bluuebunny/crossref_metadata_2025 huggingface dataset:
King's Theory in Practice with Elders
Authors: Woods Elaine C.
Published: March 2007

This article discusses the utilization of Imogene M. King's (1981) theory of goal attainment with a group of elderly clients who were living in a nursing home and experiencing many of the chronic health problems frequently associated with advanced age. Group members met weekly for 10 weeks to explore methods to promote continuous health restoration. Application of King's theory of goal attainment, utilizing interactions, transactions, perceptions, and expressions of self, facilitated mutual nurse-client goal identification and achievement.
Quality of Life for Persons Living with Alzheimer's Disease: The Human Becoming Perspective
Authors: Parse Rosemarie Rizzo
Published: March 2007

The purpose of this research was to ascertain the meaning of quality of life for persons living with Alzheimer's disease. The human becoming theory was the nursing perspective for this descriptive-exploratory study in which 25 people, designated as having mild to moderate Alzheimer's disease, were asked to describe their quality of life. Findings showed that quality for these participants is a contentment with the remembered and now affiliations that arises amidst the tedium of the commonplace, as an easy-uneasy flow of transfiguring surfaces with liberating possibilities and confining constraints, while desiring cherished intimacies yields with inevitable distancing in the vicissitudes of life, as contemplating the ambiguity of the possibles emerges with yearning for successes in the moment.Implications for further research and practice are also discussed.
Methodological Ponderings Related to the Power as Knowing Participation in Change Tool
Authors: Barrett Elizabeth Ann Manhart , Caroselli Cynthia
Published: March 2007

Based on 15 years of research using the Power as Knowing Participation in Change Tool, the authors summarize tool development, including reliability and validity, and discuss specific methodological issues and insights. These include clarity of instructions and complexity of language used in the PKPCT along with response set, norms, and sensitivity of the instrument to detect differences between groups. Problems of linear measurement are discussed along with the appropriateness of both qualitative and quantitative methods of studying power from the view of the science of unitary human beings. Recommendations for further psychometric studies of power are proposed.
Adequacy and Allocation within Higher Education: Funding the Work of Education Schools
Authors: Howard Richard D. , Hitz Randy , Baker Larry J.
Published: March 2007

The perception held by many teacher educators is that the commitment by colleges and universities to education programs is weak and funding for education lags far behind that of other disciplines. This perception was validated by a national study in which expenditure data for education programs were compared to those of other academic disciplines. The results of the study are presented in this article, followed by a discussion of the role a strong national accrediting body could play in support of stronger funding for teacher education programs.
Educational Politics from Below
Authors: Apple Michael W.
Published: March 2007

With this issue, we are pleased to inaugurate a new feature in Educational Policy. Michael W Apple, John Bascom Professor of Education at the University of Wisconsin-Madison and a member of our advisory editorial board since the journal's beginning 13 years ago, will regularly write an essay on significant new books or documents that deserve critical attention. "Reviewing Policy"will go beyond the book review format to provide a stimulating look at current scholarship and policy. All too often, the justifiable demands on policy makers and researchers to engage in action immediately keep people from taking the time to reflect on the ethical, political, and educational implications of specific policies and practices. One of the aims of "Reviewing Policy " will be to engage in exactly that kind of critical reflection. There is no one who can provide a better critical perspective than Michael Apple. He is one of the pioneers of the critical pedagogy movement and has worked for more than three decades to provide a constructive yet critical examination of policy and practice in education.
Illuminating the Impact of State Educational Policy Promoting School Reform on Curriculum and Instruction in Programs of Urban Teacher Preparation
Authors: Weiner Lois , Rand Muriel , Pagano Alicia , Obi Roselynn , Hall Althea , Bloom Arlene
Published: March 2007

Using their experiences as teacher educators as a starting point, the authors identify and describe the most salient manifestations of state policy in their work with prospective urban teachers. Analysis of six vignettes demonstrates how experiences of teacher educators might be interpreted to support commonly accepted tenets of systemic reform: for instance, alignment of institutional mandates. However, another reading of the narratives demonstrates that systemic reform as it has become operationalized adversely affects urban teacher preparation in several important areas because the centrality of teachers 'thinking and beliefs is ignored, and power differentials among education 's constituencies have been reinforced.
Educational Indicators and Enlightened Policy
Authors: Darling-Hammond Linda
Published: March 2007

This article examines how educational indicators have been and may be used to serve educational policy ends, what the potential benefits and dangers are of various uses, and how guidelines for appropriate relationships between indicators and policy might be forged. The article draws particular attention to recent debates and difficulties in fashioning a constructive role for educational indicators—a role that illuminates educational issues without distorting the educational process or harming students and schools by misusing indicator data. It argues that efforts to try to use indicators as administrative controls or policy levers are misguided. Instead, if they are to support student learning and school improvement, indicator systems should be developed to illuminate educational activities and processes as the basis for reflective policy-making.
The Recentralization of School Districts
Authors: Brown Daniel J.
Published: March 2007

