A longitudinal study of the psychosocial impact of stroke on primary support persons

We investigated longitudinally the effects of a stroke on the social support systems and well-being of the patient's primary support person, both acutely and as the condition stabilized. Individuals who had suffered a first stroke and a primary support person participated in two waves of data collection, carried out in 6-month intervals beginning 7 weeks after the stroke. Our data show that the prevalence of depressive symptoms is from 2 1/2 to 3 1/2 times higher than rates found among representative samples of middle-aged and elderly populations. Mean level of depression did not change over time, although level of optimism declined significantly. Multiple regression analyses showed that levels of depression and perceived burden in support persons are highly related to aspects of the stroke such as its severity, and that demographic variables such as age and income play a relatively minor role in attenuating these relations in the acute adjustment phase. However, from 7 to 9 months after the stroke, well-established demographic variables such as health, income, and age were significant predictors of depression. Individuals who were older and who had good health and higher incomes were least depressed.     

Cognitive monitoring and strategy choice in younger and older adults

Younger (24- to 39-year-old) and older (60- to 88-year-old) adults learned a list of vocabulary words; one half of the words were studied using a generally more powerful strategy (mnemonic keyword method), and one half mediated with a less powerful approach (generating semantic contexts). Before using these strategies as part of the experiment, neither younger nor older adults judged that the keyword method was more effective and neither group preferred one strategy over the other. After using the strategies and taking a test of strategically studied unfamiliar vocabulary words, the younger subjects reported accurately the relative effectiveness of the two strategies and selected the one that had worked better for them to apply to a subsequent list of vocabulary items. The older participants were not as aware of the differential potency of the strategies and did not rely as much as did the younger subjects on knowledge of strategy utility in making strategy choices. In short, metacognitive awareness of strategy effects produced by monitoring and use of metacognitive awareness in regulating strategy choice were more pronounced in the younger compared with the older sample in this study.     

Remarriage as a coping response for widowhood

Consideration and use of remarriage as a response to cope with the death of a husband was examined in 39 women who had been widowed and had subsequently remarried, 192 widows who had considered remarriage but had not yet remarried, and 420 widows who had not considered remarriage. Controlling for age, we found that women who had remarried reported fewer current concerns than did the other two groups. Furthermore, we found that women who retrospectively recalled the most concerns immediately after the death of the spouse were the ones who eventually remarried. The remarried group believed that they were experiencing significantly fewer concerns now than they had after the spouse's death; the women who had not considered remarriage believed that they were experiencing the same number of concerns now as before; and those women who had considered remarriage believed that they were experiencing significantly more concerns. Implications for remarriage as a coping mechanism for widowhood and the relation of age to remarriage decisions are discussed.     

Increasing similarity in the values and life plans of male and female college students? Evidence and implications

A time-series analysis of college freshmen indicates that from 1969 to 1984 there has been a dramatic increase in the value women place on status-attainment goals, but not a comparable decrease in the value placed on domestic-nurturant goals—a pattern that reflects an amalgamation rather than a masculinization of the feminine value constellation. As the value placed on status-attainment goals has not increased as significantly for males, there has been a narrowing of the difference in the value constellations of the sexes over this time period. Further, there has been a greater increase in the percentage of women than men aspiring to graduate degrees and to the highest status professional and executive occupations, resulting in increased congruence in the educational and high-status career goals of women and men. The limitations and implications of these data are discussed.The research for this paper was funded by a grant from the Josiah Macy Jr. Foundation. I thank Andrea Tyree and Norman Goodman for reading and commenting on earlier drafts of this paper. I particularly thank Stephen Cole for his incisive comments.     

Measurement of activity in small animals using a microcomputer-controlled system

A computer-controlled system that detects spontaneous activity (locomotion and rearing) and diurnal activity rhythms in small animals is described. Automatic recording of subtotals during test periods provides data about habituation (nonassociative learning). The system is relatively inexpensive to construct. Fabricated from highly reliable circuit components, it provides replicable measures that enable comparisons between different experimental treatments to be made using parametric statistics.     

Production and control of auditory signals in attention research using the Apple-Psych system

A technical issue in auditory spatial attention research is how best to provide low-cost, accurate control of the frequency, duration, and location of acoustic signals. Three solutions to the problem are compared: use of the internal oscillator of the Apple lIe, use of a Mountain A/D+D/A card, and use of an external oscillator chip. The unique advantages and drawbacks of each system are discussed. All share some common problems of external speaker interface, timing control, and interface with the software. Hardware and software solutions implemented on the Apple-Psych system are discussed, along with data that demonstrate the precision control achieved with the system.     

Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.     

Beyond medical ethics: New directions for philosophy and medicine

A unique relationship exists between physicians and philosophers — one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the social cultural and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary.