Persistent versus transient depressive symptoms in relation to platelet hyperactivation: a longitudinal analysis of dementia caregivers

BACKGROUND: Depressive symptoms and caregiving stress may contribute to cardiovascular disease (CVD) via chronic platelet activation; however, it remains unclear whether this elevated activation constitutes a trait or state marker. The primary objective was to investigate whether persistent depressive symptoms would relate to elevated platelet activation in response to acute psychological stress over a three-year period. METHODS: Depressive symptoms (Brief Symptom Inventory) were assessed among 99 spousal dementia caregivers (52-88 years). Platelet P-selectin expression was assessed in vivo using flow cytometry at three time-points over the course of an acute stress test: baseline, post-stress, and after 14 min of recovery. Two competing structural analytic models of depressive symptoms and platelet hyperactivity with three yearly assessments were compared. RESULTS: Although depressive symptoms were generally in the subclinical range, their persistent elevation was associated with heightened platelet reactivity and recovery at all three-years while the change in depressive symptoms from the previous year did not predict platelet activity. LIMITATIONS: These results focus on caregivers providing consistent home care, while future studies may extend these results by modeling major caregiving stressors. CONCLUSIONS: Enduring aspects of negative affect, even among those not suffering from clinical depression are related to hemostatic changes, in this case platelet reactivity, which might be one mechanism for previously reported increase in CVD risk among elderly Alzheimer caregivers.

The moderating role of personal mastery on the relationship between caregiving status and multiple dimensions of fatigue

OBJECTIVE: A substantial proportion of chronically-stressed spousal dementia caregivers report fatigue. The objective of this study was to examine whether personal mastery moderates the relationship between caregiving status (caregiver/non-caregiver) and multiple dimensions of fatigue. METHODS: Seventy-three elderly Alzheimer's caregivers and 41 elderly non-caregivers completed the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and questionnaires assessing mastery. RESULTS: Regression analyses indicated that global fatigue was significantly higher for caregivers (M = 38.0 +/- 21.0) compared to non-caregivers (M = 18.2 +/- 10.4). However, personal mastery moderated the relation between caregiving status and global fatigue (t = -2.03, df = 107, p = 0.045), such that for those with low mastery, caregivers' fatigue scores were 18.1 points higher than non-caregivers, and for those with high mastery, this difference was only 7.5 points. For specific dimensions of fatigue, mastery moderated the relations between caregiving status and both emotional (t = -2.01, df = 107, p = 0.047) and physical (t = -2.51, df = 107, p = 0.014) fatigue. Specifically, association between caregiving status and emotional fatigue was greater when mastery was low than when mastery was high. Caregiving status was significantly associated with physical fatigue when mastery was low, but not when mastery was high. Significant main effects were found between mastery and general fatigue and vigor. CONCLUSION: Given the proportion of fatigued caregivers and the impact fatigue has on health; these findings provide important information regarding mastery's relationship with fatigue and may inform interventions aiming to alleviate fatigue in caregivers. Copyright (c) 2009 John Wiley ; Sons, Ltd.

Domestic Violence

Since the 1960s, there has been growing awareness regarding the issue of domestic violence as a form of violence against women, which has been largely influenced by the work of feminist activist and scholars in North America and Europe (Dobash and Dobash 1992). Other terms have been used to describe the same phenomenon, including domestic abuse, spousal abuse, wife battering, marital violence, intimate partner violence. Though there is no doubt that this problem has existed for much more than five decades, the tendency to label it as ‘private matters’ or ‘marital disagreements’ has obscured the reality of women living with abuse in their home. At a general level, domestic violence can be defined as the means used by a man in order to assert his control and domination over his intimate partner, whether they are married or not (Mullender 1996). It can involve incidents of physical and sexual violence, as well as verbal, psychological and financial abuse. Though some of its manifestations may be associated with particular cultural or religious groups – e.g. forced marriage and honour killing in South-Asian communities – domestic violence affects women from all classes and backgrounds.

