The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic

Bowling alone: The collapse and revival of American community

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

On death and dying

This survey of sexual practices in the United States has been combed by the media for items of interest to the public: monogamous sex is much more widespread in this country than has been thought; infidelity is less frequent than presumed; vaginal intercourse is the defining experience of heterosexual behavior; watching one's partner undress is stimulating to many people; married couples have more sex than single people (unmarried, cohabiting couples have the most sex of all); the majority of couples experience sex twice a week to several times a month; 2.8% of men identify themselves as homosexual and 1.4% of women do so, but a higher percentage of people consider a same-gender experience to have some appeal; 75% of men always experience orgasm compared with 28.6% of women, but more nearly equal numbers of men and women declare themselves satisfied with their sexual experiences. The book is, in fact, a

The Social Organization of Sexuality: Sexual Practices in the United States

This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered.

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Psychological well-being revisited: advances in the science and practice of eudaimonia.

Objectives: This research tests the influences of age, biological, and psychosocial factors on sexual expression in later life. Method: The American Association of Retired Persons Modern Maturity Sexuality Survey collected data on diagnosed illnesses, treated illnesses, sexual desire, sexual attitudes, partner circumstances, and sexual behavior from 1,384 persons ages 45 and older. Ordered logistic regression models estimate the associations of age, biological, and psychosocial factors with the frequency of five sexual behaviors. Results: Diagnosed illnesses and treatments are generally unrelated to frequency of sexual activity. Sexual attitudes are related to frequency of partnered behavior and sexual desire is related to frequency of masturbation among both women and men. Satisfaction with the physical relationship with a partner is strongly related to behavior. Age remains significant after all other factors are controlled. Discussion: The authors conclude that the nature of sexual expression in later ...

Sexual behavior in later life.

COVID-19 fatalities exemplify "bad deaths" and are distinguished by physical discomfort, difficulty breathing, social isolation, psychological distress, and care that may be discordant with the patient's preferences. Each of these death attributes is a well-documented correlate of bereaved survivors' symptoms of depression, anxiety, and anger. Yet the grief experienced by survivors of COVID-related deaths is compounded by the erosion of coping resources like social support, contemporaneous stressors including social isolation, financial precarity, uncertainty about the future, lack of routine, and the loss of face-to-face mourning rituals that provide a sense of community and uplift. National efforts to enhance advance care planning may help dying patients to receive care that is concordant with the preferences of them and their families. Virtual funeral services, pairing bereaved elders with a telephone companion, remote counseling, and encouraging "continuing bonds" may help older adults adapt to loss in the time of pandemic.

https://www.tandfonline.com/doi/pdf/10.1080/08959420.2020.1764320

Bereavement in the Time of Coronavirus: Unprecedented Challenges Demand Novel Interventions.

gression models and data from a sample of 293 older adults, we estimated the effects of family relationship quality on the likelihood of completing ACP and appointing a spouse or adult child as DPAHC. Analyses controlled for demographic and health characteristics. Results. Better o verall family functioning increased the odds of ACP. Higher levels of spousal support increased the odds of holding informal discussions, whereas spousal criticism reduced the odds of naming one’s spouse as DPAHC. Both criticism and emotional support from children increased the odds that a child was named as DPAHC. Discussion. F amily dynamics affect ACP in complex ways and should be considered when patients and their families discuss end-of-life care and make DPAHC designations.

/pdf/family-relationships-and-advance-care-planning-do-supportive-2dubwl7lnu.pdf

Family Relationships and Advance Care Planning: Do Supportive and Critical Relations Encourage or Hinder Planning?

Purpose: We document the extent to which older adults accurately report their spouses’ end-of-life treatment preferences, in the hypothetical scenarios of terminal illness with severe physical pain and terminal illness with severe cognitive impairment. We investigate the extent to which accurate reports, inaccurate reports (i.e., errors of undertreatment or overtreatment), and uncertain reports (responses of ‘‘do not know’’) are associated with spouses’ advance care planning and surrogates’ involvement in the planning. Design and Methods: We used data from married couples who participated in the Wisconsin Longitudinal Study in 2004. These 2,750 couples were in their mid-60s and in relatively good health. We conducted multinomial logistic regressions. Results: Surrogates were accurate in the majority of cases, made errors in 12% to 22% of cases, and were uncertain in 11% to 16% of cases. Errors of overtreatment and undertreatment were equally prevalent. For both scenarios, discussing preferences was associated with lower odds of an uncertain surrogate response. Implications: We suggest ways that health care practitioners could facilitate family-level conversations in order to ensure that patients’ preferences are accurately represented in end-of-life care settings.

Spouses' Effectiveness as End-of-Life Health Care Surrogates: Accuracy, Uncertainty, and Errors of Overtreatment or Undertreatment

Objectives:This study examined childhood socioeconomic status (SES) as a predictor of later life cognition and the extent to which midlife SES accounts for associations. Methods: Data came from 5,074 participants in the Wisconsin Longitudinal Study. Measures from adolescence included parents' educational attainment, father's occupational status, and household income. Memory and language/executive function were assessed at ages 65 and 72 years. Results: Global childhood SES was a stronger predictor of baseline levels of language/executive function than baseline memory. Associations involving parents' education were reduced in size and by statistical significance when accounting for participants' midlife SES, whereas associations involving parental income and occupational status became statistically nonsignificant. We found no associations between childhood SES and change in cognition. Discussion: Findings contribute to growing evidence that socioeconomic differences in childhood have potential consequences for later life cognition, particularly in terms of the disparate levels of cognition with which people enter later life.

Sara M. Moorman

Papers

Sexual behavior in later life.

Bereavement in the Time of Coronavirus: Unprecedented Challenges Demand Novel Interventions.

Family Relationships and Advance Care Planning: Do Supportive and Critical Relations Encourage or Hinder Planning?

Spouses' Effectiveness as End-of-Life Health Care Surrogates: Accuracy, Uncertainty, and Errors of Overtreatment or Undertreatment

Childhood Socioeconomic Status and Later Life Cognition: Evidence From the Wisconsin Longitudinal Study: