bluuebunny/crossref_metadata_2025 huggingface dataset:
On a Circular Inclusion Embedded in an Infinite Matrix Subjected to a Point Load
Authors: Yi W. , Sanford R.J.
Published: March 2007

In this paper, an analytical solution for the two-dimensional mixed bound ary value problem of a circular inclusion is presented. The inclusion is embedded in an infinite medium and is subjected to a point force acting at the center of the inclusion. The inclusion/matrix interface is considered to be imperfect, across which the displacements may be discontinuous while the tractions remain continuous, as opposed to a perfectly bonded or smooth interface. The imperfect interface is modeled by a distribution of elastic springs, which transfer pressure directly but offer resistance to local extension and shear. For such an imperfect interface model, the basic principles of continuum mechanics re quire that the normal displacements be continuous at portions of the inclusion/matrix in terface where the corresponding normal tractions are compressive, so that no material penetration will occur. A dual series formulation is used in the present problem, and it leads to a weakly singular integral equation. The integral equation is solved numerically to obtain the stress distributions along the interface region.
Empowering “Professional” Relationships
Authors: lee Ashcraft Karen
Published: March 2007

This article revisits the relationship between feminist and bureaucratic organization. Much feminist critique has denounced bureaucratic impersonality and proposed the reunion of professional and personal. Yet, little is known of what happens when actual organization members merge “private” matters with “public” life. This article turns to feminist practice as a way to enhance feminist organization theory and, thus, to enrich organizational communication studies with pragmatic alternatives to gendered organization. The author reports an ethnographic study of one feminist organization’s efforts to personalize work relations, which ironically reproduced the division of public and private. The case challenges feminist assumptions about the role of emotionality and sexuality in empowering “professional” relationships and extends an alternative, provisional form of theorizing about feminist practice.
Becoming a Character for Commerce
Authors: Tracy Sarah J.
Published: March 2007

This study of cruise ship activities’ directors analyzes emotion labor, self-subordination, and discursive construction of identity in the context of a total institution. It opens with a review of social theories of emotion and emotion work and Foucauldian concepts of power and identity. The case, based on fieldnotes, documents, and interview data, analyzes (a) the arbitrary nature of emotion rules; (b) the dispersion of emotion control among supervisors, passengers, peers, and the self; (c) employee self-subordination and privatization of burnout; and (d) identity as coconstituted through resistance and consent to emotion labor norms. The article concludes with a discussion of theoretical and practical implications.
Communication Climate, Job Satisfaction, and Organizational Commitment
Authors: Trombetta John J. , Rogers Donald P.
Published: March 2007

This study attempted to investigate the effects of communication on organizational commitment (employee loyalty). Based on data from 521 nurses in four general care hospitals, the relationships among three communication variables, four demographic variables, job satisfaction, and organizational commitment were statistically analyzed. The results of the study suggest that communication does affect organizational commitment, that communication affects job satisfaction (employee morale), but that job satisfaction does not affect organizational commitment. A model of these relationships is proposed.
Account Episodes in Organizations
Authors: Braaten David O. , Cody Michael J. , DeTienne Kristen Bell
Published: March 2007

Two studies were conducted to examine the communication and evaluation of accounts in organizational settings. Study 1 involved a survey of employees at a financial institution who recalled and reported on recent account episodes. Results supported Schonbach's theory of conflict escalation: Aggravating forms of reproaches elicited aggravating forms of accounts, as well as aggravating forms of evaluation. Mitigating forms of accounts were honored more frequently than aggravating accounts, but specific subcategories were significantly more effective than others. Both form of reproach and type of evaluation were significantly related to anger, stress, dissatisfaction, and complaints. Study 2 focused attention on the impression management function served by account giving. Some forms of accounts (i.e., excuses) were effective in exonerating the account-giver of blame but entailed negative consequences concerning the account-giver's image.
The Gap in Total Quality
Authors: Fairhurst Gail T. , Wendt Ronald F.
Published: March 2007

Using the routine work conversations from Fairhurst, an analysis of the jargon and themes of the total quality (TQ) and high commitment work systems (HCWS) visions was conducted. The juxtaposition of the linguistic references of both visions revealed a gap in TQ. In this commentary, we explore the implications of this gap and how it may be related to organizational change.
Information System Training, Usage, and Satisfaction
Authors: Gardner William L. , Gundersen David E.
Published: March 2007

