce the concept and outline the social and linguistic parameters of the discussion, before examining the history and social geography of the term itself and those whom it is used to define, concentrating on those aspects that pertain to questions of race and racism, first in the United States, then Australia. Certain of the socio-political ramifications of `Whiteness' are touched upon, in the course of arguing that usage of the term `White Trash' constitutes a form of `hidden', albeit consequential, racism.
Legislating Virtue, or Fear and Loathing in Istanbul?
Authors: Houston Christopher
Published: June 2009

Over the past decade or so, a number of secular critics and Muslim activists of the Islamist social movement in Turkey have described the political conflicts dominating Turkish social life in cultural terms, as a struggle between incompatible cultural orders. A rich variety of similes have been used to describe the clash and its protagonists: black and white Turks, Islamist untouchables, Turkey's Negroes, even transgendered secularists (Western souls in Turkish bodies). This narrative construction leads to a number of unhelpful generalizations, all of which serve to obscure the merging shades of grey between Islamists and secularists. It also overemphasizes the efficacy of the civilizing project of the Turkish state. The article argues that the term `legislating virtue' better captures the complexity of contemporary political conflict.
Psychotropic Drug Use and the Relation Between Social Support, Life Events, and Mental Health in the Elderly
Authors: Pérodeau Guilhème M. , du Fort Guillaume Galbaud
Published: June 2009

This study aimed to determine if self-reported social support and life events explained differences in levels of anxiety and depression among 109 elderly psychotropic drug users compared to 90 nonusers (aged 62 to 98). Two thirds of the respondents were French-speaking, mostly female (82.1%) and widowed (57.4%), and recipients of a home care program in Montreal, Canada. The life event and social support scales, broken down by item value, did not differentiate users from nonusers, except for feelings of loneliness reported by 40% of users compared to only 16% of nonusers (p < .001). Analysis of the relation between psychiatric symptomatology and psychosocial variables, broken down by item value, showed greater sensitivity among users to perceived (subjective) lack in social support. In contrast, only “feelings of loneliness” had an effect on the level of mental health of nonusers. There was no effect with regard to objective items of social support.
Older Nonmetropolitan Residents' Evaluations of Their Transportation Arrangements
Authors: Glasgow Nina , Blakely Robin M.
Published: June 2009

This article uses data from focus groups to examine how older nonmetropolitan residents of upstate New York construct their transportation arrangements during different stages of the life course. The article also analyzes the effectiveness of different modes of transportation in facilitating life-maintenance and higher order needs of older individuals. Almost universally, youngold (age 65 to 74) rural residents drive themselves to most of their activities; a small proportion also use public buses to fill some of their transportation needs. Old-old (age 75 and older) individuals, by necessity, rely on a wider range of transportation options because of driving cessation among some in this group. The focus groups allowed older participants to speak for themselves regarding what they liked and disliked about different transportation options, thus providing findings that policy makers and transportation planners might use for designing transportation systems that meet the needs of older rural and small-town residents.
The Retirement Migration of U.S. Veterans, 1960, 1970, 1980, and 1990
Authors: Cowper Diane C. , Longino Charles F. , Kubal Joseph D. , Manheim Larry M. , Dienstfrey Stephen J. , Palmer Jill M.
Published: June 2009

This study compares migration patterns during four decades and profiles the demographic characteristics of veteran and nonveteran migrants ages 60 and older in 1990. A substantial increase in veteran migration was expected when World War II veterans retired. With minor exceptions, the top 10 destinations for veterans in the past two censuses are states in the Sunbelt and Pacific Northwest that are well-known for the attraction of their amenities. The nonveteran migrants show a much wider geographic range that includes the Sunbelt states as well as states in the Northeast and Midwest. The profile of migrant characteristics suggests that differences may be due, in part, to age and gender differences of veterans, who are younger, on average, and nearly all male. The life course migration model helps to put this finding in perspective.
Eligibility for In-Home Respite Care: Ethnic Status and Rural Residence
Authors: Chumbler Neale R. , Dobbs-Kepper Debra , Beverly Claudia , Beck Cornelia
Published: June 2009

