Do elderly Medicare recipients contact physicians appropriately?

Objectives: This research identified characteristics of persons and their illness episodes that predict appropriate and inappropriate decisions to seek medical care.

Methods: This study analyzes 1,292 health care decisions of 885 elderly members of an HMO in Los Angeles. Illness episodes are divided into three categories based on the expertise of a panel of 22 geriatricians, using a formal mathematical analysis derived from anthropological consensus theory.

Understanding and controlling response bias in needs assessment studies.

This study demonstrated that estimates of agency awareness in the typical needs assessment study are probably inflated by a response bias labeled "agency awareness overclaming." Overclaimers (respondents who reported being aware of fictitious agencies) reported being aware of more real agencies than other respondents. Estimates of agency awareness may also be biased, because certain segments of the population were more likely to exhibit agency awareness overclaiming.

Depression and attribution in abused children and their nonoffending caregivers.

This study examined depression and attribution in 17 abused children and their nonoffending caregivers. Analysis indicated that negative attributions were significantly related to higher scores on depression of both children and caregivers, that depression scores of caregivers were unrelated to depression of their abused children, but that caregivers, nevertheless, assessed their children's self-reported depression as similar to their own self-reported depression.

New zwitterionic butanesulfonic acids that extend the alkaline range of four families of Good buffers: evaluation for use in biological systems.

Four new zwitterionic butanesulfonic acid buffers that are structurally related to four families of Good buffers were evaluated for use in biological systems. These buffers, with pKa values from 7.6 to 10.

Infant communication and the development of hypnotic responsivity.

The research on the development of hypnotic responsivity indicates that it emerges, ex nihilo, sometime after the age of 3. The measures used to assess hypnotic responsivity rely on complex verbal instructions, thus precluding investigation of infancy. Recent research on infancy, however, suggests that the ontogenesis of hypnotic responsivity is likely to be found in fundamental human capacities that emerge in the first weeks and months of life.

Speech acts: sampling the social construction of mental retardation in everyday life.

A sample of speech acts in everyday discourse referring to persons or events having to do with the term mental retardation was analyzed in order to investigate the belief that language use both constructs and reflects cultural norms that define the social roles of persons reduced to object status through categorical membership. Speech acts gathered suggest four emergent themes: the discourse of category membership, the dichotomy of normal and abnormal, issues of place and space, and fear. These themes were explicated from a social constructionist perspective, displaying the way speech acts construct mental retardation and subvert individuals with the label into demeaned and ridiculed objects of cultural fear.

Uninsured spells of the poor: prevalence and duration.

The number of persons without health insurance is increasing. Although research has focused on the uninsured poor and the duration of spells without health insurance, less attention has been paid to the dynamics of spells without health insurance among those in poverty. Here it is shown that the typical uninsured spell is longer for the uninsured poor (roughly 8.

Photoreceptor orientation and alignment in nasal fundus ectasia.

Background: We investigated whether Stiles-Crawford (SCE) functions, a measure of photoreceptor orientation and alignment, are disturbed in patients with nasal fundus ectasia (tilted disc; Fuch's coloboma without apparent pupillary involvement).

Methods: SCE functions were obtained in three observers with nasal fundus ectasia, using psychophysical methods.

Results: In all cases, disruption of photoreceptor alignment can be inferred.

Expectations and motives for alcohol use in a psychiatric outpatient population.

The purpose of the study was to assess alcohol expectancies and motives of psychiatric outpatients with and without comorbid current or lifetime substance use disorders. Seventy-five psychiatric outpatients with diagnoses of mood disorders, anxiety disorders, and substance use disorders were administered the Alcohol Effect Expectancy Questionnaire-Abridged Version and the Drinking Motives Measure. Results demonstrated that the internal reliabilities for the two scales were comparable with those reported for these measures in the general population.

On what basis hope? Modern progress and postmodern possibilities.

Modern and postmodern versions of hope as they apply to services for persons labeled as having mental retardation were examined. Proponents of modernism construct hope as relying on an ever-improving science to accurately comprehend mental retardation and other disabilities and the effectiveness of professional interventions. This myth of scientific progress is traced in various forms through American intellectual history to the development of special education as interventionist social science.

Surgical residents' scores on measures of Machiavellianism and physicians' uncertainty.

51 self-reported scores on the Mach V Scale and 56 scores on Physician's Reactions to Uncertainty Constructs from surgical residents in three different specialties (30 general, 14 orthopedics, 9 urology, and 3 other) showed no significant difference between means on the two measures.

