자연주의적 탐구조사(Naturalistic Inquiry)

A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.

The need to belong: Desire for interpersonal attachments as a fundamental human motivation.

In this article, the author describes a new theoretical perspective on positive emotions and situates this new perspective within the emerging field of positive psychology. The broaden-and-build theory posits that experiences of positive emotions broaden people's momentary thought-action repertoires, which in turn serves to build their enduring personal resources, ranging from physical and intellectual resources to social and psychological resources. Preliminary empirical evidence supporting the broaden-and-build theory is reviewed, and open empirical questions that remain to be tested are identified. The theory and findings suggest that the capacity to experience positive emotions may be a fundamental human strength central to the study of human flourishing.

http://www.elaborer.org/cours/A13/lectures/Fredrickson2001.pdf

The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions.

Numerous studies show that happy individuals are successful across multiple life domains, including marriage, friendship, income, work performance, and health. The authors suggest a conceptual model to account for these findings, arguing that the happiness-success link exists not only because success makes people happy, but also because positive affect engenders success. Three classes of evidence--crosssectional, longitudinal, and experimental--are documented to test their model. Relevant studies are described and their effect sizes combined meta-analytically. The results reveal that happiness is associated with and precedes numerous successful outcomes, as well as behaviors paralleling success. Furthermore, the evidence suggests that positive affect--the hallmark of well-being--may be the cause of many of the desirable characteristics, resources, and successes correlated with happiness. Limitations, empirical issues, and important future research questions are discussed.

/pdf/the-benefits-of-frequent-positive-affect-does-happiness-lead-4k0h6bmoho.pdf

The Benefits of Frequent Positive Affect: Does Happiness Lead to Success?

Background 
The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.
Objectives 
This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.
Data Extraction 
Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.
Results 
Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).
Conclusions 
The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.

Please see later in the article for the Editors' Summary

/pdf/social-relationships-and-mortality-risk-a-meta-analytic-2ghmxi4ksm.pdf

Social Relationships and Mortality Risk: A Meta-analytic Review

18002 Background: Resectable non-small-cell lung cancer (NSCLC) has been once considered as a surgical disease and therefore managed by surgeons alone, as the primary therapeutic option was surgica...

Elderly patients with resected stage II, IIIA non-small cell lung cancer, increased referral rate to medical oncologists, 1992-2002

Immunologic function is one of the most intensively studied physiologic processes in gerontology, in part due to the explosive growth in all aspects of immunologic research in the past three decades, and to the ease of obtaining immunocytes (lymphocytes, monocytes, and polymorphonuclear leukocytes) for study. There are more fundamental reasons, however, why the study of immunology is particularly relevant to gerontology. Immunologic function declines with age, as do most physiologic functions. Concomitant with this decline in immune function, there is a rise in the incidence of many infections and malignancies with age. There is greater morbidity and mortality associated with common infections in adults over age 65 years. Elderly persons respond less well to protective immunizations against common infections such as influenza and pneumococcal pneumonia. Also intriguing have been observations dating back to the 1930s (described later) linking changes in immune function with changes in the life span of various animal species. An understanding of immunologic changes might be important not only in understanding the aging process, but also in developing potential strategies to prevent some of the morbidity and other changes that occur with age.1,2 This chapter describes changes in the immune system attributed to aging, and gives an overall sense of our understanding of aging and immune function as we near the end of the twentieth century.

Changes in Immunologic Function

669 Background: In 5/98 the results of CALGB 9344 were presented at ASCO: adjuvant paclitaxel provided a significant survival benefit for women with lymph node (LN) positive BC. We have now evaluat...

The impact of CALGB 9344 on adjuvant taxane (T) Use for breast cancer (BC)

BACKGROUND Potentially inappropriate medication (PIM) use is a risk factor for hospitalization and mortality. However, there were few studies focusing on the impact of provider type on PIM use. OBJECTIVE We aimed to estimate the initial and refill PIM prescribing rate for physician visits and nurse practitioner (NP) visits and the impact of provider type on PIM prescribing. RESEARCH DESIGN We used 100% Texas Medicare data to define physician visits and NP visits in 2016. The rate of visits with a PIM prescription from the same provider was measured, distinguishing between initial and refill prescription to estimate the PIM rate and adjusted odds ratio (OR) by provider type. RESULTS There were 24.1 per 1000 visits with a prescription for a PIM: 9.0 per 1000 visits for an initial PIM and 15.1 per 1000 visits for a refill PIM. A visit to an NP was less likely to result in an initial (OR = 0.74, 95% confidence interval [CI] = 0.70-0.79) or refill (OR = 0.54, 95% CI = 0.51-0.57) PIM. The association of lower odds of receiving a prescription for an initial PIM from an NP was substantially stronger among black enrollees than white enrollees (OR = 0.44, 95%CI = 0.30-0.65 for blacks and OR = 0.73, 95%CI = 0.68-0.78 for white enrollees). The association of an NP provider with lower odds of receiving a PIM refill was more pronounced in older patients and in those with more comorbidities. CONCLUSIONS NPs prescribed fewer initial PIMs and were less likely to refill a PIM after an outpatient visit than physicians. The lower odds of receiving PIMs during an NP visit varied by age, race/ethnicity, rurality, and number of comorbidities.

James S. Goodwin

Papers

Elderly patients with resected stage II, IIIA non-small cell lung cancer, increased referral rate to medical oncologists, 1992-2002

Changes in Immunologic Function

The impact of CALGB 9344 on adjuvant taxane (T) Use for breast cancer (BC)

Potentially inappropriate medication prescribing by nurse practitioners and physicians

Active life expectancy of older US and foreign-born Mexican Americans: The Mexican-Origin Population