The prospect is advanced that school districts which are introducing school-based management now may recentralize their decision-making authority later A study of five decentralized districts revealed many reasons why recentralization could occur. An important distinction between two kinds of decentralization was made: one organizational (in which decisions are delegated),the other political (in which authority is given fully to autonomous groups).Structural reasons for recentralization included lack of provision for accountability, lack of evidence of effectiveness, and the advent of retrenchment. Political reasons for recentralization included the unwillingness of central office staff to share power and the hostility of unions. Such realities suggest that unless districts proceed with decentralization thoughtfully and with commitment, they may abandon the innovation.
Social Networks and Home-School Relations
Authors: Graue M. Elizabeth
Published: March 2007

Although parental participation in schooling is a common topic in the rhetoric of educational reform, few researchers have looked at the process by which people learn to become parents. This article describes how parents in two communities constructed their roles in a social context shaped by economic resources, local notions of home-school relations, and information networks. Framed from a Vygotskian perspective, it examines parenting as a social activity that is internalized by individuals through their daily interactions. It connects the actions of parents with the activities of schools, showing the relationships between family ideas about their roles and the practices of school as interrelated.
The Shift from Equity to Adequacy in School Finance
Authors: Clune William H.
Published: March 2007

A shift is occurring in school finance from equity to adequacy, and from emphasis on inputs to emphasis on high minimum outcomes as the goal of both educational policy and finance. A true adequacy model is emerging, a system of school finance that links resources to outcomes to ensure all students receive an adequate level of education. Implementing true adequacy would require each district to adopt a set of high minimum goals, identify resources necessary for attaining those goals, and have a long-range investment plan for deploying the resources and developing the corresponding instructional program. The money needed to implement true adequacy would be roughly $5,000 per pupil. Given the number of students in high-poverty districts across the country, the total package would come to $25 billion nationwide.
Schools' Role in the Provision of Support Services for Children and Families: A Critical Aspect of Program Equity
Authors: Zigler Edward F. , Finn-Stevenson Matia
Published: March 2007

Attempts to redefine equal educational opportunities not only in terms of spending, but also in terms of student performance, are important, but if all students are to achieve a certain level of academic achievement, we must broaden our understanding of how children learn and what influences their capacity to learn and ensure that financial resources are provided for child and family-support services that begin at birth. This article reviews the research that forms the basis for this recommendation and describes the School of the 21st Century as an approach to optimize the growth and development of children and their ability to profit from academic instruction.
Research Universities, Schools of Education, and the Schools: A Case Study of Implementing Cooperative Research and Extension in Education
Authors: Wagner Jon
Published: March 2007

This article examines a 6-year effort by a major research university to implement a program of cooperative research and extension in education that involves three central features: professional intermediaries, "key school" partnerships, and cooperative research and development projects. Through an analysis of how and to what effect these features have been implemented, revisions are proposed to the cooperative extension model that could increase its value as a template for reorganizing relationships between research universities, their schools of education, and the schools. Also examined are the implications of these revisions for in K-12 schools.
Reforming Reading Instruction on Multiple Levels: Interrelations and Disconnections Across the State, District, and Classroom Levels
Authors: Standerford N. Suzanne
Published: March 2007

Although states are increasingly attempting to influence classroom instruction through government policy, reforming instruction, when seen as an ecology of games (Firestone, 1989) with each level of the game having its own rules, audiences, and schedules, is often less successful than policymakers envision. This study analyzes one reform by following the games at the state, district, and classroom levels and illustrates the ways in which efforts toward reform at these levels are both interrelated and disconnected. The study suggests that the often predictable way in which these games are played needs to be considered if future reform efforts are to be successful.
The Comparative Politics of Accountability of New South Wales and Alberta
Authors: Webber Charles F. , Townsend David
Published: March 2007

This article summarizes qualitative data gathered during a series of large group presentations and focus group discussions that addressed the comparative politics of accountability in New South Wales, Australia, and Alberta, Canada. Participants compared government mandated accountability initiatives and highlighted salient features of the politics of accountability: confusion surrounding the definition of quality; the importance of involving stake-holders in the establishment of evaluation criteria; the need to articulate clearly stakeholders 'beliefs; and the changing nature of responses to questions like "Why evaluate?" and "What constitutes credible evaluation data?" Further, participants noted the potentially destructive nature of popular accountability slogans and described the need for sufficient time for educators to implement change initiatives, some teachers' resistance to change, and the importance of supportive administrative leadership. Finally, the participants noted that accountability measures in both countries had a negative impact on professional development, staff morale, and career ambition.
Anticonvulsant Use in Treating Dementia-Related Agitation
Authors: Gardner Marie , Ditmanson Leonard , Garrett Robert W , Luu Thuy , Meiling Forrest
Published: March 2007

Dementia is often accompanied by disturbances in behavior which require treatment with medications. Traditionally, antipsychotics and benzodiazepines have been used. Their modest beneficial effects must be balanced against toxicities such as drug-induced parkinsonism which leads to falls, and worsened cognitive function. Anticonvulsant medications have been used in the past to treat agitated and aggressive behaviors from various conditions. Recent reports attest to their usefulness in treating behavioral problems secondary to dementia. Carbamazepine and divalproex sodium have proven effective in treatment while newer agents like gabapentin may be useful as well. These agents may be preferable because they target a broad variety of symptoms and diseases, are less likely to induce extrapyramidal reactions and some have a low drug interaction profile.
Therapeutic Drug Monitoring of Therapy for Infectious Diseases
Authors: Oliphant Catherine M.
Published: March 2007

Optimal use of antimicrobial agents is dependent on a multitude of factors. Empiric therapy should be based on the patient's underlying disease states, the most likely organisms suspected, and susceptibility patterns. Once susceptibilities are known, therapy should be streamlined. A number of factors must be evaluated during therapy. The site of infections must be considered when choosing antimicrobial agents. The minimum inhibitory concentration (MIC) should be evaluated ; the antimicrobial agent's MIC should be at or below the breakpoint for the organism to be considered susceptible. Antimicrobial agent selection and dosing should take into consideration not only the MIC, but also the post-antibiotic effect, if applicable. Serum concentrations of antimicrobial agents should be obtained and evaluated to ensure therapeutic levels and to avoid potential toxicities. The choice of an antimicrobial agent is complicated by the emergence of antibiotic resistance. Drug-resistant gram-positive and gram-negative infections are increasing. We must attempt to control resistance by choosing appropriate antimicrobial agents and maximizing dosages. Pharmacists can play a critical role in the management of patients who receive antimicrobial agents.
Evaluation of Published Pharmacoeconomic Studies
Authors: Johnson Jeffrey A. , Coons Stephen Joel
Published: March 2007

Studies involving economic analyses are being published with increasing frequency in medical and pharmacy literature. As members of pharmacy and therapeutics committees, or as clinicians dealing directly with patient management, pharmacists will be expected to evaluate published economic studies and apply results of such publications to their respective practice settings. The purpose of this article is to provide insight for practitioners into the evaluation of published pharmacoeconomic studies. Although pharmacoeconomic analyses may take many forms, there are several methodological concerns that are common to all. In light of this, we first discuss the evaluation of economic studies in general terms. Following this, two recently published pharmacoeconomic analyses are reviewed as examples of what one might consider in the critical evaluation of published pharmacoeconomic studies. Copyright © 1995 by W.B. Saunders Company
Alternatives to Standard Status Asthmaticus Therapy
Authors: Everett Julie A.
Published: March 2007

Even with the currently available treatment, morbidity and mortality from asthma continues to rise. Patients with status asthmaticus who do not respond to standard therapy are at risk for respiratory failure and possible mechanical ventilation. Treatment options for refractory status asthmaticus remain limited and alternative and controversial therapies may need to be considered. Alternative therapies include continuous nebulized beta-agonists, ipratropium bromide, intravenous magnesium sulfate, ketamine, or heliox. Morbidity and mortality may be decreased by increased utilization of these alternative therapies. Pharmacists can play a key role in monitoring and recommending new and alternate therapies.
Acknowledging Intuition in Clinical Decision Making
Authors: Rew Lynn
Published: March 2007

The purpose of this study was to develop and validate a scale to measure nurses’ acknowledgment of using intuition in clinical decision making. Development and validation of the scale was carried out in three phases. In Phase 1, scale items were generated from the published literature in nursing and management and a Content Validity Index (CVI) of .96 was computed on responses from a panel of five experts. In Phase 2, the scale was pilot-tested on a random sample of 106 psychiatric mental health nurses. In Phase 3, the revised scale was presented to a convenience sample of 112 nurses attending continuing education programs. Seven items were found to explain 40.6% of the variance in scores and were retained as the final unidimensional scale. Construct validity was supported by a difference in means of two groups that also differed on another measure of intuition.
Psychological, Economic, and Social Mediators of the Education-Health Relationship in Older Adults
Authors: Murrell Stanley A. , Meeks Suzanne
Published: March 2007