This study used a mail survey to explore the extent to which the hospitality industry employs various information technologies, including computer-mediated communication systems. In addition, we examined the relationships between users' perceptions of computer training and their reported satisfaction and usage of specific computerized information systems. The results indicate that: (1) hotel/motel size and chain-affiliation are related to information system complexity; (2) chain-affiliated hotels/motels provide less computer training, and less “in-house” training, than independents; (3) more training is reportedly provided for electronic cash registers than personal computers; (4) information system complexity is positively related to user satisfaction; (5) computer training is associated with higher levels of system usage and user satisfaction; and (6) user expertise is strongly related to system usage. Finally, we consider directions for future research and the implications of these findings for managers in the hospitality industry and beyond.
Organizational and Professional Identification
Authors: Russo Tracy Callaway
Published: March 2007

This study examined organizational and professional identification among a group of professional employees-the journalists at one daily metropolitan newspaper. It used two kinds of data to compare identification with these two targets and, further, to examine the relationships between identifications, autonomy, and job satisfaction. Survey results revealed significantly higher identification with the profession of journalism than with the journalists' employing newspaper. Journalists' accounts in individual interviews and the researcher's observation of on-the-job talk provided the context for interpreting the quantitative results. Accounts and observations contributed explanations for the blurred boundaries between the targets found in the survey results. In addition, the qualitative data demonstrated the role of anticipatory and vocational socialization and work group demographics in the identifications of this group.
Neuman's Framework and Ventilator Dependency: A Pilot Study
Authors: Lowry Lois W. , Anderson Beth
Published: March 2007

The purpose of this article is to illustrate how the Neuman systems model guided a pilot study with ventilator-dependent patients. Mechanical ventilation was the external stressor to which these subjects reacted. The interaction of Neuman's client system variables was investigated to see which variables most influenced the weaning process. The pilot served to link model concepts with research variables and to identify appropriate procedures and tools for data collection.
Quality of Life and Goal Attainment
Authors: King Imogene M.
Published: March 2007

King's conceptual framework of three dynamic interacting systems (personal, interpersonal, social) provides a structure for observing the interacting elements that enhance or impinge on quality of life. Interactions and transactions with the nurse lead to goal-setting for individuals, families, and society. Goal-setting usually leads to goal attainment, which produces satisfaction with self and improves one's ability to achieve future success. The goal of King's theory (which is derived from her conceptual system) is health for individuals, groups, and society. This article explores the use of King's theory of goal attainment in maintaining and promoting health, which influences quality of life.
Two Views of Homeless Children's Art: Psychoanalysis and Parse's Human Becoming Theory
Authors: Baumann Steven L.
Published: March 2007

In the past decade there has been a dramatic rise in the number of children living in shelters in the United States. The traditional literature suggests that these children are at risk for various developmental, educational, and health problems, and that they are in need of assistance. Psychoanalytic theory and Parse's human becoming theory have fundamentally different views of human nature and of human activities such as artistic expression. While both theories can contribute to the present understanding of the experience of children in shelters and provide frameworks for a shelter-based nursing practice, it is suggested in this article that psychoanalytic theory is reductionistic and prescriptive and may close rather than open new possibilities.
Power and Spirituality in Polio Survivors: A Study Based on Rogers' Science
Authors: Smith Dorothy Woods
Published: March 2007

Rogers' model was used to study patterns of power and spirituality in polio survivors (n = 172) and people who have not had polio (n = 80). Participants completed the Power as Knowing Participation in Change Test and the Spiritual Orientation Inventory. Power was positively related to spirituality (r = .34, p < .005). Polio survivors manifested the same power (t = .44, df = 250, p = .33) and greater spirituality than people who had not experienced polio (t = 3.79, df = 250, p < .001), indicating that patterns of human field change are related to surviving polio. Recommendations include replicating this study with other populations and continuing to develop a theory of spirituality within Rogers' framework.
Hermeneutics: Philosophical Traditions and Nursing Practice Research
Authors: Allen David G.
Published: March 2007

This analysis begins with the premise that nursing practice research has often ignored or suppressed the fact that nurses participate in and benefit from the same American illness care nonsystem that leaves 40 million citizens without health care. This collective denial has its historical roots in philosophic foundationalism, health care authoritarianism, and nursing's disciplinary isolation. Philosophical hermeneutics offers perspectives that emphasize the inescapability of nursing's history. This article traces some of the main themes in philosophical hermeneutics and their potential significance for nursing practice research. The relationship between hermeneutic philosophy and research methods employed in interpretive traditions (for example, grounded theory) and the role of experimental design in addressing hermeneutic questions are discussed.
Nursing: The Ontology of the Discipline
Authors: Reed Pamela G.
Published: March 2007