This research examined whether older adults'ethnicity (African American vs. White) and type of rural residence were associated with nurse case managers' determinations of eligibility for in-home respite care service use, after adjusting for sociodemographic as well as physical and cognitive status characteristics. This study reports the results of a program evaluation of a state Medicaid waiver program for support services. The study sample consisted of 775 older adults residing in the rural counties (63) of Arkansas and enrolled in a Medicaid waiver program for support services. Logistic regression analyses revealed that the combination of being African American and residing in rural counties of smaller population sizes combined with nonadjacency to metropolitan statistical areas were associated with a lower likelihood of being eligible for in-home respite care. The article ends with a discussion on programplanning, policy, and practice initiatives in light of the findings.
Alcohol Consumption in Older Adults: A Comparison of Two Assessment Methods
Authors: Wilcox Sara , King Abby C.
Published: June 2009

Two methods of assessing alcohol consumption in older adults were compared. Participants (52 men, 82 women) recruited through random-digit-dial telephone contacts completed a survey that included a section on alcohol consumption. Within 1 month, participants completed a paper-and-pencil dietary intake questionnaire (EPAT) that included an alcohol consumption item. The two alcohol assessment measures were significantly correlated (r = –.75); however, 13% reported greater alcohol consumption on the EPAT, and only 1.5% reported higher consumption on the alcohol survey. Rates of agreement were lower among participants who drank more than the sample average (32% reported greater alcohol consumption on the dietary measure). Embedding questions within a more general dietary intake assessment may enhance selfreported alcohol consumption in older adults. Dietary measures such as the EPAT are practical for clinical use because they provide alcohol and nutritional information, areas that should be routinely assessed, and they are brief and easy to administer.
Client Satisfaction With Community-Based Services in a Pilot Cost Share–Service Coordination Program
Authors: Bear Mary , Sauer Margaret
Published: June 2009

The purpose of this research was to measure client satisfaction with community-based services (CBS) in a pilot service coordination–shared cost program. Data were collected with telephone surveys from 307 clients. Instruments with demonstrated reliability and validity were used to measure satisfaction with each of the following CBS: homemaker, home-delivered meals, personal care, transportation, and handyman and/or chore services. Results indicated that on average, clients were satisfied with each of the CBS they received. Gender, income, and level of satisfaction with other CBS were shown to have some influence on satisfaction levels.
Social Interactions at Work and the Well-Being of Daughters Involved in Parent Care
Authors: Atienza Audie A. , Stephens Mary Ann Parris
Published: June 2009

This study examined the associations between positive and negative social interactions at work and the psychological and physical well-being of 103 women who had parent care responsibilities and who were also employed. Higher levels of problematic interactions at work surround ing attempts to balance caregiving and work responsibilities were related to poorer well-being, even after work involvement and role stress had been considered. Findings also indicated that problematic interactions with an immediate supervisor were related to poorer physical health, whereas problematic interactions with a coworker with whom the caregiver worked most closely were related to poorer psychological well-being. In contrast, supportive interactions regarding attempts to balance caregiving and work responsibilities were unrelated to well-being. This study highlights the importance of examining problematic interactions at work among caregivers, particularly interactions associated with managing caregiving and work roles.
Dr. Mom and Other Influences on Younger and Older Adults’ OTC Medication Purchases
Authors: Stephens Eric C. , Johnson Mitzi M. S.
Published: June 2009

The present study examined age differences in the sources of information that older and younger adults use when making decisions about purchasing over-the-counter (OTC) cold/allergy medications. Participants completed a questionnaire addressing information sources that influence OTC purchases and advertising awareness. The questionnaire was given either before or after completing a decision task in which they searched a computerized display of label information and chose one of seven brand name medications to purchase. Analyses revealed age-related differences in sources of information considered and label information used when purchasingOTC medications. Priming participants to recall specific advertising claims using the questionnaire had little effect on the information used by younger or older adults. Younger adults relied on price and product use information, whereas older adults relied on side effect and drug interaction information. This finding has implications forOTC label design and health care professionals who counsel patients about OTC medication usage.
Home-Delivered Mental Health Services for Aged Rural Home Health Care Recipients
Authors: Kaufman Allan V. , Scogin Forrest R. , MaloneBeach Eileen E. , Baumhover Lorin A. , McKendree-Smith Nancy
Published: June 2009