Objective: Mediators in the relationship of education to health were examined to further explicate education as a resource. Methods: Income, life satisfaction, services, and social support were assessed as mediators of the education-health relationship following criteria developed by Baron and Kenny and Holmbeck as applied to four aspects of health. A probability sample of 1,667 participants (age 55 and older) was interviewed in their homes. Results: Education was related to all health measures and to all mediators; all mediators were related to all health measures. Education continued to have significant relationships to all health measures after each mediator was entered, but its contribution was lower in each analysis. Life satisfaction was consistently a strong mediator. Discussion: Low-energy aspects of health may be more likely to be mediated by variables of a more psychological nature. Overall, educational attainment is a good investment for successful aging.
Incorporating Assistive Devices into Community-Based Long-Term Care
Authors: Agree Emily M. , Freedman Vicki A.
Published: March 2007

Objectives:This article examines the use of assistive devices as a part of the long-term care arrangements of community-dwelling older Americans. It examines the potential for assistive devices to substitute for and supplement personal care assistance. Methods:Data from the Phase 2 Disability Supplements to the 1994-1995 National Health Interview Surveys are used to compare the use of personal care and equipment among persons reporting difficulty with a given activity of daily living. Results:The capacity of equipment to substitute for or supplement personal care is highly task-specific and depends on the characteristics of the devices and the personal care providers. In general, those using simple devices are less likely to use informal care, whereas those using complex devices are more likely to use formal care services. Discussion:Technology has the potential to confer quality of life enhancements for older persons and their caregivers and cost savings for payers.
The Health Consequences of Multiple Morbidity in the Elderly
Authors: Seeman Teresa E. , Guralnik Jack M. , Kaplan George A. , Knudsen Lisa , Cohen Richard
Published: March 2007

Longitudinal data from the Alameda County Study are used to examine three health consequences of multiple or co-morbidity, defined as the coexistence of two or more chronic conditions and/or symptoms. Age-adjusted analyses of the consequences of baseline co-morbidity show significant associations in both age groups with 17-year mortality, and with the development of multiple new conditions and the occurrence of depression over a 9-year follow-up. After adjustments for sociodemographic characteristics and health behaviors, all associations with multiple new conditions remain significant. The association with depressive symptoms. however, remains significant for the younger age group only and the associations with mortality become nonsignificant in both age groups.
Health Care Utilization of Canadian Snowbirds
Authors: Marshall Victor W. , Longino Charles F. , Tucker Richard , Mullins Larry
Published: March 2007

Older English-speaking Canadian seasonal migrants to Florida (N = 2046) were surveyed during the winter of 1986. They are users of two health care systems and are generally in good health. When they do need to use health care resources, however, they show a distinct preference for the Canadian system. There is a sensitivity to health concerns, especially among the older of the migrants. This sensitivity generates considerable precautionary behavior including pretravel visits to their Canadian family doctors, stocking up on drugs before the trip, and taking out health insurance for Canadians traveling abroad. The behavior is strategic in that it is both intentional and oriented to contingencies. Cost of health care may be a motivating factor because such strategic behavior is inversely related to income in this relatively affluent migrating population. The flock of Canadian snowbirds is not likely to place exorbitant demands on the U.S. health care system.
Age Differences in HMO Receptivity
Authors: Ward Russell A.
Published: March 2007

The changing health care market has highlighted the role of the individual in choosing health care providers. HMOs are a relatively novel option, particularly for Medicare beneficiaries. National survey data are used to assess patterns of HMO receptivity. Older persons are less familiar with the HMO model. They also express less favorable attitudes toward HMOs and less enrollment interest. HMO receptivity is a function of health care attitudes and experiences and the nature of available information about HMOs. Age differences in HMO receptivity reflect the effects of cohort membership and aging on these factors.
Medication Use and Functional Decline among Community-Dwelling Older Women
Authors: Magaziner Jay , Cadigan Doris A. , Fedder Donald O. , Hebel J. Richard
Published: March 2007

This prospective study evaluates the relationship between the number of prescription and over-the-counter medications used in community-dwelling aged women and changes in mental, physical, and instrumental functioning. Data are derived from two in-home interviews (one year apart) of 609 women 65 years or older identified through a random sample of households in a 20-contiguous census tract area of Baltimore, Maryland. After controlling for age, education, physical health, number of chronic conditions, and baseline functional status, prescription medication use is associated with declines in ability to perform PADL and IADL tasks and increases in symptoms of depression. No associations are observed between prescription drug use and changes in cognitive functioning over one year. The use of over-the-counter drugs is associated with declines in PADL tasks only. Several explanations for results are discussed. Suggestions for future study and prescribing to the significant minority of persons taking multiple medications are given.
Nursing Home Utilization in Adults
Authors: Wingard Deborah L. , Williams-Jones Denise , McPhillips Janice , Kaplan Robert M. , Barret-Connor Elizabeth
Published: March 2007