The purpose of this article is to contribute to clarifying the ontology of the discipline by extending existing meanings of the term nursing to propose a substantive definition. In this definition, nursing is viewed as an inherent human process of well-being, manifested by complexity and integration in human systems. The nature of this process and theoretical implications of the new nursing are presented. Nurses are invited to continue the dialogue about the meaning of the term and explore the implications of nursing, substantively defined, for their practice and science.
Application of King's Theory of Goal Attainment and the Carondelet St. Mary's Case Management Model
Authors: Tritsch Joy M.
Published: March 2007

The promulgation of managed care has become the catalyst for nursing leaders to creatively develop new approaches for the effective and efficient utilization of resources. The transition into a capitated environment has heightened the need for theory-based practice to new levels. The application of King's theory of goal attainment and the Carondelet St. Mary's case management model offers hope for a practical approach to the actualization of discipline development.
The Construct of Thriving in Pregnancy and Postpartum
Authors: Walker Lorraine O. , Grobe Susan J.
Published: March 2007

This article explores the construct of thriving as an integration of nutritional (manifested in weight), psychosocial, and lifestyle concerns of childbearing within the context of Orem’s self-care deficit theory. Provisional definitions of thriving in pregnancy and postpartum are proposed. Preliminary dimensions of thriving in postpartum are based on factor analysis of weight, lifestyle, and psychosocial data from 145 women after childbirth. Four dimensions emerged: psychosocial distress, lifestyle patterns, a weight factor, and a body image factor. Although the dimensionality of postpartal thriving reported is preliminary, it provides a beginning foundation for assessment and intervention for postpartal women.
Mapping the Road toward Bethlehem: Parameters for Discourse on the Relationship between Religion and Public Education
Authors: Mwlligan Jeffrey Ayala
Published: March 2007

This article argues that the relationship between religion and secular education in the United States can and must be renegotiated if public education is to survive challenges to its existence from conservative religious communities. Taking as its premise that such a renegotiation is constitutionally permissible, it examines several challenges any such effort must face and suggests six necessary, though not necessarily sufficient, criteria which ought to guide conversations aimed at rethinking this relationship in a multicultural democracy.
The Changing Role of Interest Groups in Education: Nationalization and the New Politics of Education Productivity
Authors: Cibulka James G.
Published: March 2007

The politics of education in the United States has changed in recent decades from one approximating professionally dominated subgovernments to issue networks, which are characterized by more ideational, macropolitical interest groups as well as shifting and unstable coalitions. This transformation is caused, first, by the growth of national discourse and federal power The two often go hand in hand but are not synonymous, and nationalizing influences have expanded despite unresolved debate about the federal role in education. Other courses include the intensified debate, divergent demands for reform of public schools, and the expanding role of the political right. The new politics of education productivity has reshaped the way discourse on education policy is conducted and the perceptions of common interests. Despite nationalizing trends in setting policy agendas, implementation of reforms is dominated by local politics, where micropolitical interests often frustrate reformers. This tension is built into our political system.
Micropolitical Dynamics of Education Interests: A View From Within
Authors: Johnson Bob L.
Published: March 2007

Using concepts and frameworks from political science and organizational theory, this article examines a set of defining micropolitical issues associated with education interest groups: the politics of group formation and maintenance, the politics of group governance, role and subunit politics, and the politics of ideology. Little conceptual and empirical research on the micropolitical dynamics of education interest groups can be found in the politics of education literature. This article provides a context for understanding the micropolitical dynamics of educational interests and seeks to encourage research in this area.
Implementing Site-Managed Educational Changes: Examining Levels of Implementation and Effect
Authors: Heck Ronald H. , Brandon Paul R. , Wang Jonathan
Published: March 2007

Although states have attempted to influence educational outcomes through decentralizing decision-making authority over the past decade, the evidence that such reforms encourage schools to implement programs that improve outcomes has been slow to accumulate. This study examines the effect of a statewide policy intended to raise student achievement in schools serving high numbers of at-risk students through emphasizing teacher participation in school-based decision making about school needs. The results indicated that the policy was successful in encouraging teacher participation in decisions about student needs and the selection of improvement activities. Subsequently, features of the participating schools' environments and teachers' beliefs about the value of chosen improvement activities combined to produce successful site implementation. Some evidence also suggested the policy led to improved student reading achievement in the early elementary grades among schools that had participated in the program over several years.
The Ethics of Democracy: Individuality and Educational Policy
Authors: AlemáN Ana M. MartíNez
Published: March 2007

The author revisits earlier discussions of the importance of the development of the individual for a democratic society, looking in particular at the "pragmatic utopianism" of John Dewey. The article proceeds from a view of personal growth, subjectivity, and communal relations that challenges the class stratification brought about by capitalist forces that serve to undermine an individual's democratic agency. The author explores the role and function of the individual in educational policy in the hope that such an examination will broaden theories and analyses of the role of class in educational policy.
The Educational Outcomes of Hispanics and Non-Hispanics in Arizona: Implications for National and State Policy Makers
Authors: Gonzalez Arturo , De La Torre Adela
Published: March 2007

