Environmental factors in suicide in long-term care facilities.

One major purpose of this study was to identify environmental factors related to suicide in long-term care facilities. Questionnaires were mailed to a random sample of administrators at 1,080 facilities. Information was collected on facility characteristics, overt suicide, and intentional life-threatening behavior. Chi-square analyses revealed 4 environmental characteristics related to suicidal behavior and deaths from suicide: staff turnover, size, auspices, and per diem cost. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than public or private facilities; facilities charging less experienced more deaths.     

As If Your Life Depended on It: Promoting Cognitive Development to Promote Wellness

In this article the authors discuss key elements of the cognitive-developmental perspective and the need to integrate it as an important component of the wellness model. Each speaks to the personal empowerment of every person to live a rewarding and responsible life. Each also emphasizes the ongoing promotion of growth rather than secondary prevention or remediation.     

Factors related to sleep quality in healthy elderly women.

Elderly women in subjectively good health--free of acute illness and major sleep pathologies--who were self-identified as good (n = 22) and poor (n = 16) sleepers were compared on measures of physical health, psychological symptoms, psychosocial status, and life-style. Poor sleepers reported longer sleep latencies, less total sleep time, more nonrestorative sleep, and more daytime fatigue than did good sleepers. Sleep recordings confirmed subjective reports, with shorter total sleep times and trends for lower sleep efficiency, longer sleep latencies, and more wake-after-sleep onset among women with subjective poor sleep. Poor sleepers also were more frequent users of sedative-hypnotic medications in the past. Current medication use, alcohol and caffeine use, daytime napping, and exercise were equivalent in both groups. Psychosocial status failed to discriminate groups. Poor sleepers reported significantly more psychological symptoms than did good sleepers. The levels of both psychological symptoms and sleep disturbance were mild.     

The Logic of the Development of Feminism; or,Is MacKinnon to Feminism as Parmenides Is to Greek Philosophy?

Catharine MacKinnon's investigation of the role of sexuality in the subordination of women is a logical culmination of radical feminist thought. If this is correct, the position of her work relative to radical feminism is analogous to the place Parmenides's work occupied in ancient Greek philosophy. Critics of MacKinnon's work have missed their target completely and must engage her work in a different way if feminist theory is to progress past its current stalemated malaise.     

The accuracy of maternal self-reports: Agreement between reports on a computer simulation compared with observed behaviour in the supermarket

The validity of maternal self-reports about their parenting behaviour is evaluated with two studies. In both studies, the mothers were observed shopping in the supermarket with their 2-year-old children. One week later they responded to multiple choice questions on a computer that simulated the experience of shopping with their children. The exact agreement between the two types of data was then assessed. The results from the first study involving 28 mothers revealed some agreement, although it was generally low. In an effort to increase the level of agreement, the computer simulation was revised to allow multiple responses and to clarify some of the simulation vigenettes. A replication study resulted in a considerably higher level of agreement for 22 mothers. Implications of this method for researchers and practitioners are discussed.     

The gestural repertoire and its evolution over the second year

The entire repertoire of communicative gestures was documented in a longitudinal, observational study of 10 infants, whose combined ages covered the range from 9 to 22 months. Early in the second year, giving as a request to do something with the object increased, while emotive gestures decreased. Later in the second year, pointing gestures increased, while protest gestures tended to decrease. Combining gestures with vocalization tended to increase only for protest gestures later in the second year. Eye contact showed a small but continuous increase in coordination with gestures over the second year, particularly with comment, request, and emotive gestures. These findings indicate an increasing use of the parent as an agent and of the informative function in non-verbal communication during this period of transition to verbal communication.     

Brief report: An extension of the sequential alternating treatment design using reversals with subjects not available concurrently

This brief report proposes an extension of the traditional Alternating Treatments Design that would be acceptable to use in hospital and residential settings where subjects are often not concurrently available. Concerns about the inability of traditional designs to work in these special situations and the emergence of a “scientist–practitioner split” are discussed. An example of how the Extended Alternating Treatments Design might be used is provided.     

Genetic counselor as a member of an outreach education team

As part of a program to improve maternal and infant health in New Jersey, the Robert Wood Johnson Foundation has funded seven regional consortia throughout the State. One of the goals of the Northern New Jersey Regional Consortium is to provide a comprehensive educational program for ambulatory care staff. An outreach education team was established that includes a perinatal nurse educator, a neonatal nurse educator, a nutritional counselor and a genetic counselor. Many issues in genetics can be initially addressed by the ambulatory care provider. A good understanding and awareness of the impact of genetic issues in patient care is needed to enhance the ability to recognize patients needing special services. Early assessment of possible risk for developmental disabilities can lead to appropriate comprehensive care and improved pregnancy outcome. Regular in-service programs, addressing the way heredity contributes to developmental disorders, the latest techniques used in genetics and the available management programs, can be provided. The present study is an evaluation of the effectiveness of the program.