Home health care programs are generally able to meet a wide variety of older persons’ medical care needs, but are often unable to provide for the specialized needs of those patients who are experiencing emotional problems. This situation is most problematic in rural communities where services to meet the mental health needs of homebound elders are often not available. This article reports the results of a study that tested the efficacy of providing home-delivered psychotherapy to 78 elderly patients of a rural home health care agency. Patients who completed the brief, task-centered psychotherapeutic intervention reported improvements in their emotional well-being and indicated significant reduction of the problems associated with the target complaints that were the focus of the interventive activities. These results suggest that home-delivered psychotherapeutic interventions may have an important role to play in treating the mental health problems of older, rural, home health care recipients.
Effects of Improved Morbidity Rates on Active Life Expectancy and Eligibility for Long-Term Care Services
Authors: Laditka Sarah B. , Laditka James N.
Published: June 2009

This study examines effects of better health on active life expectancy and eligibility for long-term care services, using data from the 1984-1990 Longitudinal Study of Aging and microsimulation techniques. Results show that better health increases total life expectancy (TLE), the proportion of life spent unimpaired, and the amount of time spent unimpaired. Women experience larger proportional increases in active life expectancy under assumptions of better health. Better health also reduces the proportion of men and women who would be eligible for long-term care services. However, better health decreases the proportion of men eligible for long-term care services more than it decreases the eligible proportion of women. The results reinforce the importance of focusing on policies designed to promote healthy lifestyles and to reduce the prevalence of chronic conditions.
Effects of an Occupation-Based Intervention on Mobility Problems Following a Cerebral Vascular Accident
Authors: Johnson Jennifer A. , Schkade Janette K.
Published: June 2009

The usefulness of a new occupational therapy approach to intervention was explored with three individuals who had sustained a cerebral vascular accident (CVA). This new approach, the Occupational Adaptation Frame of Reference (OA), was used to guide the occupational therapist in the treatment of mobility problems associated with the CVA. Participants were assessed and treated by an occupational therapist in their home environment. Three case studies were compiled from qualitative and quantitative data. Data were gathered through observation, videotaping, narrative stories, and the Movement Rating Scale. Results revealed that intervention based on OA was associated with improved mobility skills.
Utilization of Respite Services: A Comparison of Users, Seekers, and Nonseekers
Authors: Kosloski Karl , Montgomery Rhonda J. V. , Youngbauer John G.
Published: June 2009

Four hundred fifty-eight family caregivers of Alzheimer's patients in Michigan were interviewed to identify factors associated with respite use. Of these caregivers, 176 were using respite (users), 128 had inquired about the service but had not yet used it (seekers), and 154 had neither used nor inquired about respite services (nonseekers). Separate logistic regression models were evaluated to identify users versus nonusers ( n = 458) and seekers versus nonseekers ( n = 282). Need for assistance with activities of daily living, availability of other caregivers, concern with cost, and adherence by the respite programto an established service schedule contributed significantly to the model distinguishing service users from nonusers. Caregiver burden, the presence of other caregivers, and the availability of transportation services made significant, unique contributions to the model distinguishing seekers from nonseekers.
Individual-Cultural Transactions: Implications for the Mental Health of Rural Elders
Authors: Scheidt Rick J.
Published: June 2009

Little is known of the ways that individual-cultural transactions affect the mental health of older adults, particularly those residing in rural environments. Using race and ethnicity as primary cultural constructs, this article describes why it is important to “unpack” the usual definers of culture and mental health to understand their multiple meanings for individuals targeted by rural researchers and practitioners. Three psychological approaches of great promise for this effort are illustrated. These include Phinney's focus on multiple meanings of ethnicity within the developing individual, Kleinman's ethnopsychiatric research examining how local cultures actively shape the experience and interpretation of illness (as distinct from disease), and Gutmann's theory of geropsychiatric pathology linking culturation and deculturation to healthy and degradative psychological outcomes among older adults. Implications of the work of these three researchers for rural mental health researchers and practitioners are offered.
Innovative Rural Mental Health Service Delivery for Rural Elders
Authors: Bane Share DeCroix , Bull C. Neil
Published: June 2009