Rates of nursing home utilization between 1972 and 1986 were determined for 1,302 men and women living in an upper-middle-class community in Southern California. Leading diagnostic reasons for admission were dementia, cancer, and stroke, and the leading nondiagnostic reason for admission was an inability to carry out activities of daily living. In this cohort, rates of nursing home utilization increased with age. Women at all ages used nursing homes at a higher rate than men, although their probability of survival once admitted was greater. Admission rates were higher over time or prior to death than when observed cross-sectionally. Rates were highest in the year prior to death but declined at time of death.
Fall Mortality and Related Medical Conditions in the Elderly
Authors: Mendlein James M. , Sattin Richard W. , Waxweiler Richard J. , Lui Kung Jong , McGee Daniel L.
Published: March 2007

To investigate whether selected medical conditions increase an older person's risk of fall mortality, we analyzed 1985 multiple-cause-of-death data for persons aged 65 years or older. The 8,713 cases had a fall listed as the underlying cause of death; the 1,438,872 controls all had noninjury causes of death. Pulmonary embolism, syncope, and alcohol dependence syndrome were all strongly associated with fall deaths (prevalence odds ratio; POR = 11.7, 11.9, and 7.7, respectively). Osteoporosis, Alzheimer's disease, Parkinson's disease, senile dementia, and acute myocardial infarction were moderately associated. The prevalence odds ratios for pulmonary embolism were greater for females than for males, and increased with age. Cases were more likely to have had a pulmonary embolism if they had a fracture of the femoral neck (prevalence odds ratio; 21.0), or other lower limb fracture. Unlike the other medical conditions studied, pulmonary embolism is likely to be a sequela rather than a precursor of a fall-related injury, and, thus, is potentially preventable after hospitalization.
The Influence of Living Alone on Depression in Elderly Persons
Authors: Dean Alfred , Kolody Bohdan , Wood Patricia , Matt Georg E.
Published: March 2007

The mental health effects of living alone on elderly persons are not well known. Using multiple regression models, the authors attempted to distinguish the influence of living alone on depressive symptoms from the influence of other highly relevant variables: social support, stressors, age, sex, and marital status. The data derive from a stratified community probability sample of persons 50 years of age and older. The authors find that elderly persons who live alone have higher levels of depressive symptomatology; and this relationship is independent of the influence of expressive support from friends, face-to-face interaction with friends, undesirable life events, disability, and financial strain. The depressive influence of living alone is greater on men than women. Undesirable health events have a stronger impact on those who live alone, particularly women. Marital status influences depression indirectly through its influence on living alone. Implications of these and other findings are discussed.
Self-Reported Sexual Functioning in Elderly Blacks and Whites
Authors: Keil Julian E. , Sutherland Susan E. , Knapp Rebecca G. , Waid L. Randolph , Gazes Peter C.
Published: March 2007

Nearly 50% of the elderly (260 years) survivors of the Charleston Heart Study Cohort reported problems with becoming sexually aroused. The problem was associated with age and ranged from 30% at age 60 to 69 to over 60% at ages 80 and above. Significant predictors of arousal problems were older age, lower pulmonary function, physical disability, an increased usage of prescription drugs, and a fair or poor perception of health. Among respondents reporting no problems with arousal, the age-adjusted proportions of those reporting a frequency of sexual activity three or more times per month were White men 36%, Black men 29%, high socioeconomic Black men 47%, and White and Black women 14%. After considering age and arousal problem, the most consistent and significant predictors of frequency of sexual activity across all race-sex groups were marital status and education or income.
Effects of Age on Physiological and Psychological Functioning among COPD Patients in an Exercise Program
Authors: Emery Charles F.
Published: March 2007

Older adults with chronic illness may be at greater risk of psychological distress than healthy older adults. This study examined the effect of age on physiological and psychological functioning of exercising older adults with chronic obstructive pulmonary disease (COPD). Sixty-four older adults (mean age = 67.4 +7.0; 35 male, 29 female) with COPD were included in the study. All subjects participated in a 30-day rehabilitation program consisting of exercise (walking, stationary bicycle, pool exercises), education, and stress management. Subjects underwent assessments of physiological functioning (e.g., bicycle ergometry, 12-minute walk), cognitive status (e.g., memory, psychomotor speed, concentration), and psychological well-being (e.g., anxiety, depression, psychiatric symptoms) before and after the exercise program. Results were analyzed by repeated measures multivariate analysis of variance, with age (median split = 67.5 years) as a between-subject factor. Although the exercise program appeared to have a greater effect on physiological functioning and on concentration and short-term memory of younger-old subjects, both groups of subjects achieved gains in physiological functioning, cognitive functioning, and psychological well-being.
Buddy Support among Older Smokers in a Smoking Cessation Program
Authors: Kviz Frederick J. , Crititenden Kathleen S. , Clark Melissa A. , Madura Karen J. , Warnecke Richard B.
Published: March 2007