The majority of the literature dealing with Hispanic and immigrant education focuses primarily on large states to the detriment of other states, such as Arizona. Using the 1990 5% Census Public Use Microdata Sample file for Arizona, this study estimates the role of ethnicity and immigration at different education levels after controlling for individual and household variables. The study also links state fiscal revenue to a high school diploma, arguing that policy makers have this economic incentive to increase high school graduation rates. The study’s findings argue for a reconsideration of funding priorities to shore up the weakest points in the education pipeline.
The Cleveland Collaborative and the Pursuit of Mathematics Curriculum Reform
Authors: Bruckerhoff Charles E.
Published: March 2007

The main effect of the Cleveland (Ohio) Collaborative for Mathematics Education has been to rejuvenate the teachers. They have benefited not only from the opportunity to join other professionals in a decision-making process, but from the regular association with other mathematics teachers in the district, which has led to productive forms of collegiality. Despite these gains, curriculum and instruction for mathematics remains under the heavy influence of systematic programming, traditional conceptions of teaching and learning, and serious attendance problems. This article argues that the Collaborative must next work to effect a shift from system wide programming to classroom teacher decision making.
Before and after School Desegregation: African-American Parents' Involvement in Schools
Authors: Edwards Patricia A.
Published: March 2007

In this article, the author summarizes three generations of desegregation efforts since the Brown decision, with the intent to highlight parent voices. The author puts forth arguments that researchers and policymakers should turn their attention to the importance of broader sociocultural facets of desegregation. The author provides recollections from her mother, elementary school principal, and first-grade teacher showing that African-American parents did not have to be formally invited to participate in their children's education before school desegregation. The author also gives her own recollections of PTA meetings, fundraising activities, social gatherings, and visits to her classroom by her mother. She describes the efforts since desegregation to invite African-American parents to become involved in school affairs. She suggests that educators must examine whether African-American parents feel invited or uninvited.
Systemic Reform, Equity, and School Finance Reform: Essential Policy Linkages
Authors: Hirth Marilyn A.
Published: March 2007

There is an unquestionable connection between systemic reform, equity, and school finance reform that requires the attention of educators and policymakers at all levels of government. Instead of disconnected reform initiatives prevalent in the 1980s, the 1990s is the beginning of a new era of educational reform that strives for coordination, integration, and cohesion around a clear set of outcomes. Within this framework of systemic reform, it is essential that policies leading the efforts be coordinated with school finance reforms that foster equity. This article analyzes the factors that must be considered when forging these linkages. The concepts of equity and adequacy are discussed along with their relationship to school finance litigation. Examples of linkages between systemic reform and school finance reform are examined. A policy linkage model is proposed that illustrates the connections between the policy-making bodies, systemic reform initiatives, and the various components of school finance reform. General recommendations for policymakers to consider when fostering reform initiatives are suggested.
Can the Odds Be Changed?
Authors: Meier Deborah Willen
Published: March 2007

There are plenty of examples of small, self-governing schools of choice that successfully serve high-risk students in both the public and the private sector If we pose the problem differently, their examples can offer systemic solutions. To do so we need to rethink how public institutions are held accountable. We need, for example, to rely on instruments of accountability that are consistent with our ends: increasing the intelligent and responsible behavior of the people closest to (and including) the learners. In New York City, an experiment in developing such a systemic alternative is currently under way with support from the Annenberg Foundation. Unless we find a way to match what we know works on a small scale with what we do on a large scale, we are likely to end up concluding that public education itself is the culprit.
Editors' Introduction to the Politics of Accountability: Challenges in Retrospect
Authors: Macpherson Reynold J. S. , Cibulka James G. , Monk David H. , Wong Kenneth K.
Published: March 2007

This collection reports the outcomes of an international policy research project from 1994 to 1997 that was concerned with how power is being used in education to construct and discharge obligations between stakeholders, and to suggest how such processes might better serve educational ends. Research was commissioned and gathered that examined how the politics of education at site and systemic levels have been contributing to the reconstruction of accountability policies in an international policy context, a context characterised by conceptual disarray, multiple reform strategies, blunt administrative instruments, and plural political cultures. The primary finding of the project is that a responsible politics of accountability are needed at all levels to reconnect the processes and criteria of accountability to learning, teaching, leading, and governing. Such educative politics can both bestow legitimacy and generate improvement.
Solutions in Search of Educational Problems: Speaking for Computers in Schools
Authors: Bigum Chris
Published: March 2007