This paper describes rural mental-health service delivery models identified in a 1995 yearlong search by the National Resource Center for Rural Elderly for innovative programs. Programs are classified into those providing direct service and those with an education and training focus. The leadership role of a single individual, palatibility to a rural elderly clientele, and flexibility are found to be shared characteristics of successful direct service models. Successful educationally oriented models are characterized by ongoing involvement of community leaders, development of specialized rurally specific curricula, and marketing that enabled programs to survive beyond their initial demonstration project funding. It is concluded that successful rural models of mental health care must be based on information that is germane to rural community life, specific training of mental health professionals to work in rural settings, engagement of rural elders as peer counselors in outreach, and strong linkages with existing services and programs.
Developing Programs to Meet the Needs of Alzheimer's Families in Rural Maine
Authors: Turyn Romaine M.
Published: June 2009

In 1992, Maine had only the rudiments of an integrated system of diagnostic and supportive services for people with Alzheimer's disease. Needs assessments confirmed that caregiver attitudes, geography, a lack of awareness of available services, and limited diagnostic and other specialized resources were major barriers to establishing an effective, comprehensive, and coordinated system of services for people with Alzheimer's disease. Responding to this situation, Maine received funds to develop the capacity to respond to the immediate needs of individuals with Alzheimer's disease and their families and to promote service system development. This article outlines the objectives of the project and highlights the successes and challenges experienced in Maine. Several important themes emerge that should be considered when developing programs to meet mental health needs in rural areas.
Meaning and Management of Food Security Among Rural Elders
Authors: Quandt Sara A. , Arcury Thomas A. , McDonald Juliana , Bell Ronny A. , Vitolins Mara Z.
Published: June 2009

Food insecurity is the limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways. This study uses fixed response and textual data obtained through in-depth interviews with adults 70 years and older from a multiethnic population in rural North Carolina to examine the incidence of food insecurity and how older adults experience food insecurity and maintain food security. We interviewed 145 elders up to five times over the course of 1 year. Responses to standard food insecurity questions indicate that only 12% of older adults experience food insecurity. However, analysis of textual data reveals common themes concerning food insecurity that suggest that these questions may underestimate the number of rural elders who are food insecure and not tap the potential vulnerability of others who are dependent on precarious nutritional self-management strategies to meet their needs.
Rural Long-Term Care Integration Developing Service Capacity
Authors: Bolda Elise J. , Seavey John W.
Published: June 2009

This article uses a case study–based framework for analyzing acute and long-term care systems' integration efforts in rural areas and their impacts on service capacity. The article examines opportunities for enhancing service capacity, as illustrated by the experiences of rural programs in three states: Arizona, Illinois, and Vermont. Local control, local leadership, the medical/ social paradigm, and policy stimulation are the dimensions used to examine the unique characteristics of rural integration efforts and their influence on rural long-term care service capacity. The article discusses the importance of technical support, professional collaboration, financing flexibility, and attention to protection of rural safety-net services in developing rural long-term care infrastructures.
Case Management Issues in Rural Long-Term Care Models
Authors: Schraeder Cheryl , Britt Teri
Published: June 2009

This article reviews research on some of the more visible long-term care case-management systems. In particular, the two generations of the Social Health
Family, Peer, and Staff Social Support in Nursing Home Patients: Contributions to Psychological Well-Being
Authors: Carpenter Brian D.
Published: June 2009

This study examined whether nursing home patients identified social support as coming from institutional peers and staff as well as family members. Associations among social support from those three sources, psychological well-being, and motivation to participate in treatment were explored in 32 patients. A majority described peer and staff support networks that were as large as or larger than their family support network. Subjective perceptions of support, but not size of network, were associated with well-being. Perceived support from peers was associated with less depression, greater positive affect, and greater motivation. Perceived support from staff and family was less consistently associated with well-being and motivation. Results suggest that peer and staff support contribute to the well-being of older adults and may complement family support during inpatient admissions or residential stays. Clinical and programmatic interventions that facilitate peer and staff support might enhance patient well-being and stimulate participation in self-care.
Providing Dementia Outreach Education to Rural Communities: Lessons Learned From a Train-the-Trainer Program
Authors: Connell Cathleen M , Holmes Sara B. , Voelkl Judith E. , Bakalar Harriet R.
Published: June 2009