Use of buddy support in a minimal-contact smoking cessation program using a manual and television segments was assessed among 313 participants aged 50 and older. Almost one fourth engaged a buddy, and those aged 50 to 59 were more likely to have engaged a buddy than those 60 and older. Having a buddy was associated with better use of the manual among both age groups. Participants who needed help from others to quit smoking were less likely to have quit than those who did not need help from others. Overall, participants with a buddy were almost twice as likely to quit as those without a buddy, but with age controlled, the association held only for those aged 50 to 59. Among participants who made at least one attempt to quit during the previous year, those who engaged a buddy were more than twice as likely to quit smoking than were those without a buddy.
Predictors of Use of Secondary Carers Used by the Elderly Following Hospital Discharge
Authors: Given Barbara A. , Given Charles W. , Stommel Manfred , Lin Chen-Sheng
Published: March 2007

This research examines how caregiver-patient relationship (female spouses, and adult daughters and daughters-in-law) when cross classified with patient coresidence patterns explains the level of secondary carers' involvement among patients with newly added needs for assistance at home following hospital discharge. Among 196 primary caregivers (104 spouses, 92 daughters and daughters-in-law), patient needs were divided into ADL and mobility limitations, and medical tasks. Secondary carer involvement was categorized into levels differing at two observations: one following discharge and a second 3 months later. Analyses focused on explaining the levels of involvement of secondary carers following hospital discharge and the changes in secondary carers' involvement between the two observations. The baseline and change analyses revealed that caregiver-patient relationship was more important than coresidence patterns or patients' demands in explaining assistance from secondary carers. The implications of these findings on caregivers' reactions and policies regarding home care are explored.
The Epidemiology of Pad Consumption among Community-Dwelling Incontinent Women
Authors: Sandvik Hogne , Hunskaar Steinar
Published: March 2007

The aim of the study was to explore the use of incontinence pads among community-dwelling women in a well-defined area of western Norway (total female population 122,516). In Norway incontinence aids are prescribed by doctors and paid for by the national insurance. Data were collected at local insurance offices and through interviews with an age-stratified (20-89 years) random sample of incontinent women. Identified were 2,991 pad users (1-year period prevalence 2.4%). Prevalence rose sharply with advancing age, reaching a maximum of 30.1% in the 90+ age group. Median number of pads used per day was 1.8. Middle-aged women used fewer and smaller pads than the rest. When compared with the number of pads actually delivered, the incontinent women tended to overestimate their consumption.
Clinical Validation of the Geriatric Depression Scale (GDS)
Authors: Chan Alfred Cheung-Ming
Published: March 2007

This study has attempted to validate the Geriatric Depression Scale translated version (Chinese) with a psychiatric outpatient sample ( N= 461) of males and females aged 60 or above, from 10 government-maintained psychiatric outpatient clinics between January 1992 and February 1993. Reliabilities and validities were exceptional. Internal consistency reliability was .89 (alpha), and the test-retest reliability was .85 (alpha). Criterion-related (psychiatrist diagnosis) validity was good at .95, and concurrent validity (with CES-D) was .96. Item analysis also confirmed consistency—all 30 items were significantly correlated with the full GDS. However, its sensitivity (70.6%), specificity (70.1%), false negatives (29.4%), and false positives (29.9%), though acceptable, were not as impressive. The overall result has shown that the GDS is generally applicable to the Chinese elderly population and is good for measuring depressive symptoms. The scale can be easily applied in the community by health care professionals. However, further follow-up studies are recommended.
Differential Relationships of Risk Factors to Alternative Measures of Disability
Authors: Landerman Lawrence R. , Fillenbaum Gerda G.
Published: March 2007

The purpose of this article was to determine whether risk factors for four dimensions of disability differ and whether it is legitimate to use aggregated disability measures in risk factor analyses. Using data from the baseline Duke Established Populations for Epidemiologic Studies of the Elderly survey (n = 4,162), the authors examined four measures of disability-basic activities of daily living (ADLs), household ADLs, advanced ADLs, and mobility-and an aggregated measure consisting of these four measures summed. Sociodemographic risk factors were examined using stage wise multivariate regression analysis for the five measures of disability. Weighted least squares with an arbitrary distribution function estimator were used to determine differences in each risk factor's performance across the unaggregated measures. Risk factors varied in strength, presence, and direction of impact across the four dimensions of disability; as a result, analyses using an aggregated measure were misleading.
Long-Range Antecedents of Functional Capability in Later Life
Authors: Atchley Robert C. , Scala Marisa A.
Published: March 2007

A number of demographic, social, psychological, lifestyle, and health characteristics have been advanced as precursors of functional limitation among those who survive to old age. This study uses data from a 16-year longitudinal study to examine long-range antecedents of the respondents' level of physical functional capability in 1991. The model predicting functional capability from longitudinal data is more complex and more effective for women than for men. Older age, lower self-rated health, lower functional capability, and lower physical activity level in 1975 predict 35% of the variation in functional capability among women in 1991. Only older age and lower self-rated health are predictive for men and account for just 11% of the variation. These findings suggest a need for gender-specific models of antecedents of physical functional limitations in later life.
Gender Differences in the Risk of Developing Disability among Older Adults with Arthritis
Authors: Peek M. Kristen , Coward Raymond T.
Published: March 2007

Objectives:Although older women are disabled from arthritis at higher rates than men, there is an inadequate understanding of the factors that place women at higher risks. The purpose of this research is to improve understanding of gender differences in the process of becoming disabled among older adults with arthritis. Methods: Gender differences in risk factors associated with developing a disability during a 30-month period are examined among a sample of noninstitutionalized elders with arthritis ( N= 749). Results:Results from discrete time-hazard models indicate that sociodemographic factors account for gender differences in disability with activities of daily living (ADLs). However, for difficulties performing instrumental activities of daily living (IADLs), gender differences remain unexplained by variations in demographic and health factors. Discussion:More descriptive and explanatory work needs to focus on gender differences in IADL disability; however, these findings suggest that the gendered nature of the IADL tasks influences gender differences in IADL disability.
The Family Role in the Context of Long-Term Care
Authors: Montgomery Rhonda J. V.
Published: March 2007

Current long-term care policy and practices are built on the premise that family is and should be the primary party responsible for impaired older persons. This article presents evidence that this premise and the resulting policies and practices are (a) built on myth; (b) fueled by gender, income, and ethnic inequalities; and (c) largely responsible for the creation of a service system that has inadequate capacity to meet current and future needs. An alternate paradigm, which places primary responsibility for long-term care needs on the individual, is proposed here and implications for newpolicy direction are outlined. The projected benefits of this shift in paradigm will be the development of a more viable and more equitable long-term care system that has the capacity to provide high quality care to meet the expanding need.
The Importance of Genetic and Environmental Effects for Self-Reported Health Symptoms
Authors: Pedersen Nancy L. , Steffensson Birgitta , Berg Stig , Johansson Boo , Mcclearn Gerald E.
Published: March 2007

Objectives:This study delineated the nature of individual differences in self-reported health status across a 30-year period. Potential survival and selection effects on mean levels, variances, and genetic and environmental sources of variance were evaluated. Methods:Self-reported health status in 1963 was evaluated in 5,229 pairs of twins from the Swedish Twin Registry and in a subsample of 351 pairs surviving to the age of 80 years in 1993. Structural equation modeling evaluated genetic and environmental contributions to total variance and change in variance. Results:For men but not women, the genetic and environmental influences on health symptoms differed between survivors and nonsurvivors. Total variance increased, reflecting an increase in environmental variance, across the 30 years for both genders. Genetic variance decreased longitudinally for men. Discussion:The increase in variation from the mid-50s to the mid-80s appears to be due to an accumulation in environmental variation. There are gender differences that deserve further exploration.
Financial Measures in Nonprofit Organization Research: Comparing IRS 990 Return and Audited Financial Statement Data
Authors: Froelich Karen A. , Knoepfle Terry W. , Pollak Thomas H.
Published: March 2007

The IRS 990 Return is becoming an increasingly prominent source of financial data underlying descriptions of the nonprofit sector and studies of nonprofit organizations. However, questions about the quality of the data continue to be of concern. This study of 350 nonprofit organizations investigates the adequacy, reliability, and appropriate interpretation of IRS 990 Return data through comparisons of selected entries with corresponding measures from each organization’s audited financial statements. Both quantitative and qualitative methods are used to examine and explain the consistency between the two data sources. The study concludes that the IRS 990 Return can be considered an adequate and reliable source of financial information for many types of investigations, but preparers and users of the data need a clearer understanding of its purposes to enable appropriate interpretations.
Nonprofit Boards: Crucibles of Expertise or Symbols of Local Identities?
Authors: Abzug Rikki , Galaskiewicz Joseph
Published: March 2007

Nonprofit boards, as boundary spanners, often serve the institutional purpose of affording legitimacy to organizations. Neo-institutional theory suggests that nonprofit organizations, as particularly susceptible to legitimacy demands of changing environments, would tend toward rationalizing internal structures. This article, using historical panel data, explores the extent of one form of rationalization, recruiting trustees with college education and/or professional or managerial occupations. It finds that trustees with college education, managers, and professionals continue to have significant representation on nonprofit boards. Also, many boards are increasingly less exclusive with respect to gender, race, and religion. Some select nonprofit boards, however, continue to be dominated by different gender, racial, and religious identities, suggesting that nonprofit boards also serve the purpose of representing different identity and/or interest groups in the community.
Fair Housing Advocacy Groups: Litigation as a Source of Nonprofit Funding
Authors: Cheever Kathryn A. L. , deLeon Peter
Published: March 2007

