Does prospective memory influence quality of life in community-dwelling older adults?

Older adults commonly experience declines in prospective memory, which describes one’s ability to “remember to remember,” and can adversely affect instrumental activities of daily living and healthcare compliance. However, the extent to which prospective memory failures may influence quality of life in typically aging older adults is not well understood. One-hundred and four community-dwelling older Australians (aged 50 to 82 years) were administered a comprehensive, neuropsychological battery that included the Memory for Intentions Screening Test (MIST), Prospective and Retrospective Memory Questionnaire (PRMQ), Instrumental Activities of Daily Living Questionnaire (IADLQ), and World Health Organization Quality of Life-8 (WHOQOL-8). Multiple regressions controlling for negative affect, medical comorbidities, and other neurocognitive functions revealed an interaction between prospective memory and instrumental activities of daily living in the concurrent prediction of quality of life. Among the 39 older adults who reported multiple problems on the IADLQ, lower performance-based prospective memory (MIST) and higher self-reported prospective memory failures in daily life (PRMQ) were significantly associated with lower quality of life (WHOQOL-8). Conversely, no significant associations were observed between prospective memory and quality of life in the 65 participants without IADL problems. Prospective memory difficulties adversely impact quality of life in community-dwelling older adults who experience problems independently managing their instrumental activities of daily living. These findings extend prior literature showing that prospective memory plays a unique role in the real-world outcomes of older adults and clinical populations and highlight the need to develop effective strategies to enhance prospective memory functioning in these vulnerable groups.     

Induction when rats lick for 1% liquid-sucrose reinforcement

Previous research reported that rats responding for 1% liquid-sucrose reinforcement when 32% sucrose reinforcement is upcoming will decrease their response rate (contrast) if licking is the dependent measure and increase their response rate (induction) if pressing a lever is the dependent measure. The present study investigated whether induction could be observed when licking served as the dependent measure and whether induction in lever pressing and contrast in licking behaviour could be concurrently observed. Experiment 1 found induction when rats licked to earn the rewards but consumed them at a location separate from the spout licked to earn them. Experiment 2 also found induction when rats earned (and consumed) rewards by licking the same spout throughout the session. Experiment 3 separately measured instrumental lever pressing for sucrose rewards and licking the sucrose during the reward period. We found that both measures increased for 1% sucrose when 32% sucrose reinforcement was upcoming. The present results indicate that the type of response is not the sole determinant of whether contrast or induction is observed. Rather, they suggest that other procedural details, such as the location of reinforcer delivery, influence which effect is observed. The results also indicate that associative processes underlie the appearance of induction in responding for 1% sucrose.     

The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Introduction

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Methods

We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.

Results

1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).

Conclusions

Moral intuitions shed light on variation in physician judgments about cost issues in health care.

     

“Where Are You?” Defensive Dissociation and Fragments of Annihilated Faith

This article addresses the relation between defensive dissociation and faith. Defensive dissociation is understood as a response to severe trauma. In this response there is no interpreting subject to process the event linguistically and the result is fragments of unformulated memory that continue to be painfully present long after the original trauma. The victim of severe trauma alternates between the need to be here in the presence of other human beings and the dissociative isolation of not being here. There are two related claims in this article. First, defensive dissociation stands for an event where faith is annihilated. As a defense it protects a person's remnant sense of faith, subjectivity, agency, and personhood by creating a space of non-experience. Fragments of annihilated faith continue to be present in the person's present formulations of faith and concomitant behaviors, relationships, and use of objects. The second claim is that the core of severe trauma remains outside the victim and community's capacities to represent it symbolically. This incommunicable core of annihilated faith can be contained by a community of faithful persons who are willing to face the horror of non-being and being nowhere without succumbing to despair.     

Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.     

Citizen Involvement & Quality of Life: Exit, Voice and Loyalty in a Time of Direct Democracy

This paper explores the connection between quality of life and direct democracy. Using state level data for participation and quality of life, we find that those states with a high quality of life see higher participation in direct democracy than those with lower quality of life. However, the passage of direct democracy measures has the inverse relationship indicating the importance of maintaining the status quo for states with higher quality of life measurements.     

Response to “Masturbation: Scientific Evidence and Islam’s View”

Journal of Religion and Health -     

Mothers' Impact on Daughters' Cardiovascular Reactivity in a High‐Threat Context: An Immersive Virtual Environment Study

Applying Attachment Theory, research on confirmation, the Entropy Model of Uncertainty, and the Biopsychosocial Model of Challenge and Threat, this investigation examined the role of mothers' communication on adolescents' cardiovascular response to threat. An experimental design allowed for the manipulation of maternal response to daughters experiencing a rapidly approaching wildfire in an immersive virtual environment. Results revealed complexities in the relative benefits of maternal vocalic presence during high‐threat situation, with the mother's history of confirming feedback playing an important role in daughters' cardiovascular response. Implications for knowledge are addressed and methodological possibilities of using immersive virtual environments are noted.