Although several educational outreach programs designed to address the needs of older adults with dementia in rural areas have been reported in the literature, few have been systematically evaluated. The purpose of this article is to describe the Dementia Education Train-the-Trainer Program (DE-TTT-P), designed to disseminate information about dementia in rural areas of Michigan. Twenty-eight health care providers completed the DE-TTT-P and now serve as trainers. Over the course of the 18-month program, 3,276 rural residents attended one of the 223 dementia education sessions offered by the trainers. After summarizing the design, implementation, and evaluation of the program, the discussion offers lessons learned and strategies to maintain the newly formed network of trainers beyond the official project period.
The Alzheimer's Family Caregiver as Decision Maker: A Typology of Decision Styles
Authors: Wackerbarth Sarah B.
Published: June 2009

This study developed a typology of decision styles and discussed its usefulness for providing support to family caregivers of people with Alzheimer's disease. During semistructured interviews, 28 caregivers described making a total of 159 caregiving decisions. The analysis involved the classification of the caregivers' experiences into categories and the formation of a typology of the styles used throughout the decision-making process. Predecision styles include proactive, reactive, and inactive and are based on caregivers' tendencies to prepare for and initiate the decision. Postdecision styles include forecasting, attempting, and depending and are based on the caregivers'implementation plans. Although many (46.4%) of the caregivers tended toward a particular decision style, the majority were not consistent. Eight of the ten categories of decisions made appeared to require a particular decision style. Decision-making needs based on caregiving decision styles are presented to guide the provision of decision support to family caregivers.
Expanded Care and Quality of Life Among Elderly Social HMO Members
Authors: Green Carla A. , Capitman John , Leutz Walter
Published: June 2009

Drawing on interviewsummaries from 52 in-depth interviews with SocialHMOmembers, coded for quality-of-life themes, we explore how home-and community-based services affect quality of life, autonomy, and control. We identify areas where services positively influence quality of life, including promoting functional independence and preventing further functional decline, and we raise questions about important quality-of-life related care that has been outside the Social HMOs'priorities or which they have been unable to adequately address. Elders might benefit if the Social HMOs and other similar programs could be expanded to include services such as training in falls prevention, increased attention to social needs, and better assessment and follow-up of mental health problems.
Use of Telephone-Administered Survey for Identifying Nutritional Risk Indicators Among Community-Living Older Adults in Rural Areas
Authors: Sharkey Joseph R. , Haines Pamela S.
Published: June 2009

The ability of Elderly Nutrition Programs, especially in rural areas, to address increasing needs for disparate program services is linked to determining which older people are most likely to be at nutritional risk and what constitutes the potential risk. The purpose of this study is to characterize nutritional risk factors in a probability sample of rural elders (n = 152) through telephone interviews using a 67-question modified version of the Nutrition Screening Initiative's Level I and II screens. Participants reported high levels of unintentional weight loss, medication use, multiple health conditions, and depression. This study demonstrates that comprehensive information on general health, eating habits, living environment, and functional status can be collected from rural elders by telephone. Because much of the reported nutritional risk in this sample occurs in residents living in areas not receiving nutrition services, expanded nutritional risk data can be used to anticipate need for programs and services in areas not presently served.
Strengthening the Long-Term Care Workforce
Authors: Dill Janette S. , Craft Morgan Jennifer , Konrad Thomas R.
Published: June 2009

Given high rates of turnover among direct care workers in long-term care settings, it is important to identify factors affecting organizational-level turnover rates. In this study, the authors examine the impact of a workforce intervention program (Workforce Improvement for Nursing Assistants: Supporting Training, Education, and Payment for Upgrading Performance [WIN A STEP UP]) on turnover rates of direct care workers in nursing homes. Using data collected yearly between 2002 and 2006 from 405 nursing homes in North Carolina, the authors employ random effects modeling to predict a dichotomous outcome of “above-average” versus “below-average” turnover. Results indicate that nursing homes participating in the WIN A STEP UP program are 15% more likely to have below-average turnover than are nonparticipating nursing homes. Organizational factors such as ownership type and Medicaid participation also influenced turnover, whereas labor market factors had no independent effects. The results suggest that workforce development projects that increase the training of direct care workers and provide associated rewards show some potential to lower turnover rates of the direct care workforce.
Perceived Control, Self-Reinforcement, and Depression Among Asian American and Caucasian American Elders
Authors: Wong Shyh S. , Heiby Elaine M. , Kameoka Velma A. , Dubanoski Joan P.
Published: June 2009