Civil rights advocacy has long been a part of the U.S. tradition of nonprofit charity organizations. Even before the passage of federal, state, and local fair housing laws, groups of concerned citizens gathered together to improve opportunities for equal housing choice. Fair housing councils (FHCs) cropped up across the country as the Civil Rights movement expanded throughout the nation. As a part of then on profit “quiet revolution,”some FHCs have come across a new way to affirmatively further fair housing with much reduced government subsidies. This article explores the successes (and failures) of fair housing advocacy nonprofits that have sought compensatory and punitive damages through the courts for frustration of their missions and diversion of their resources. Some of these groups have moved from dependency on federal, state, and local government funds to reliance on court orders and civil settlements, whereby fair housing scofflaws pay for their transgressions by funding the work of these advocacy organizations.
Higher Education-Community Partnerships: Assessing Progress in the Field
Authors: Maurrasse David J.
Published: March 2007

Urban universities and colleges have increasingly been investing in partnerships with their local communities. As this burgeoning movement emerges from its infancy stages, numerous questions about assessing and funding these efforts arise. The author relies on his experiences as a participant observer, evaluator, and researcher to address the following questions: What are effective measurements of progress in higher education community partnerships? What is the significance of this movement’s stage in development regarding the availability of resources and the appropriateness of assessment? The author also relies on his observations of the field of corporate social responsibility to see if it sheds any light on how one should think about resources and assessment of higher education-community partnerships. Although measurable outcomes of these efforts are essential, process is a major factor, given the significance of relationships to success. For example, if trust and communication do not exist between partners, effective outcomes will remain elusive.
Working amid Corporatism and Confusion: Foreign NGOs in China
Authors: Hsia Renee Yuen-Jan , White Lynn T.
Published: March 2007

Foreign nongovernmental organizations (NGOs) face impediments in the People’s Republic of China. Many such problems result from the NGOs’lack of stable connections to the government. Academic literature on China is rich with data about links between the state and indigenous “civil” organizations, but relations between the government and foreign development NGOs have received less coverage in public. This article bypasses the widely accepted view of the Chinese state as solely corporatist. It describes Chinese regulation of foreign assistants in development and then offers two case studies of recently established NGOs. It concludes that, rather than demonizing the government for its faults in other areas, foreign development workers in China should be willing to work with government structures whenever possible. Only by understanding the political climate and regulatory structure, as well as the available options, can foreign NGOs hope to establish a long-term presence in China and effect lasting change.
Advocacy by UK-Based Development NGOs
Authors: Hudson Alan
Published: March 2007

With Northern development nongovernmental organizations (NGOs) becoming more involved in advocacy and policy influence, they are increasingly being asked questions about their effectiveness, legitimacy, accountability, and governance. In an effort to contribute to these debates and to inform NGOs’ thinking, this article provides an overview of the advocacy activities of UK-based NGOs. Using material from a recently completed research project, this study examines the growth of UK NGOs’ advocacy; the ways in which NGOs actually do advocacy; the position of advocacy within NGOs; the efforts of NGOs to work together in advocacy in the face of pressures to differentiate themselves; the ways in which NGOs relate to donors; issues of legitimacy, representation, and accountability; and evaluation.
Internal Revenue Service 990 Data: Fact or Fiction?
Authors: Froelich Karen A. , Knoepfle Terry W.
Published: March 2007

This exploratory study examines the reliability and validity of Internal Revenue Service (IRS) 990 data, an increasingly prevalent source of financial measures in the research of nonprofit organizations today. Correlations between selected financial measures taken from the IRS returns of 270 nonprofits and the identical measures gathered from the same organizations via mail questionnaire are examined, followed by examination of financial statements and interviews with participants in the accounting process from a subsample of the organizations. High correlations show the IRS 990 Returns to be a generally reliable source of financial data, although this varies by entry, organizational size, and NTEE category. The validity of this data, however, is questionable. The growing prevalence of expense shifting combined with a lack of rules, guidelines, and monitoring of internal expense allocations allows for increasing distortions in the financial picture portrayed by the IRS 990 Return.
Big Fights: Competition between Poor People's Social Movement Organizations
Authors: Hall Leda McIntyre , Hall Melvin F.
Published: March 2007

Using a national survey and interviews with organizers, the authors find two broad areas of competition between social movement organizations (SMOs). Territorial competition focuses on turf and resources. Organizational competition comprises recruitment of staff leadership styles, definition of issues, training strategies, and recruitment of members. In this study of poor people's SMOs, the authors find that competition differs between SMOs in national federations and those that are independent, local groups. Further, they find that competition, rather than cooperation, is the prevailing pressure on SMOs.