Computer use in schools is framed by the beliefs of users about computers and schooling. These beliefs are reflected in the day-to-day practices in schools and derive from local experience, policy, opinion, and debates about computers, schools, and education. Many discourses that frame computer use in schools are based on a distinction between the human and nonhuman elements of computer use. Each of these discourses attributes essential properties to the computer, thereby broadly determining the role of the computer and consequently of the teacher and learner Actor network theory avoids the human-nonhuman dualism and makes explicit the negotiations and alliances that are employed in particular settings that give rise to particular groups speaking on behalf of computers in schools and provides a basis for moving from essentialist frameworks toward new possibilities for computers and schools.
Pharmacists Strive to Promote the Safe and Appropriate Use of Medications: A Commentary on Eckerd's Patient Care™ Program
Authors: Lampe-Izaguirre Tina
Published: March 2007

In the current health care arena, patients have a multitude of prescription, over-the-counter, herbal, natural, and nutritional products available to them. A common perception among the public at large is that any medication that does not require a prescription is safe to take. This simply is not the whole truth. Eckerd pharmacists play an important role in preventing accidental poisoning through monitoring of patient use of, and addressing patient inquiries about, any medication-related products.
A Practical Guide to Drug Product Selection: Getting to Know the Food and Drug Administration's (FDA's) Approved Drug Products List (Orange Book) With Therapeutic Equivalence Evaluations
Authors: Rosen David L.
Published: March 2007

This article provides pharmacists and other health professionals with a practical guide to using FDA's Orange Book, the authoritative source for FDA approved products and their respective therapeutic equivalence ratings. Copyright © 1995 by W.B. Saunders Company
The Age of Atypical Antipsychotics
Authors: Pies Ronald
Published: March 2007

Atypical antipsychotics (AAPs) have led to refinements in the pharmacological management of schizophrenia and related disorders. Most AAPs produce fewer extra- pyramidal side effects than conventional agents, and appear to ameliorate "negative symptoms" to a greater degree. In general, many AAPs have a higher ratio of 5HT2 to D2 receptor occupancy than do conventional neuroleptics. This ratio may confer some of the "atypical" qualities to these agents, though regional brain selectivity may also be involved. Although clozapine and risperidone are the two AAPs clinicians now have available, many other similar agents are close to clinical development. Copyright © 1996 by W.B. Saunders Company
The Effects of a Short-Term Exercise Program on Movement, Pain, and Mood in the Elderly
Authors: Ross M. Candice , Bohannon Alice S. , Davis Debra C. , Gurchiek Larry
Published: March 2007

Therapeutic effects of a short-term Tai Chi exercise program for the elderly were evaluated in a pretest-posttest quasi-experimental design. This pilot study evaluated changes in flexibility, balance, sway, pain, and mood after a short slow-motion exercise. The program consisted of a series of movements involving turning, shifting weight, bending, and arm movements in combination with diaphragmatic breathing with slow movements. The measured effects included improved balance, sway, range of motion, decreased perceived pain, and lessened trait anxiety. Participants included 11 elderly females. Instruments consisted of standard goniometry, the Multiple Affect Adjective Check List, stopwatch measures of single-leg stance and a tandem walk (sway), and visual analog measurement of pain. Findings included significant improvement (p = .05) in trait anxiety and pain perception. Improvements in mood, flexibility, and balance may have a profound effect on the incidence of falls, injuries, resulting disability, and overall quality of life.
Holistic Interventions for Acute Pain Episodes
Authors: Cole Barbara H. , Brunk Quincealea
Published: March 2007

Pain is a universal experience that lends itself to nursing interventions based on a holistic approach. Pain is a dynamic process, and relaxation techniques are based on the recognition of the interaction between the physiological and psychological components of the human body. Although acute episodes of pain are found in all areas of nursing practice, limited research using relaxation techniques as supplements to pharmacologic intervention has been reported. This article reviews six research studies that have implications for holistic interventions in nursing practice. Theoretical bases, findings, and discussion of relevance for holistic nursing practice are presented as well as recommendations for future research in the area of relaxation technique use during episodes of acute pain.
Effects of Caregiving, Gender, and Race on the Health, Mutuality, and Social Supports of Older Couples
Authors: Wallsten Sharon S.
Published: March 2007

