Medication Administration By Family Members of Dependent Elders In Shared Care Arrangements

Twenty-three long-term care family caregivers whose care-recipients were enrolled in adult day care programs participated in face-to-face, semistructured interviews designed to learn more about their medication administration experiences. Two distinct styles of decision making were identified: self-directed and physician-directed. To help them with their medication administration responsibility, both groups used primary (physicians, pharmacists, or both) and secondary sources of information (the internet, information hotlines, nurses, more experienced caregivers, and family members with health backgrounds). Self-directed caregivers, who were significantly younger than the physician-directed caregivers, were twice as likely to report use of secondary sources of information to manage their medication administration tasks. Secondary sources of information appear to be important for the development of a caregiver's maturation and critical thinking skills over the long term and need more attention from formal providers in shared care relationships with family caregivers.     

Mothers' attachment representations and choice of infant care: center care vs. home

In the debate concerning the effects of day care on infant development, insufficient attention has been paid to the potential relationship between pre‐existing emotional differences among mothers and the type of care they choose for their infants. To shed light on this issue, this study examines the attachment representations of mothers who choose day‐care centres as opposed to mothers who choose to remain at home with their infants. Participants were 76 primiparous mothers. Mothers' attachment classifications were assessed by the Adult Attachment Interview [AAI; Main M, Kaplan N, Cassidy J. 1985. Security in infancy, childhood, and adulthood: a move to the level of representation. In Growing Points of Attachment Theory and Research. Monograph of the Society for Research in Child Development, 50, (1–2, serial no. 209), Bretherton I, Waters E (eds); 66–104]. Results indicate that more Day‐care than Home‐Care mothers are classified as insecurely attached. These results highlight the contribution of maternal emotional characteristics to the effects of diverse child care arrangements on infant development. Copyright © 2001 John Wiley & Sons, Ltd.     

The end of theoretical orientations?

Theoretical orientation is the most pervasive organizing device in psychology. Ideas, books, people, therapies, and other salient matters are frequently classified into psychodynamic, behavioral, humanistic, cognitive, or other orientation categories. The continued prominence of theoretical-orientation classification belies a breakdown in its applicability to contemporary psychology. Psychotherapy remains a stronghold. However, with internal and external forces endorsing particular approaches, theoretically-based practices will be forced to yield to evidence-based ones. The final dismantling of traditional theoretical categories by evidence-based practice standards paradoxically provides a hopeful impetus to otherwise arrested theoretical development. Manifest avowed theoretical orientation is distinguished from a latent theoretical-orientation construct, and the ways a new kind of meta-theory of therapy will reduce the naivete and increase the applicability of clinical research is discussed.     

Using system differences to orchestrate change: a systems-guides intervention model

Successful community-based interventions require that change agents give attention to the complexities of interwoven systems, described in the literature as complicated or complex, purposeful or purposive. The author further notes the separate standards, norms, principles and/or goals (here-named systems-guides) of systems. This paper describes the author's experience as a consultant to a multi-system collaboration where observed tensions among participants resulted in the author's implementation of a three-step systems-guides model, which can increase change agents' effectiveness with systems. The steps comprise: detection (of systems, systems-guides, and discrepancies between them; here through observation); documentation (of discrepancies; here through small group discussions); dissemination (to systems participants; here to the collaboration). Two small but fundamental systems changes emerged from systems participants, not from the change agent/author who facilitated systems members' recognition of discrepancies. A major limitation in the implementation of this systems-guides model centers on the critical necessity of the close relationship change agents must have with the involved systems.     

Effects of positive youth development programs on school, family, and community systems

A review of efforts at social system change in 526 universal competence-promotion outcome studies indicated that 64% of the interventions attempted some type of microsystemic or mesosystemic change involving schools, families, or community-based organizations in an attempt to foster developmental competencies in children and adolescents. Only 24% of the reports provided quantitative data on the change that occurred in targeted systems. However, studies containing the necessary information produced several mean effect sizes that were statistically significant, and ranged from modest to large in magnitude. These data indicate that attempts to change social systems affecting children and adolescents can be successful. Future work should measure more thoroughly the extent to which the systemic changes that are targeted through intervention are achieved, and investigate how such changes contribute to the development and sustainability of the outcomes that might be demonstrated by participants of competence-promotion programs. The authors wish to thank David Wilson for supplying the macros used to calculate study level effect sizes and Mark Lipsey for supplying the SPSS macros used to weight effect sizes and calculate mean effects across studies. This study was supported in part by a grant from the William T. Grant Foundation (#2212) awarded to the first and last authors.     