This study investigated the role of perceived control and self-reinforcement in depression among community-dwelling elders from different ethnic backgrounds. The first purpose of this study was to determine the extent to which the behavioral competencies of self-reinforcement and perceived control covary with and predict depression scores among 205 elderly individuals (77 Asian American and 128 Caucasian American). The second purpose was to examine possible cultural differences in depression, self-reinforcement, and perceived control scores. It was found that self-reinforcement predicted depression for the total sample and each ethnic subsample concurrently and 5 months later. Perceived control predicted depression concurrently and subsequently for the Caucasian elders only. Implications for the multicultural assessment of depression among the elderly are discussed.
Public Knowledge of Late-Life Depression and Aging
Authors: Zylstra Robert G. , Steitz Jean A.
Published: June 2009

Depression among the elderly is a common, treatable condition, yet few individuals older than the age of 65 are treated for this disorder. This study used a sample of 235 adults to assess the general public's knowledge of late-life depression and aging. The data indicated that the sample had little knowledge of aging in general and even less about late-life depression. Racial differences were more prominent than were gender differences. Whites and African Americans did not differ in terms of their knowledge of aging. However, Whites were more knowledgeable of depression than were African Americans. This suggests differences in the social construct of depression in the African American community in comparison with the White community. The relationship between knowledge of aging and knowledge of depression is also discussed.
Correlates of Community Service Attitudes Among Family Caregivers
Authors: Stommel Manfred , Collins Clare E. , Given Barbara A. , Given C.W.
Published: June 2009

This article examines caregiver and care recipient characteristics associated with community service attitudes. Using Community Service Attitude Inventory subscales that were refined for use across populations, the relationship between caregiver gender, age, relationship, type of medical diagnosis, and scores on attitude subscales were investigated in a sample of 562 family caregivers. Attitudes toward services were found to be associated with caregiver gender, age, and diagnosis. Implications for research and practice are presented.
The Influence of Formal and Informal Helpers on Primary Caregivers' Perceptions of Quality of Care
Authors: Bass David M. , Noelker Linda S. , McCarthy Catherine A.
Published: June 2009

Primary caregivers' perceptions of the overall quality of care given to their impaired elderly relatives are more strongly related to the perceived helpfulness of selected formal care providers (home aides, physicians, and social workers) than to the perceived helpfulness of selected kin caregivers. Caregiver race and age, the types of other family members who are helping, and whether a nurse is involved influence caregivers'perceptions of the helpfulness of these formal care providers.
The Impact of Family Caregiver Attitudes on the Use of Community Services for Dementia Care
Authors: Pedlar David J. , Biegel David E.
Published: June 2009

This study examined the role of caregiver attitudinal variables, while controlling for other vari ables, in explaining the use of homemaking services, personal care services, transportation, caregiver services, and the number of services used in a sample of 82 wives of community- dwelling dementia care recipients. Seven scales measuring caregiver attitudes were empirically developed Attitudes representing caregiver preference for informal care, trust in service provid ers, and service inconvenience were associated with community service use. Together, the seven scales representing caregiver attitudes improved the explanatory models developed to explain the use of homemaking services, caregiver services, and the number of types of community ser vices used but not the models that explain the use of personal care or transportation services. These findings support the use of taking caregiver attitudes into account in attempts to under stand community service use in dementia care.
Successful Aging: What's Not to Like?
Authors: Scheidt Rick J. , Humpherys Daniel R. , Yorgason Jeremy B.
Published: June 2009

The “successful aging” paradigm championed by Rowe and Kahn has become a valued and powerful paradigm in the culture of gerontology. It has been particularly useful for understanding distinctions between primary and secondary aging in later life, leading to numerous intervention studies designed to identify, prevent, and reverse functional losses associated with usual aging. We pose some cautionary questions regarding the assumptions, conceptualization, and application of the perspective. We suggest that the paradigm is parochial with respect to defining criteria; fails to incorporate adequately life course dynamics, particularly the multiple meanings of age-related losses and dependency; fails to address the generalizability of assumptions and findings to heterogeneous populations of elders; ignores evidence indicating numerous routes to aging well; and fails to consider the implications for elders who cannot age “ successfully” due to incapacitation or lack of access to environmental resources.
Predictors of Use of Chronic Care Services by Impaired Members in the Social Health Maintenance Organization Demonstration
Authors: Lynch Marty , Harrington Charlene , Newcomer Robert
Published: June 2009