Objectives:The purpose of this article is to report caregiving, gender, and race effects on the physical health, social supports, and mutuality of older couples. Methods:The study involves cross-sectional results from a longitudinal study of 234 older couples, 118 in caregiving situations and 116 comparison couples. Spouses were interviewed in their homes. Results:Spousal older caregivers are in poorer physical health than noncaregivers but have no greater numbers of social supports to help them in the caregiving role. Also, African Americans are in poorer physical heath than Caucasians; yet, as caregivers, they have no greater numbers of social supports than Caucasian caregivers. Although females have more social supports than males, female caregivers have more negative feelings about their husbands than male caregivers have about their wives. Discussion:Males and African Americans are in potentially more severe caregiving situations than their female and Caucasian counterparts. Results of this study are compared to Wallsten (1999), which found that African Americans and males had more favorable psychological indicators of stress. The two studies complement each other but open the question of response bias as a factor.
Access to Community-Based Long-Term Care
Authors: Miller Nancy A. , Harrington Charlene , Goldstein Elizabeth
Published: March 2007

Objective:The authors explore state variation in expenditures for Medicaid communitybased care services for the period 1990 to 1997. Method:A random effects panel model is used to explore the relationship between state demographic, supply, economic, programmatic, and political factors and states’ Medicaid community-based care expenditures. Results:Although states increased provision of services over the study period, significant state-level variation was evident. Expenditures were positively associated with state per capita income, regulation of nursing home bed supply, and the number of Medicare home health users but were negatively related to nursing home bed supply. Conclusions:Recent legal rulings, combined with the demonstrated preferences of most individuals to receive care in the community, require policies to foster the expansion of Medicaid community-based care. The most consistent relationships that are amenable to policy intervention relate to state fiscal resources and long-term care supply regulation.
Retirement and Mental Health
Authors: Drentea Patricia
Published: March 2007

Objectives: This research examines whether retirement is associated with mental health and how one’s daily pursuits mediate this association. It tests two perspectives from the sociology of work and the sociology of mental health. Methods:Using data from two surveys, the 1995 Aging, Status, and Sense of Control and the 1987-1988 National Survey of Families and Households, regression analysis was used to examine retirement, activities, and well-being. Results:In support of the view that work is alienating and retirement liberating, retirees experienced less anxiety and distress and higher positive affect. Retirees’ lower anxiety and distress were explained by activity characteristics. In support of the viewthatwork is empowering and retirement demoralizing, retirement is associated with lower sense of control in both data sets, in part because of the daily pursuits. Retirement was not associated with depressive symptomatology. Discussion:Suggestions for creating opportunities that enhance well-being are discussed.
Health and Helping among the Elderly
Authors: Chappell Neena L.
Published: March 2007

This article compares helping networks of men and women for four different illness situations among a random sample of elderly individuals aged 60 and over living in an urban center on the Canadian Prairies (N = 743). Helping networks vary depending on the illness situation. Gender differences are also evident in helping networks, reflecting gender differences in overall interaction patterns. Men are more likely to receive assistance from spouses, and women are more likely to receive assistance from nonspousal others, even when taking availability into account. These gender differences in helping networks are evident for less serious illness situations, such as potential availability during health emergencies and assistance with common ailments. For more serious illness situations (serious conditions and functional disability), many of these gender differences disappear. That is, in the face of serious health threats differential societal expectations for men and women dissipate.
Changes in Prevalence of Depressive Symptoms in Alameda County
Authors: Roberts Robert E. , Lee Eun Sul , Roberts Catherine Ramsay
Published: March 2007

Trends in depression are examined using data from the Alameda County Study, a three-wave, prospective community survey covering an 18-year period (1965-1974-1983). Age-period-cohort effects in rates of depressive symptoms were analyzed using logistic regression procedures to adjust for attrition due to loss-to-follow-up and nonresponse. The results indicate the presence of all three effects. There was a marked period effect, with rates in 1974 significantly higher than in either 1965 or 1983. There also was a definite cohort effect, with older cohorts exhibiting higher rates of depressive symptoms than younger cohorts. These findings do not provide support for an "age of melancholia" nor for an increasing cohort effect in succeeding generations. These prospective data on depressive symptoms are contrasted with those from studies that use cross-sectional data to estimate temporal trends in clinical depression, employing retrospective reports of lifetime prevalence and discussing possible reasons for the disparate findings.
Heart Disease Risk Factors as Determinants of Dependency and Death in an Older Cohort
Authors: Barrett-Connor Elizabeth , Wingard Deborah L.
Published: March 2007

Rates of death and dependency were determined for 621 men and women aged 65 years or more, living in an upper-middle-class community in Southern California. Between 1972 and 1986, 44% of the men and 27% of the women died; as expected, mortality rates increased with age and were higher in men than women at all ages. Dependency, defined as service use (institutional or community based), also increased with age but differed little by sex (56% of men and 53% of women). In multivariate analysis, predictors of death and dependency were age, presence of chronic disease and (in women) lack of siblings. After exclusion of those with chronic disease, obesity, marriage, and alcohol use were also associated with reduced risk in men (although the association with alcohol use was not significant). Only 29% of men and 14% of women died without some period of dependency. This dependency was most common in the year before death; less than 20% were dependent for 2 or more years prior to death. Dependency before death increased with age in men but not in women.
Illness Episodes, Physician Visits, and Depressive Symptoms
Authors: Berkanovic Emil , Hurwicz Margo-Lea
Published: March 2007

