Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

Erik Eriksen is a remarkable individual. He has no college degrees yet is Professor of Human Development at Harvard University. He came to psychology via art, which explains why the reader will find him painting contexts and backgrounds rather than stating dull facts and concepts. He has been a training psychoanalyst for many years as well as a perceptive observer of cultural and social settings and their effect on growing up. This is not just a book on childhood. It is a panorama of our society. Anxiety in young children, apathy in American Indians, confusion in veterans of war, and arrogance in young Nazis are scrutinized under the psychoanalytic magnifying glass. The material is well written and devoid of technical jargon. The theme of the volume is that it is human to have a long childhood which will leave a lifelong residue of emotional immaturity in man. Primitive groups and

Childhood and Society.

Background: As more and more cancers occur in elderly people, oncologists are increasingly confronted with the necessity of integrating geriatric parameters in the treatment of their patients. Methods: The International Society of Geriatric Oncology (SIOG) created a task force to review the evidence on the use of a comprehensive geriatric assessment (CGA) in cancer patients. A systematic review of the evidence was conducted. Results: Several biological and clinical correlates of aging have been identified. Their relative weight and clinical usefulness is still poorly defined. There is strong evidence that a CGA detects many problems missed by a regular assessment in general geriatric and in cancer patients. There is also strong evidence that a CGA improves function and reduces hospitalization in the elderly. There is heterogeneous evidence that it improves survival and that it is cost-effective. There is corroborative evidence from a few studies conducted in cancer patients. Screening tools exist and were successfully used in settings such as the emergency room, but globally were poorly tested. The article contains recommendations for the use of CGA in research and clinical care for older cancer patients. Conclusions: A CGA, with or without screening, and with follow-up, should be used in older cancer patients, in order to detect unaddressed problems, improve their functional status, and possibly their survival. The task force cannot recommend any specific tool or approach above others at this point and general geriatric experience should be used.

Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG).

Background: The vital role played by family caregivers in supporting dying cancer patients is well recognized, but the burden and economic impact on caregivers is poorly understood. We prospectively examined the psychosocial, occupational and economic impact of caring for a person with a terminal illness. Methods: We studied 89 caregivers of women with advanced breast cancer receiving care at either the Ottawa or Hamilton regional cancer centres in Ontario. Patients were followed until their death or study completion at 3 years. Patients identified a principal caregiver to participate in the study. The Karnofsky Performance Status (KPS) index, the Medical Outcomes Study 36-item Short Form (SF-36), the Hospital Anxiety and Depression Scale, the Zarit Burden Inventory, FAMCARE and the Medical Outcomes Study Social Support Survey were administered during follow-up. Economic data were collected by means of a questionnaire administered by an interviewer. Assessments were conducted every 3 months during the palliative period (KPS score > 50) and every 2 weeks during the terminal period (KPS score ≤ 50). Results: Over half of the caregivers were male (55%) and the patient9s spouse or partner (52%), with a mean age of 53 years. At the start of the palliative period, the caregivers9 mean physical functioning score was better than the patients9 (51.3 v. 35.1, 95% confidence interval [CI] 13.3–20.0); there were similar mean mental functioning scores (46.6 and 47.1 respectively); similar proportions were depressed (11% and 12%); and significantly more caregivers than patients were anxious (35% v. 19%, p = 0.009). More caregivers were depressed (30% v. 9%, p = 0.02) and had a higher level of perceived burden (26.2 v. 19.4, p = 0.02) at the start of the terminal period than at the start of the palliative period. Burden was the most important predictor of both anxiety and depression. Of employed caregivers, 69% reported some form of adverse impact on work. In the terminal period 77% reported missing work because of caregiving responsibilities. Prescription drugs were the most important component of financial burden. Interpretation: Caregivers9 depression and perceived burden increase as patients9 functional status declines. Strategies are needed to help reduce the psychosocial, occupational and economic burden associated with caregiving.

/pdf/family-caregiver-burden-results-of-a-longitudinal-study-of-177xci05nd.pdf

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers

Results of regression models, like estimates, are typically presented as tables that are easy to understand. Sometimes pure estimates are not helpful and difficult to interpret. This is especially true for interaction terms in logistic regression or even more complex models, or transformed terms (quadratic or cubic terms, polynomials, splines), where the estimates are no longer interpretable in a direct way. In such cases, marginal effects are far easier to understand. In particular, the visualization of marginal effects makes it possible to intuitively get the idea of how predictors and outcome are associated, even for complex models.

/pdf/ggeffects-tidy-data-frames-of-marginal-effects-from-1majcnei1k.pdf

ggeffects: Tidy Data Frames of Marginal Effects from Regression Models

http://du.diva-portal.org/smash/get/diva2:1428734/FULLTEXT01

Trends and gender associations in social exclusion in older adults in Sweden over two decades.

This study examines the effects of an intervention that involves the compilation of a book of wartime experiences on a group of housebound older people who live in the community with the support of social services. Using the theoretical framework of the Hopelessness Theory of Depression (Abramson, Metalsky, & Alloy, 1989), we examine the impact of attributional style (Abramson et al., 1989) and efficacy (Bandura, 1977; Houston, 1995) on changes in psychological well-being following the intervention. Prior to the intervention, participants completed a newly constructed Extended Attributional Style Scale for the Elderly and the General Health Questionnaire (Goldberg & Hillier, 1979). Following the intervention there was a significant improvement in psychological well-being across the sample-those with depressogenic styles and low efficacy and those with high efficacy and nondepressogenic styles reported most improvement. The findings indicate that a relatively small-scale intervention can have a significant impact on the well-being of order people living alone in the community.

Attributional Style, Efficacy, and the Enhancement of Well-Being Among Housebound Older People

Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage National Background Report for the United Kingdom

Design in Caring Environments is a study of residential care buildings for older people carried out by architects and psychologists from the Universities of Sheffield and Loughborough. The study is a search for evidence that building design influences the quality of life of residents and the quality of care given by staff. Thirty eight care homes were observed and analysed in terms of their physical and environmental provision in parallel with an assessment of the quality of life of a sample of the residents in each home. The research finds that building design does appear to have an impact on quality of life both positively and negatively. There are indications that a risk-averse culture leads to a diminished lifestyle, and that physically supportive environments are life enhancing. The implications for the design of residential buildings are the subject of this paper.

The Influence of Building Design on the Quality of Life of Older People

Few studies have explored older people's expected future quality of life (QoL), despite evidence that perceptions of one's future influence healthy aging. Research on this topic should embrace a range of potential influences, including perceptions of one's neighborhood and region. This study examined expected QoL in a random sample of the population of Dalarna, a Swedish region. A self-completion questionnaire assessed demographic characteristics, current neighborhood and regional evaluations, self-evaluations, expectations for the future, and current and expected QoL. In total, 786 people aged ≥65 years participated. A sequential multiple regression model explained 44% of the variance in older people's expected QoL, with self-reported health (sr (2) = .03), Expected Regional Opportunity (sr (2) = .03), and Perceived Regional Status (sr (2) = .02) having the strongest associations with expected QoL. Research on the importance of one's neighborhood to QoL in older people should encompass people's perceptions of their region, to better inform social policy for healthy aging.

Kevin McKee

Papers

Trends and gender associations in social exclusion in older adults in Sweden over two decades.

Attributional Style, Efficacy, and the Enhancement of Well-Being Among Housebound Older People

Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage National Background Report for the United Kingdom

The Influence of Building Design on the Quality of Life of Older People

Five Years From Now: Correlates of Older People’s Expectation of Future Quality of Life