Developmental control of cell division in leech embryos.

During embryogenesis, cell division must be spatially and temporally regulated with respect to other developmental processes. Leech embryos undergo a series of unequal and asynchronous cleavages to produce individually recognizable cells whose lineages, developmental fates and cell cycle properties have been characterized. Thus, leech embryos provide an opportunity to examine the regulation of cell division at the level of individual well-characterized cells within a community of different types of cells.

Protective factors within the family, and their role in fostering resiliency in African American adolescents.

Violence has reached epidemic proportions in the United States, with African American males residing in urban areas bearing the brunt of this epidemic. The violence permeating our society emanates from a variety of societal ills, including poverty, racism, substance abuse and exposure to violence. Traditionally, methods of research on adolescent violence have focused on an identification of associated risk factors.

Clients' evaluation of health care services in a battered women's shelter.

There is a dearth of evaluation research regarding shelter health care. Health needs outweigh health services which are rarities within shelter settings (Gross & Rosenberg, 1987). The purposes of this article are to review the need for shelter health care, describe how shelter-based advanced practice nurses (APNs) addressed health care needs and program goals in one shelter setting, and report findings from an impact evaluation study where APN services were rated by shelter clients (n = 69) for themselves and their children (n = 95).

Outreach to homeless mentally ill people: conceptual and clinical considerations.

This paper describes a model of outreach predicated on developing a trusting, meaningful relationship between the outreach worker and the homeless person with mental illness. We describe five common tasks inherent in this model of outreach (establishing contact and credibility, identifying people with mental illness, engaging clients, conducting assessments and treatment planning, and providing ongoing service). Other issues discussed include: (a) Responding to dependency needs and promoting autonomy; (b) setting limits while maintaining flexibility; (c) resistance to mental health treatment and follow-up service options.

Time-management training: effects on time behaviors, attitudes, and job performance.

This quasi-experimental field study examined the effects of a time-management training program on 44 employees' self-reports of time-management behavior control over their time, job satisfaction, and stress responses, and on supervisor's ratings of these employees' job performance. Contrary to expectations, respondents did not report more frequent use of time-management behaviors, more job satisfaction, or less job-induced tension after training, compared with those not receiving training. Job performance did not significantly change after training.

Detecting abuse against women in the home.

Assault is the single major cause of injury to women. Between 1.8 and 4.

Expression of the cell cycle control gene, cdc25, is constitutive in the segmental founder cells but is cell-cycle-regulated in the micromeres of leech embryos.

The identifiable cells of leech embryos exhibit characteristic differences in the timing of cell division. To elucidate the mechanisms underlying these cell-specific differences in cell cycle timing, the leech cdc25 gene was isolated because Cdc25 phosphatase regulates the asynchronous cell divisions of postblastoderm Drosophila embryos. Examination of the distribution of cdc25 RNA and the zygotic expression of cdc25 in identified cells of leech embryos revealed lineage-dependent mechanisms of regulation.

Partner abuse against female nursing students.

Although nurses may have the necessary skills to plan care of clients in a variety of settings, experience and research demonstrate that nursing interventions with women victims of violence have been consistently inadequate. Of the 243 nursing students included in this study, 8% reported experiencing physical abuse, and 18.9% reported experiencing nonphysical abuse.

Compromises in the visual field with the M43 aviation mask.

This study evaluated peripheral vision through the M43 protective mask currently worn by aviators in the AH-64 Apache helicopter. A Humphrey Visual Field Analyzer was used to measure the sensitivity of a subject's visual field with and without the mask. The results were analyzed using Dicon's Fieldview software.

Fears of normal and retarded children.

The developmental features of the fears of 112 nonretarded and 42 retarded children were examined. With development, the fears of nonretarded children became more closely aligned with real sources of threat that involve human agency and less fearful of imaginary things. The retarded children displayed patterns of fears similar to their mental-age peers rather than chronological peers and were more likely to deny being fearful than their nonretarded peers.

Predicting psychiatric symptoms among homeless people.

Multiple regression was used to predict psychiatric symptoms among homeless people. The following variables were significant predictors of psychiatric symptoms: current life satisfaction, previous psychiatric hospitalization, the number of stressful life events, social support, problem drinking, and childhood unhappiness. The results are discussed in terms of their policy and practice implications, particularly the need for crisis intervention services and for dual-diagnosed clients.