Professional Responsibility in Elder Law: A Synthesis of Preventive Law and Therapeutic Jurisprudence

This article focuses on the professional responsibilities that a lawyer owes to older clients. Specifically, this article proposes that when working with older clients, lawyers have a special responsibility to ensure that their clients have the capacity to manage their own affairs and to ensure their clients' legal, financial, and personal interests are protected in case of sudden future incapacity. Furthermore, a lawyer working with older clients has a responsibility to remain cognizant of the realities of ageing without giving in to the falsities of senior citizen stereotypes. Through an integration of Therapeutic Jurisprudence and Preventive Law, a proactive, client-centered, four-stage framework for advancing therapeutic goals through preventive lawyering is developed. The framework is then applied to a model lawyer/client interaction typical of elder practice. The advantages and limitations of the four-stage framework are discussed.     

Measuring Adherence to Medical Treatments in Childhood Chronic Illness: Considering Multiple Methods and Sources of Information

Adherence to medical treatment is a significant problem for children and adolescents with chronic conditions, such as asthma, diabetes, and cystic fibrosis. The consequences of nonadherence can be serious, contributing to increased symptoms, unnecessary hospitalizations, and declines in physical functioning. The quality of data obtained from clinical trials can also be affected by poor adherence, leading to erroneous conclusions concerning the efficacy of drug treatments and the dosages that are needed to achieve those effects. Adherence problems in both clinical research and practice also lead to substantially higher health care costs. In order to further our understanding of the barriers that lead to poor adherence and identify strategies that are effective in addressing them, we need to develop reliable and valid measures of adherence behaviors. Using cystic fibrosis as a model of a serious, chronic disease that requires a difficult and time-consuming medical regimen, three different types of adherence measures are considered: self-report questionnaires, daily diary reports, and electronic monitors. The specific advantages and disadvantages of each type of measurement are reviewed, and specific recommendations are made for future research.     

Music skills and the expressive interpretation of music in children with Williams-Beuren syndrome: pitch, rhythm, melodic imagery, phrasing, and musical affect.

This paper studied music in 14 children and adolescents with Williams-Beuren syndrome (WBS), a multi-system neurodevelopmental disorder, and 14 age-matched controls. Five aspects of music were tested. There were two tests of core music domains, pitch discrimination and rhythm discrimination. There were two tests of musical expressiveness, melodic imagery and phrasing. There was one test of musical interpretation, the ability to identify the emotional resonance of a musical excerpt. Music scores were analyzed by means of logistic regressions that modeled outcome (higher or lower music scores) as a function of group membership (WBS or Control) and cognitive age. Compared to age peers, children with WBS had similar levels of musical expressiveness, but were less able to discriminate pitch and rhythm, or to attach a semantic interpretation to emotion in music. Music skill did not vary with cognitive age. Musical strength in individuals with WBS involves not so much formal analytic skill in pitch and rhythm discrimination as a strong engagement with music as a means of expression, play, and, perhaps, improvisation.     

Sample size determination for at test given at value from a previous study: A FORTRAN 77 program

When uncertain about the magnitude of an effect, researchers commonly substitute in the standard sample-size-determination formula an estimate of effect size derived from a previous experiment. A problem with this approach is that the traditional sample-size-determination formula was not designed to deal with the uncertainty inherent in an effect-size estimate. Consequently, estimate-substitution in the traditional sample-size-determination formula can lead to a substantial loss of power. A method of sample-size determination designed to handle uncertainty in effect-size estimates is described. The procedure uses thet value and sample size from a previous study, which might be a pilot study or a related study in the same area, to establish a distribution of probable effect sizes. The sample size to be employed in the new study is that which supplies an expected power of the desired amount over the distribution of probable effect sizes. A FORTRAN 77 program is presented that permits swift calculation of sample size for a variety oft tests, including independentt tests, relatedt tests,t tests of correlation coefficients, andt tests of multiple regressionb coefficients.     

Age and gender differences in oppositional behavior and conduct problems: a cross-sectional household study of middle childhood and adolescence

Behavior problems among youths cannot be understood without explaining their age and gender differences, but age and gender differences cannot be explained until they have been accurately described. In a household survey of 1,285 youths aged 9 to 17 years, there were no gender differences in oppositional behavior, but aggression, property offenses, and status offenses were more common among boys. Levels of oppositional behavior were greater at younger ages, aggression peaked near the middle of this age range, and property and status offenses were more prevalent at older ages. These findings are generally consistent with developmental models of conduct problems but are inconsistent with a recent model of gender differences and raise questions about the external validity of current taxonomies.     

PROBLEM SOLVING,PLANNING AND PERSONALITY*

The present study was designed to investigate student behaviour in a river-crossing problem in light of prior experience, intelligence, personality, mode of presentation and age. Ninety-six students at Year 6 and 61 students at Year 8 from schools in Australia were administered the Eysenck Junior EPQ and IVE scales, together with six cognitive tasks used to index the Luria successive and simultaneous processing and planning functional units. Each student was given a river-crossing problem presented in one of two modes and at one of two levels of difficulty. Success on the river-crossing problem was found to be independent of age, mode of presentation or prior experience on the task. There was a significant effect due to problem awareness, intelligence and empathy and a mode by success interaction. An attempt was made to group students into problem-solver ‘types’. The results were discussed in terms of the link between cognitive and affective variables and intervention programmes.     

Child care and influence among the mekranoti of central brazil

Various researchers have argued that women's influence may be limited by child-care requirements. This study uses quantified data from the Mekranoti-Kayapó of Central Brazil to examine some specific arguments. Among the Mekranoti, women who spend more time caring for children rate lower on influence. But the reasons for this correlation are less clear. Child care does not seem to hinder a woman's ability to contribute to subsistence. Nor does it seem to have much effect on the personality characteristics that might affect the leadership potential of child caretakers. Child care may, however, restrict a woman's ability to acquire the personal connections needed to exercise influence.This article is based on a chapter from the author's doctoral dissertation. The author thanks Daniel R. Gross, Carol R. Ember, Madeline Ritter, Nancy Flowers, Daniel G. Bates, and Robert A. LeVine for their many helpful suggestions in preparing the study. The author also thanks various people for help in carrying out the fieldwork on which they study is based: S. Gross, G. Verswijver, R. Thomson, K. Jefferson, M. Stout, F. Leoi, and R. Cardoso de Oliveria, G. Diaz, K. Taylor, A. Ramos, G. Zarur, R. De Barros Laraia, L. Vidal, D. Montagner Melatti, J. C. Melatti, and J. Bispo dos Santos. The study was generously supported by NSF grants BNS 76-03378, BNS 73-25295, and BNS 78-24706.