Although there is a large literature examining the effects of distress on the demand for medical care, the data on which this literature is based are equivocal. Nonetheless, this literature is cited frequently by those who advocate a national mental health policy designed to produce a cost-effective "medical offset effect." In this study, longitudinal data on illness episodes, physician visits, and depressive symptoms were collected from 940 Medicare recipients enrolled in a health maintenance organization (HMO) under a Tax Equity and Fiscal Responsibility Act (TEFRA) contract. Seven waves of interviews were conducted over a period of 1 year. This article presents two sets of analyses. In the first, controlling for chronic conditions and demographics reported at baseline, the relationships between depressive symptoms reported at baseline, and all illness episodes and physician visits that occurred over the subsequent year are examined. In the second, controlling for depressive symptoms and demographics reported at baseline, the relationships between illness episodes and physician visits over the study year, and depressive symptoms recorded at the final interview are examined. The data indicate that, whereas depressive symptoms at baseline are virtually unrelated to subsequent illness episodes and physician visits, illness episodes and physician visits are related to subsequent depressive symptoms. These data indicate, therefore, that policies aimed at diverting the distressed from seeking medical care may result in further inequities in the receipt of needed care.
Mammography-Related Beliefs of Older Women
Authors: King Eunice , Rimer Barbara K. , Balshem Andrew , Ross Eric , Seay Janet
Published: March 2007

Although breast cancer risk increases with age, most studies show that mammography use decreases. A 15-minute telephone survey of 548 women health maintenance organization (HMO) members aged 65 to 74 who had not obtained a mammogram within the past year was undertaken to identify sociodemographic factors as well as knowledge, belief, and attitudinal characteristics associated with mammography history. Women who had never had a mammogram were less likely to have received a physician's recommendation and more likely to express negative attitudes about mammography, such as having a mammogram means "looking for trouble" and "makes me nervous." In addition, they expressed doubts about their need to have a mammogram and reported that "other problems" prevented them from having a mammogram. These results suggest that women who have never had a mammogram may require more intensive interventions to encourage them to obtain mammograms. In addition to receiving a mammography recommendation from their physicians, they might benefit from individual or small group educational sessions where negative attitudes about mammography could be explored and modified.
Two Shorter Forms of the CES-D Depression Symptoms Index
Authors: Kohout Frank J. , Berkman Lisa F. , Evans Denis A. , Cornoni-Huntley Joan
Published: March 2007

Brief measurement devices can alleviate respondent burden and lower refusal rates in surveys. This article reports on a field test of two shorter forms of the Center for Epidemiological Studies Depression (CES-D) symptoms index in a multisite survey of persons 65 and older. Factor analyses demonstrate that the briefer forms tap the same symptom dimensions as does the original CES-D, and reliability statistics indicate that they sacrifice little precision. Simple transformations are presented to show how scores from the briefer forms can be compared to those of the original.
Failure to have Prescriptions Filled among Black Elderly
Authors: Bazargan Mohsen , Barbre Ann R. , Hamm Verneda
Published: March 2007

Despite extensive research on drug consumption and compliance with drug regimens within the geriatric population, little attention has been given to the failure to have prescriptions filled among elderly in general and Black elderly in particular. The prevalence and correlates of patients' failure to have prescriptions filled were investigated for a sample of 571 Black elderly. In terms of prevalence, 12.8% of this sample asserted that they had received a prescription from a physician and not had it filled during the 6 months period prior to interview. Multivariate logistic regression was employed to detect the significant predictors of this type of noncompliance. According to our data, failure to have prescriptions filled was significantly greater among Black elderly with higher levels of anxiety, those with lower levels of internal health locus of control, those who did not have prescription medication coverage through Medic-aid, those who were currently using prescription medications, those who consumed greater numbers of over-the-counter medications, and those who reported more financial problems. Implications of these findings are discussed.
Functional Ability in the Oldest Old
Authors: Camacho Terry C. , Strawbridge William J. , Cohen Richard D. , Kaplan George A.
Published: March 2007

