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PubMed2006

Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations.

PURPOSE: There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. DESIGN AND METHODS: The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale (LSNS-6), which was used to screen for social isolation among community-dwelling older adult populations in three European countries. Based on the concept of lack of redundancy of social ties we defined clinical cut-points of the LSNS-6 for identifying persons deemed at risk for social isolation. RESULTS: Among all three samples, the LSNS-6 and two subscales (Family and Friends) demonstrated high levels of internal consistency, stable factor structures, and high correlations with criterion variables. The proposed clinical cut-points showed good convergent validity, and classified 20% of the respondents in Hamburg, 11% of those in Solothurn (Switzerland), and 15% of those in London as at risk for social isolation. IMPLICATIONS: We conclude that abbreviated scales such as the LSNS-6 should be considered for inclusion in practice protocols of gerontological practitioners. Screening older persons based on the LSNS-6 provides quantitative information on their family and friendship ties, and identifies persons at increased risk for social isolation who might benefit from in-depth assessment and targeted interventions.

Aged↗
PubMed2004

The role of cannabis in supporting young people's cigarette smoking: a qualitative exploration.

This paper reports findings from a qualitative study which explores the role of cannabis in young people's lives during their early teenage years. In particular, it focuses on the relationship between cannabis and tobacco-related beliefs and behaviour. Fifty-nine young people of both sexes, aged 13-15, from different socioeconomic backgrounds, and with a wide range of cigarette and cannabis use experience, took part in the study. All were recruited from youth club settings and most were interviewed in self-selected friendship pairs. The paper argues that, while many young people appear to hold predominantly negative views about cigarettes, particularly in relation to their potential to foster dependence, cannabis is often viewed as relatively benign. In spite of these beliefs, for some 'cannabis-oriented' young people, their cannabis use appears to support and reinforce their smoking habit. The paper concludes that a coordinated approach to the planning and delivery of services which addresses young people's health risk behaviours is required. Smoking cessation and drugs education practitioners need to break with tradition, and find ways of working more closely together.

Adolescent↗
PubMed2005

Ambivalence and uncertainty: experiences of and attitudes towards addiction and smoking cessation in the mid-to-late teens.

The late teens is an important transitional period as adolescents move into new social worlds which support or challenge their smoking. This paper draws on research with 99 Scottish 16- to 19-year olds which explored their understanding of their smoking and attitudes towards quitting and cessation support. The study involved qualitative interviews mostly with friendship pairs. Interviewees also completed a brief smoking questionnaire. Most regarded themselves as smokers but few thought they were addicted. Many were interested in quitting but this was not a priority. Perceived barriers to quitting related primarily to habitual and social aspects of dependence including friends' smoking, the smoking culture at work or college, stress and boredom. Few were interested in nicotine replacement therapy or cessation services, which they felt belonged to the world of older addicted smokers. The most effective quitting strategy was thought to be will-power. Traditional cessation services are therefore in their current form unlikely to appeal to older adolescents. Services aimed at this age group need to be grounded in their understandings of smoking and the social factors which support smoking. Young smokers should also be helped to understand how support may increase quitting success and how encourage quitting before smoking becomes entrenched in their daily routines.

Adolescent↗
PubMed2006

Richard Wiseman and the medical practitioners of restoration London.

The case histories used to illustrate Richard Wiseman's Several Chirurgicall Treatises (1676) reveal not only pathological and therapeutic detail but much information about the range of occupational relationships between Wiseman and the many London physicians with whom he collaborated on cases (more than forty are identified in an appendix to this article). His interaction with the two physicians with whom he had most to do, Francis Prujean and Walter Needham, exemplifies the extremes of such relationships. With Prujean, an older man and a leading figure in the College of Physicians, a formal and hierarchical relationship was observed, in which distinct occupational lines were maintained. In the case of Needham, a younger physician whose devotion to anatomical study was shared by Wiseman, a friendship developed between the two men that carried over into practice and tended to break down occupational and intellectual distinctions, so that Needham sometimes involved himself in Wiseman's surgical practice, and Wiseman initiated medical research later reported by Needham to the Royal Society.

Clinical Medicine↗
PubMed1992

The concept of the person in the parens patriae jurisdiction over previously competent persons.

This article reviews the medieval law background of the parens patriae jurisdiction of the state as it has been exercised over incompetent persons who formerly were competent adults, concluding that the fiduciary standard implied in the statute De Prerogative Regis (1324), which is the basis for modern guardianship status, requires that the court and guardian adopt an attitude of respectful friendship toward the incompetent person, just as though they were to be accountable to the person himself, were he to recover his faculties and become competent once more. This fiduciary responsibility, originating in the device of the "use" or trust employed for the management of the estates of lunatics, contrasts with the self-interested feudal guardianship used for the custody of "natural fools" or "idiots", who were under paternalistic arrangements. The article argues that because the determination of legal incompetence and the consequent transfer of custody of the person and property of an incompetent person to the state would result in a drastic forfeiture of liberty and property interests were it not for the fiduciary obligation owed by the state to the incompetent, the state is under an obligation to exercise its fiduciary duties in good faith and may not impose states policies or advance state interests of its own in the supervision of the affairs of incompetent persons, apart from interests arising legitimately out of the state's institutional interest in providing competent administration for the benefit of the incompetents themselves.

Advance Directives↗
PubMed1981

Rights and responsibilities.

As an alternative to rights theory, John Ladd proposes an ethics of responsibility based on interpersonal relationships. These relationships, described as friendships, are personal in nature, founded on trust, and obtain between doctor and patient, parent and child, etc. Ladd presents his views in a most appealing way -- helping the needy, being friends with the doctor. We argue that Ladd's ethics of responsibility is plausible only because he ignores the facts of power which rights theory was designed to take into account, and that rights and the corresponding institutional model of medicine are indeed appropriate to the physician/patient relationship.

Ethics↗
PubMed1991

Peer relationships and adjustment in children with cancer.

Evaluated the psychosocial adaptations of children with cancer (n = 24, ages 8-18) as compared with same classroom controls on indices of (a) peer- and self-perceptions of sociability, aggression, and social isolation; (b) overall popularity; (c) mutual friendships; (d) feelings of loneliness; and (e) self-concept in multiple domains. Although the peer report data showed that children with cancer had a social reputation as significantly more socially isolated, no significant differences were found for their popularity, number of mutual friends, loneliness, or self-worth. Findings suggest that children with cancer have a reputation as more socially isolated, but differences were not found on measures of acceptance by peers, self-concept, or loneliness.

Adolescent↗
PubMed1993

Adjustment in the peer system of adolescents with cancer: a two-year study.

Evaluated the psychosocial adaptations of adolescents with cancer who were primarily off treatment (n = 19, ages 11-18) as compared with matched classroom controls in a 2-year longitudinal study on indices of (a) teacher, peer, and self-perceptions of social reputation; (b) multiple measures of popularity and friendships; and (c) self-reported feelings of loneliness, depression, and self-concept. Adolescents with cancer continued to have a social reputation as being more socially isolated, but no significant differences were identified on multiple measures of social acceptance or the self-reported feelings. In general, adolescents with cancer were similar to peers on numerous dimensions of psychological functioning manifesting minimal discernable psychosocial late effects.

Adaptation, Psychological↗
PubMed1997

Factors associated with peer social competence in preadolescents with craniofacial anomalies.

Examined factors associated with peer social competence in preadolescents with craniofacial anomalies (CFA). Preadolescents with relatively greater social competence reported more frequent companionship with peers, and more positive Harter (1985) Self-Perception Profile for Children perceptions of physical appearance and scholastic and athletic competence; their parents were more likely to encourage them to interact with peers. Preadolescents lower on social competence reported more loneliness and social anxiety. Parents rated them as having more behavior problems on the Child Behavior Checklist (Achenbach, 1991), especially internalizing, and were more worried about their children's friendships. Areas where preadolescents with CFA are vulnerable to poor peer relations are discussed.

Child↗
PubMed1998

A controlled study of peer relationships of children surviving brain tumors: teacher, peer, and self ratings.

OBJECTIVE: Evaluate the behavioral reputation and peer acceptance of children diagnosed and treated for brain tumors. METHOD: Twenty-eight children surviving brain tumors (8-18 years of age) were compared to 28 nonchronically ill, same classroom, same gender comparison peers (COMP). Peer, teacher, and self-report data were collected. RESULTS: Relative to COMP, children who had been diagnosed with brain tumors received fewer friendship nominations from clasmates and were described by peer, teacher, and self-report as socially isolated. Although they were no longer receiving therapy for their disease, peers perceived brain tumor survivors as being sick, more fatigued, and often absent from school. CONCLUSIONS: These data suggest that children surviving brain tumors are at risk for social difficulties even after treatment ends, although the specific cause(s) for this vulnerability were not investigated in the current study.

Absenteeism↗
PubMed2004

Body size stigmatization in preschool children: the role of control attributions.

OBJECTIVE: The current study assessed preschool-age children's control attributions for weight and the relationship of these attributions to attitudes and behavioral intentions toward children of different body sizes. METHODS: Forty-two children (mean age = 5.2 years) were interviewed about the adjectives they attributed to figures of different sizes, their preference for size in playmates, and their beliefs about children's ability to control their own weight. RESULTS: Adjective ratings for obese figures were the most negative, with no differences found for thin and average figures; the heaviest figure was also chosen less often than other figures to be a playmate. Internal attributions of control for weight were related to less positive adjective ratings for the heavier figure but not to children's friendship selections. CONCLUSION: Results suggest that the relationship between body size stigmatization and control attributions are consistent with attribution theory for young children. Practical implications of these results and possible interventions are discussed.

Affect↗
PubMed2005

A longitudinal examination predicting emergency room use in children with sickle cell disease and their caregivers.

OBJECTIVE: To examine in a longitudinal investigation perceptions of disease severity among children and adolescents with sickle cell disease (SCD) and their caregivers and to determine whether perceptions of disease severity and self-reported adjustment would account for a greater percentage of the variance in emergency room (ER) use than objective measures of disease severity. METHODS: Participants were 58 African-American children (ages 8-18 years) diagnosed with SCD who were recruited from an outpatient clinic. Children and their caregivers were administered a series of measures designed to assess caregivers' adjustment and perceptions of children's disease severity. Frequency of ER visits was tabulated over an average 4-year period. RESULTS: Caregivers' and children's social adjustment accounted for a unique portion of the variance beyond that accounted by subjective perceptions of disease severity, demographic, and objective biological markers of disease severity. Poorer psychological adjustment of caregivers as well as communication patterns among children were associated with ER use frequency after controlling for objective disease severity variables and demographic factors. Child social adjustment, specifically friendship quality, accounted for variance in children's use of the ER beyond that accounted for by social class and objective markers of disease severity. CONCLUSIONS: Support is provided for the notion that ER use for children with SCD may be independent of disease severity and predicted by caregivers' psychological adjustment and children's peer adjustment.

Adaptation, Psychological↗
PubMed2005

Supportive relationships and sexual risk behavior in adolescence: an ecological-transactional approach.

OBJECTIVE: To examine the longitudinal associations between supportive relationships with friends and parents and sexual risk behavior in adolescence based on an ecological-transactional perspective. METHODS: Analyses were conducted on 2,652 sexually active adolescents from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health). RESULTS: African-American adolescents had lower risk for sexual risk behavior. Supportive friendships and parent connectedness interacted in predicting decreased likelihood of sexual risk behavior. Mother-child communication about sex contributed to decreased likelihood of sexual risk only for girls. There were also small reciprocal effects of sexual risk behavior on decreased relationship quality over time. CONCLUSION: To better understand the parents' role in adolescent sexual risk behavior, multiple facets of parenting, the social contexts of parenting and adolescents' peers, and the effects of adolescents' behavior on these relationships should be taken into consideration.

Adolescent↗
PubMed2006

Psychological problems in children with bedwetting and combined (day and night) wetting: A UK population-based study.

OBJECTIVE: To investigate the psychological problems associated with bedwetting and combined (day and night) wetting in children aged around 7(1/2) years. METHODS: Participants were a cohort of over 8000 children enrolled in the population-based Avon Longitudinal Study of Parents and Children. Parents completed postal questionnaires assessing common childhood psychological problems, and children were asked about behavior, friendships, bullying, and self-esteem in clinical interviews. The rates of psychological problems were compared in children with bedwetting, combined wetting, and in children with no wetting problems. RESULTS: The study found a higher rate of parent-reported psychological problems in children with bedwetting and combined wetting compared with those with no wetting problems. Children with combined wetting were particularly at risk for externalizing problems. There was little difference with the child-reported measures. CONCLUSIONS: Bedwetting and combined wetting are associated with parent-reported psychological problems and combined wetting confers an increased risk for externalizing problems.

Child↗
PubMedDate not supplied

A model for linking networks in social work practice with the institutionalized elderly.

The authors describe a demonstration project that used network theory as a framework for a broad-range ecological approach to social work practice in long-term care facilities for the elderly. The importance of developing and maintaining social supports and the reciprocal benefits in linking kinship, friendship, formal caregiving, and mutual-aid networks are examined. Examples of the practical applications of network theory are presented also.

Aged↗
PubMed2002

Client's view of a successful helping relationship.

This study asked clients from multiproblem families to describe a successful helping relationship. The replies were analyzed using narrative research techniques and results are presented in conceptual categories with illustrative quotations from the interviews. The article offers conclusions about client preferences in the areas of working relationship, work styles, and worker characteristics. The results revealed two general domains of the client-worker relationship: factors that provided a sense of equality in the relationship, for example, love, friendship, and a nonjudgmental stance; and the notion that the helping relationship should parallel more normative contacts and include components such as flexibility, chemistry, luck, and going the extra distance.

Health Services Research↗
PubMed1993

Women surgeons. Results of the Canadian Population Study.

OBJECTIVE: A national survey of women surgeons in Canada was undertaken to evaluate their ability to combine career with personal and family life. SUMMARY BACKGROUND DATA: Despite increasing numbers of women entering the medical profession, women continue to select nonsurgical careers. Although there are many reports regarding women in medical specialties there is little information available regarding women who choose surgical careers. Such data will be useful in increasing the enrollment of women in surgical training programs. METHODS: A 93-item questionnaire was mailed in July 1990 to the 459 eligible female surgeons. The survey was conducted using a modified Dillman 5-step computerized method. The study was closed in May 1991. RESULTS: Of the 459 surgeons who were located, 419 (91.3%) responded. Most surgeons (65.5%) were married. Only 6.5% were separated or divorced. The majority married another professional (91.4%). One quarter married another surgeon. Of all women who married at least once, 70.9% had at least one child. Most surgeons delayed child bearing until after they had completed their surgical training. The majority of respondents were in active surgical practice (82.3% full-time, 6.0% part-time). The most common surgical subspecialty was obstetrics and gynecology (40.9%), followed by ophthalmology (21.2%), and general surgery (12.1%). Surgeons were rarely dissatisfied (4-9%) with career, marriage, health, friendships, financial status, and hobbies. Overall, 88.3% were happy with their decision to pursue a career in surgery. CONCLUSIONS: Women surgeons practicing in Canada are able to combine productive careers with rewarding family lives and are satisfied with their decision to do so despite the compromises involved.

Adult↗
PubMed2001

William Stewart Halsted: letters to a young female admirer.

OBJECTIVE: To present the first new information in the past 25 years concerning the life of Dr. William Stewart Halsted. This paper reports on recently discovered personal correspondence of Dr. Halsted, beginning at age 66, to a young lady, Elizabeth Blanchard Randall, 40 years his junior. SUMMARY BACKGROUND DATA: Dr. William Stewart Halsted is generally considered the most important and influential surgeon that this country has produced. During his Hopkins days in Baltimore (1886-1922) he was rather reclusive, and little is known of his personal life. He was married but had no children. Several biographies written by Halsted's contemporaries constitute the bulk of what is known about Halsted's personal life. METHODS: All extant letters from Dr. Halsted to Miss Randall were reviewed. Archival materials were consulted to understand the context for this friendship. The correspondence between Halsted and Randall took place during a 3-year period, although their acquaintance was probably long-standing. RESULTS: The letters reveal Dr. Halsted and Miss Randall's great and warm affection for each other, despite their 40-year age difference. The letters have a playful nature absent in Halsted's other correspondence. This relationship has not been previously noted. CONCLUSIONS: Late in Halsted's life, he developed a warm and affectionate relationship with a young lady 40 years his junior, as revealed in Halsted's correspondence. Halsted's warm, personal, and playful letters are in stark contrast to his biographers' portrayals of him as a more serious and reclusive person.

Correspondence as Topic↗