Measurement Properties of the Short Multi-Dimensional Observation Scale for Elderly Subjects (MOSES)

This study evaluated the five-factor measurement model of the abbreviated Multidimensional Observation Scale for Elderly Subjects (MOSES), originally proposed by Pruchno, Kleban, and Resch in 1988. Modifications of the five-factor model were examined and evaluated with regard to their practical significance. A confirmatory second-order factor analysis was performed to examine whether the correlations among the first-order factors were adequately accounted for by a global dysfunction factor. Findings indicated that the proposed measurement model was replicated adequately. Although post hoc modifications resulted in significant improvements in overall model fit, the minor parameters had only a trivial influence on the major parameters of the baseline model. Results from the second-order factor analysis showed that a global dysfunc tion factor accounted adequately for the intercorrelations among the first-order factors.

Where Stories Collide : Montage and the Short Story Cycle

This thesis uses Sergei Eisenstein’s filmic theories of montage to examine the modernist American short story cycle, a genre of independent short stories that work together to create a larger and interrelated whole. Similar to the shot-by-shot editing process of montage, the story cycle builds its intertextual meaning story-by-story from an aggregate of abrupt narrative transitions and juxtapositions. Eisenstein famously felt that montage, the editing together of film fragments, was not a process of linkage, but of collision –each radically different shot in a film should crash into the next shot, until audience members were intellectually provoked into synthesizing these collisions through dialectical processes. I offer montage as an interpretive strategy for negotiating the narrative collisions in story cycles such as Sherwood Anderson’s Winesburg, Ohio, William Faulkner’s Go Down, Moses, and Eudora Welty’s The Golden Apples. For Go Down, Moses, I argue that Eisenstein’s politically rendered “montage of attractions” provides a template for investigating the shock tactics behind Faulkner’s chronologically and racially entangled stories of whites and African Americans. For The Golden Apples, I consider the opposites and doubles in Welty’s fiction with Eisenstein’s similar belief in the “opposing passions” of the world. Not only, then, do I suggest that the modernist story cycle bears a cinematic influence, but I also offer Eisenstein’s theories of montage and collision as a heuristic for formal, thematic, and even political patterns in a genre infamous for its resistance to definition and classification.

The Relationship of Antipsychotic Drug Use, Resident Behavior, and Diagnoses Among Nursing Home Residents

Nursing homes have been criticized for frequent use and possible misuse of psycho-active agents. These issues are of clinical concern and policy relevance, especially since the passage of the Omnibus Budget Reconciliation Act (OBRA) of 1987. Using a sample of 419 residents, the authors examined the relationships among antipsychotic drug (AP) use, behavior, and mental health diagnoses. Only 23.2% of the residents were administered APs on a routine and/or "as-needed" basis. Based on the Multidimensional Observation Scale for Elderly Subjects (MOSES) ratings, AP users were more irritable, disoriented, and withdrawn than were nonusers. Also, AP users demonstrated agitated behaviors more frequently. Notably, AP users and nonusers differed significantly in terms of documented mental health diagnoses. Among AP users, 70.1% had documented dementia, 8.3% were psychotic or had other psychiatric disorders, and 21.6% had no mental health diagnoses. In contrast, the majority of nonusers had no mental health disorders. Logistic regression revealed that diagnostic factors, frequency of agitation, level of withdrawal, and marital status were significant predictors of AP use.