The authors studied the relationships between physical functioning and cumulative measures of behavioral and psychosocial risk factors collected over two decades for 91 persons 80 years old and older at follow-up. They found that consistency of physical activity and absence of depression were associated with better functioning as were race (non-Blacks), education, and marital status. A health practices index that combined consistency of moderate alcohol use, moderate weight, and physical activity was also associated with better functioning. Controlling for the persistence of chronic conditions generally reduced but did not eliminate the observed relationships. The association between social contacts and functioning became stronger in the presence of controls. Risk factors after age 60 appear to influence physical functioning for those who survive into their 80s and consistency appears to make a difference.
Older Floridians' Attitudes toward and Use of Dental Care
Authors: Gilbert Gregg H. , Duncan R. Paul , Crandall Lee A. , Heft Marc W.
Published: March 2007

Older Floridians (mean age 78 years) were interviewed regarding their use of dental care, attitudes toward dental care, and other characteristics hypothesized as being explanatory of dental care use. Fifty-two percent of respondents reported having been to a dentist within the past year, and 31% had not been within the previous 5 years. Five constructs measured attitudes toward dental care and dental health: (a) the importance placed on regular dental care and oral hygiene, (b) the importance of avoiding tobacco to prevent oral cancer, (c) the value of dental care, (d) negative aspects of dental care, and (e) satisfaction with the last dental visit. In a multivariate model, the value of dental care and importance of regular care and oral hygiene were significantly correlated with dental care use. These findings are consistent with the conclusion that attitudes contribute to understanding dental care use in later life, a contribution that is independent of the direct effects of socioeconomic status and dentate status.
Moderating Effects of Prior Social Resources on the Hospitalizations of Elders who Become Widowed
Authors: Feld Sheila , George Linda K.
Published: March 2007

In a prospective design, the effects of social resources before widowhood on changes in subsequent hospitalizations were compared for 86 married elders who became widowed over a 2-year period and 86 matched elders who remained married. Subjects were from the Established Populations for Epidemiologic Studies of the Elderly (Duke). Hospitalizations were used as an indicator of a serious health outcome whose report was unlikely to be biased by a widowed person's emotional state. The hypothesis that perceptions of inadequate social support from persons other than the spouse would exacerbate the effects of bereavement on hospitalizations was supported for elders who lacked close friends with whom to talk about private matters while still married; believing that no relative would provide such support and dissatisfaction with support tended to have the same effect. Inadequacies in social embeddedness (few contacts with friends, relatives, or children and being childless) had no significant moderating or main effects on change in hospitalizations.
Attitudes toward Age-Based Health Care Rationing
Authors: Kuder Linda Brasfield , Roeder Phillip W.
Published: March 2007

This study is designed to contribute to recent efforts to assess public views on age-based rationing of health care by reporting findings from a qualitative research project using focus group interviews. Group interviews find that respondents are concerned about the high costs of health care, but few attribute these costs to overuse by older people. Respondents reject the notion of specific policies limiting health care based on the age of the patient. Respondents of all ages tend to reject the idea of paying for treatment to extend the life of the hopelessly ill when all beneficial treatment efforts have been attempted. Although expressing strong feelings about equality of opportunity for health care, respondents are ambivalent about the role that government should play to accomplish this goal. Differences in attitudes toward allocation of health care appear to be associated more with differences in socioeconomic status and political orientation than with differences in age of respondents.
Are Educational Differentials in Adult Mortality Increasing in the United States?
Authors: Preston Samuel H. , Elo Irma T.
Published: March 2007

Two recent studies have compared the size of educational mortality differentials among adults in the 1980s to estimates for 1960. Both studies have concluded that educational differentials have increased for males. One study finds a similar increase for females. We reconsider this question by introducing a data source that is better suited to estimating recent differentials than either of the two that have been employed. We also evaluate the quality of the 1960 baseline estimates and introduce broader measures of inequality. We conclude that educational inequalities have widened for males but contracted for working-age females. For both sexes, inequality trends are more adverse for persons aged 65+ than for persons aged 25-64. The role of national health insurance in shaping these trends is briefly considered.
Stress in the Life Course
Authors: Ensel Walter M. , Peek M. Kristen , Lin Nan , Lai Gina
Published: March 2007

This article examines the relationship between stress and distress in the life course, emphasizing the time elapsed between the event and measurement of psychological distress. Stressors are conceptualized as either distal or proximal based on how recently they occurred. Distal stressors are further classified as status changes or undesirable life changes. Using a life history calendar approach, we examine stressors occurring over a 15-year period. We explore whether distal stressors affect current depressive symptomatology above and beyond the effect of more recent stressors and how these stressors vary in frequency and effect over 3 empirically defined age groups. While some events decrease in frequency over age, others occur consistently across age groups. Most important, distal stressors significantly impact current depressive symptomatology, independent of proximal stressors. Types of distal stressors affecting depression vary over age, indicating that the stage of life at which a stressor occurs is a significant determinant of the stressor's effect on depression.