Both group peer counselling and individual counselling reduce anxiety and depression,and increase self-esteem and overall life satisfaction in palliative cancer care

This study compared group peer counselling and individual counselling in relation to quality of life, well-being and perceived control in individuals receiving palliative cancer care. The study utilized a quasi-experimental pretest-posttest design to assess the effectiveness of counselling type, in a sample of individuals diagnosed with breast, bowel or lung cancer. Nine females underwent group peer counselling and nine underwent individual counselling. Individuals were administered self-report questionnaires which included standardized subscales that measure quality of life in terms of psychological well-being and perceived locus of control before and after counselling. Both group peer counselling and individual counselling significantly increased self-esteem, self-reported levels of overall life satisfaction, and reduced anxiety and depression. Self-esteem, overall life satisfaction, and anxiety and depression were comparable in the two counselling types, both at outset and after counselling, however, individuals with internal locii of control scored higher for self-esteem on post-test, and lower for depression and anxiety, irrespective of type of counselling.     

李大钊易学思想及其早期哲学

李大钊作为中国激进的民主主义者和中国共产党的创始人之一,其早期对易学有着独特体认和理解,并运用这种体认和理解建立起自己的宇宙观与人生观。他认为周与易体现着体与用、常与变之"宇宙二相",吾人只要"以其不变应其变",就能"以宇宙之生涯为自我之生涯",实现宇宙无尽,即"青春无尽"的人生理想。他用太极、阴阳、变易等易学原理解释、说明进化论,并力图为进化论寻求形上学根据,使之更加合乎中国人的思维习惯;他用进化论来说明易学之阴阳、变易、生生、日新等观念,从而升进了易学的变易观,使大易哲学由传统活转于近代。在他那里,实现了中学与西学、哲学与科学的有机对接。本文认为,在注重易学本身的发展、演化研究的同时,也应注意像李大钊这种对易学援引、运用的研究,进而全面评估易学对中国近代社会进程的影响。     

Functional analysis and treatment of problem behavior of elderly adults in long-term care

Functional analyses were conducted for the problem behavior of 3 older adults in a long-term care setting. Two of the problem behaviors were maintained by attention, and a third was maintained by escape from demands. Function-based interventions were implemented that resulted in decreases in problem behavior in each case. Implications for the use of functional analysis and function-based interventions in the field of gerontology are discussed.     

Teaching math skills to at-risk students using home-based peer tutoring

Home-based peer tutoring was used to teach math skills to 4 girls with deficits in mathematics and histories of abuse or neglect. Girls living in the same home formed tutoring dyads, and each participant served as both the peer tutor and the tutee during the course of the study. At the initiation of the tutoring intervention, an expert tutor provided multiple 3-min tutoring sessions to the designated peer tutor on three or four mathematics skills. The peer tutor concurrently provided 3-min tutoring sessions on the same skills to the tutee using a multiple baseline design. Results showed that participants improved their performance on all target skills. Additional interventions were implemented for some skills to improve accuracy further. Maintenance tests were also administered after 3 to 5 months of no practice on the skills. Results showed that tutors and tutees maintained their accuracy on 7 of the 12 skills assessed.     

Abortion and Health Care Chaplaincy in Australia

This paper summarizes the results gained from quantitative and qualitative research involving 327 Australian health care chaplains with regard to their involvement in abortion issues within the health care context. The findings indicate that approximately 20% of surveyed chaplains had provided some form of pastoral intervention to patients and/or their families dealing with issues of abortion and that approximately 10% of chaplains had assisted clinical staff with issues concerning abortion. There was found to be no-statistically significant difference with regard to the number of catholic chaplains compared with protestant chaplains or staff chaplains compared with volunteer chaplains involved in abortion issues. Analysis using the WHO Pastoral Intervention codings highlighted a variety of issues encountered by chaplains and the non-judgmental pastoral care used by chaplains when assisting those dealing with abortion. Some implications of this study with respect to patient and clinical staff support are suggested. Dr. Lindsay Carey, M.App.Sc., Ph.D.: National Research Fellow, Australian Health & Welfare Chaplains Association & Faculty Associate, Palliative Care, School of Public Health, La Trobe University, Melbourne, Australia. Dr. Christopher Newell, AM, Ph.D.: Associate Professor, School of Medicine, University of Tasmania, Hobart, Australia.