The United States Revised Uniform Anatomical Gift Act (2006): New challenges to balancing patient rights and physician responsibilities

Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing procurement opportunities of organs medically suitable for transplantation. Some states have enacted the Revised UAGA (2006) and a few of those have included amendments while attempting to preserve the uniformity of the revised Act. Other states have introduced the Revised UAGA (2006) for legislation and remaining states are likely to follow soon.     

Effects of texture and shape on perceived time to passage: Knowing “what” influences judging “when”

In the present study, we examined whether it is easier to judge when an object will pass one’s head if the object’s surface is textured. There are three reasons to suspect that this might be so: First, the additional (local) optic flow may help one judge the rate of expansion and the angular velocity more reliably. Second, local deformations related to the change in angle between the object and the observer could help track the object’s position along its path. Third, more reliable judgments of the object’s shape could help separate global expansion caused by changes in distance from expansion due to changes in the angle between the object and the observer. We can distinguish among these three reasons by comparing performance for textured and uniform spheres and disks. Moving objects were displayed for 0.5–0.7 sec. Subjects had to decide whether the object would pass them before or after a beep that was presented 1 sec after the object started moving. Subjects were not more precise with textured objects. When the disk rotated in order to compensate for the orientation-related contraction that its image would otherwise undergo during its motion, it appeared to arrive later, despite the fact that this strategy increases the global rate of expansion. We argue that this is because the expected deformation of the object’s image during its motion is considered when time to passage is judged. Therefore, the most important role for texture in everyday judgments of time to passage is probably that it helps one judge the object’s shape and thereby estimate how its image will deform as it moves.     

Is Expressed Emotion a Specific Risk Factor for Depression or a Nonspecific Correlate of Psychopathology?

Five Minute Speech Sample Expressed Emotion (FMSS-EE) was examined in families of youth with depressive disorders, nondepressed youth with attention deficit/hyperactivity disorder (ADHD), and community controls screened for the absence of depression and ADHD. Consistent with the hypothesis that FMSS-EE shows some specificity as a risk factor for depression, rates of critical EE were significantly higher among mothers of youth with depression as compared to mothers of nondepressed youth with ADHD, or mothers of controls. When both mothers' and fathers' scores were used to generate family EE ratings, rates of overall EE and critical EE were significantly higher for the depressed group than the control group, but the nondepressed ADHD group did not differ significantly from the other groups. Results support the hypothesis that critical EE in mothers shows some specificity as a risk factor or correlate of depression in youth.     

Middle Aging in Women: Patterns of Personality Change from the 30s to the 50s

This three-sample study focused on changes in four key features of women's personalities (identity, generativity, confident power, and concern about aging) over the course of middle age. Based on women's retrospective and concurrent feelings about their lives in their 30s, 40s, and 50s, scales were developed and validated for the four themes. We found that identity certainty, generativity, confident power, and concern about aging all were experienced as more prominent in middle age (the 40s) than in early adulthood (the 30s). We also found that these elements of personality were rated even higher in the 50s than the 40s. Scores seemed to be a function of age more than historical period or particular experiences in social roles. Scores on identity certainty, generativity, and confident power were positively related to well-being, while concern about aging was negatively related to well-being.     

Longitudinal effects of retirement on men's well-being and health

The National Longitudinal Surveys of Labor Market Experience of Mature Men provided the opportunity to look at the effects of retirement on longitudinal well-being in a sample of men aged 54 to 69 in 1976. A conceptual model predicted that the decision to retire would affect subsequent well-being through the effect of retirement on such resources as income and health. The retirement decision in turn, was predicted to be a function of prior well-being and resources. Five categories of retirees were established: voluntary early age, voluntary normal age, health, mandatory, and discouraged. The analysis restricted the sample to men who were in the labor force at the 1976 interview, had not retired before that time, and who were interviewed in 1981. About half of the sample retired in the five years between interviews. Using several different measures of well-being, voluntary retirees were found to consider themselves better off than did other retirees or comparable men still working. Negative responses to retirement were concentrated among men who retired for health reasons, probably due to their continued ill-health. The effect of retirement on well-being seems highly related to the other circumstances (especially financial security and health) surrounding the individual, rather than to the event of retirement, per se.The research reported in this paper was conducted under a contract with the Employment and Training Administration, U. S. Department of Labor, under authority of the Comprehensive Employment and Training Act. Researchers undertaking such projects under government sponsorship are encouraged to express their own judgements. Interpretations stated in this report do not necessarily represent the official position or policy of the U. S. Department of Labor. This paper was presented to the 92nd annual convention of the American Psychological Association, Toronto, Ontario, Canada, August, 1984.     

Social support as a multifaceted concept: Examination of important dimensions for adjustment

Four commonly used operationalizations of the social support concept: network contact frequency, satisfaction with support (including nine dimensions), perceived availability of support, and use of support, were related to two measures of psychological adjustment (Beck Depression Inventory and Symptom Checklist-90) and to one measure of physical adjustment (Cornell Medical Index). Subjects were 68 45- to 85-year-old, highly stressed care-givers to spouses with Alzheimer's disease. Results indicate that of the four operationalizations, Satisfaction with Support was the only significant predictor of depression and general psychopathology. The set of four support variables showed the strongest relationship to depression level, next strongest to general psychopathology, and least to physical health. The satisfaction with nine social support dimensions related differentially to the types of adjustment. Results suggest the importance of specificity (sample, support operationalization, dimensions, adjustment measures) in social support research.