Use of chronic care services by 1,868 impaired members of the first Social Health Maintenance Organization (SHMO) demonstration was examined using a modified Andersen behavioral model. Services studied included skilled and intermediate nursing facilities, adult day care, home health, and personal care. A two-part regression analysis was performed to identify significant predictors of any use and amount of use. Individual needs such as activities of daily living were important predictors of service use even for impaired SHMO members. Variance predicted by enabling variables, especially site, was also particularly significant. This emphasizes the importance of including health plan and market factors in future modeling of service use. Other important findings were that low-income members were more likely to be placed in nursing homes and only about 65% of impaired members received any formal home care.
Increasing Community Capacity to Respond to Dementing Illnesses: Process Evaluation of the Community Outreach Education Program
Authors: Connell Cathleen M , Kole Sara L.
Published: June 2009

The goal of the Community Outreach Education Program(COEP) is to disseminate information about the diagnosis, assessment, management, and treatment of dementia to health care professionals, service providers, staff of community organizations and voluntary agencies, and family caregivers in four rural and two urban sites in Michigan. To accomplish this, outreach educational interventions based on a community-development model were developed in the Thumb Area, Upper Peninsula, Northeast Michigan, Mid-Michigan, Detroit, and Flint. The present study describes a process evaluation of the COEP in these six sites, using a multiple case study approach. Shared themes in the successful implementation of the on-site interventions and in creating community capacity across the varied sites are discussed.
The Relationship Between Reasons for Activity and Older Adult Well-Being
Authors: Everard Kelly M.
Published: June 2009

The purpose of this study was to determine the relationship between activity and older adult well-being by examining the reasons for older adult activity as moderators of the relationship. A sample of 249 older adults completed a questionnaire that contained demographic, health, and activity items. Participants indicated whether they engaged in each of 44 activities, how routinely they engaged in each, and the reasons for each activity. Results from hierarchical regression analyses showed that activities engaged in for social reasons positively related to wellbeing, and activities engaged in to pass the time negatively related to well-being. Total number of activities and the number of routine activities did not relate to well-being. These findings suggest that engaging in more activities does not necessarily enhance well-being, and that the reasons for engaging in activities are important for older adult well-being.
Prevalence and Correlates of Exercise Among Older Adults
Authors: Ruchlin Hirsch S. , Lachs Mark S.
Published: June 2009

A secondary analysis of data from the 1990 Health Promotion and Disease Prevention Supplement to the National Health Interview Survey was conducted to estimate the prevalence of exercise among adults aged 55 and older and identify correlates of exercise in this population. Walking and participation in other exercises were the exercise variables, and the explanatory variables included sociodemographic measures, self-reported health status and medical conditions, and health belief measures. For both exercise measures, physical activity declined with advanced age. Age, gender, education, and the health beliefs that smoking causes heart disease and cancer were the most important correlates of walking and playing sports. Additional interventions are needed to increase participation in regular walking, the most prevalent form of physical activity among older adults. In developing and testing these strategies, investigators should place emphasis on an approach that incorporates health education rather than simple prescriptive advice regarding regular exercise.
Surfing the Net in Later Life: A Review of the Literature and Pilot Study of Computer Use and Quality of Life
Authors: White Heidi , McConnell Eleanor , Clipp Elizabeth , Bynum Louise , Teague Carmen , Navas Luis , Craven Sara , Halbrecht Herbert
Published: June 2009

The Internet offers new opportunities for communication that can help older adults avoid social isolation. Although elders may need more time and assistance in learning computer systems, many are embracing this new technology. There is growing potential not only for recreation and communication through the Internet but also the delivery of services. This study examines the feasibility of providing Internet and electronic mail access to older adults in a retirement community and the extent to which this improves psychosocial well-being. In contrast to members of a comparison group, a trend toward decreased loneliness was observed among participants. In addition, the number of computer-related problems decreased and use of the applications increased throughout the study. These preliminary results support the feasibility of implementing computer-based interventions with the potential of improving psychosocial well-being among older adults.