Cohort and Gender Differences in Psychosocial Adjustment to Later-Life Widowhood

Objectives. Despite the large body of literature on bereavement, little is known about the impact of sociohistorical context on individual reactions to spousal loss. This study examines the effect of marital status, time period and gender on physical and mental health, and whether reported difficulties following spousal loss differ at 2 distinctive time periods. Method. Two cohorts of older bereaved persons (n = 753) in Switzerland, surveyed in 1979 and 2011, were compared regarding their reports of difficulties related to marital loss. The bereaved spouses were also compared with a group of married contemporaries (n = 1,517) regarding subjective health and depressive symptoms. Results. Marital status and gender each have independent effects on subjective health and depressive symptoms. The effects of widowhood on subjective health differed significantly at both time points. Widowed individuals in 2011, especially women, reported fewer social and financial difficulties than their counterparts in 1979. However, the effect of widowhood on depressive symptoms and psychological difficulties did not differ significantly across time points. Discussion. Social changes in the late 20th century may be protective for older adults’ physical, social, and financial well-being in the face of spousal loss, yet these changes do not alleviate widow(er)s’ psychological distress.

Marital split-up and widowhood in old age: Differential impact on psychological and social well-being

Marital split-up and spousal loss are among the most stressful critical life events. Numerous studies have documented their detrimental effects on well-being, yet the large individual differences in psychological adaptation are still not well understood. Whereas in old age bereavement is normative and can be anticipated, divorce is an “off-time” transition for this age group. In contrast to bereavement which has been amply studied, research on later life divorce is still missing despite the increasing relevance of the topic due to the significant increase of divorces in older age. Based on a modified and extended view of Amato’s divorce-stress-adjustment model (2000), the aim of this contribution is to explore the differential impact of marital split-up and widowhood in older age on psychological (life satisfaction) and social well-being (social loneliness), and the adaptation to these critical life events. Our analyses are based on data gathered in a questionnaire study, which is part of the Swiss National Centre of Competence in Research LIVES. In a first step we compared three groups of individuals aged 60 to 75 years: a sample of 251 persons with a marital split-up (127 women; 123 men), a sample of 270 widowed persons (170 women; 100 men), and a group of 221 continuously married people (110 women; 111 men), which served as control group. In a second step, we investigated the role of socio-demographic variables, intrapersonal and interpersonal resources and variables of the context of loss as predictors for the psychological adaptation to a marital break-up and loss in old age. First results by ANCOVA indicate significant differences with regard to life satisfaction among the three groups, with divorced persons with the lowest scores, followed by the bereaved ones, and the married controls with the highest. Regarding social loneliness, divorced individuals report higher social loneliness than the bereaved group and the married controls (no significant difference between widowed and the married). In both loss groups, financial and intrapersonal resources, as well as the emotional valence of the loss are the most important predictors for the psychological and social adaptation. However, happiness in the past relationship is an important resource regarding the indicators for adaptation for the widowers, but not for individuals with a marital dissolution.

Collingwood on religious atonement

R. G. Collingwood’s philosophical analysis of religious atonement as a dialectical process of mortal repentance and divine forgiveness is explained and criticized. Collingwood’s Christian concept of atonement, in which Christ TeX the Atonement (and also TeX the Incarnation), is subject in turn to another kind of dialectic, in which some of Collingwood’s leading ideas are first surveyed, and then tested against objections in a philosophical evaluation of their virtues and defects, strengths and weaknesses. Collingwood’s efforts to synthesize objective and subjective aspects of atonement, and his proposal to solve the soteriological problem as to why God becomes flesh, as a dogma of some Christian belief systems, is finally exposed in adversarial exposition as inadequately supported by one of his main arguments, designated here as Collingwood’s Dilemma. The dilemma is that sin is either forgiven or unforgiven by God. If God forgives sin, then God’s justice is lax, whereas if God does not forgive sin, then, also contrary to divine nature, God lacks perfect loving compassion. The dilemma is supposed to drive philosophy toward a concept of atonement in which the sacrifice of Christ is required in order to absolve God of the lax judgment objection. God forgives sin only when the price of sin is paid, in this case, by the suffering and crucifixion of God’s avatar. The dilemma can be resolved in another way than Collingwood considers, undermining his motivation for synthesizing objective and subjective facets of the concept of atonement for the sake of avoiding inconsistency. Collingwood is philosophically important because he asks all the right questions about religious atonement, and points toward reasonable answers, even if he does not always deliver original philosophically satisfactory solutions.

Why does placement of persons with Alzheimer's disease into long-term care improve caregivers' well-being? Examination of psychological mediators.

Caregiving for individuals with Alzheimer's disease is associated with chronic stress and elevated symptoms of depression. Placement of the care receiver (CR) into a long-term care setting may be associated with improved caregiver well-being; however, the psychological mechanisms underlying this relationship are unclear. This study evaluated whether decreases in activity restriction and increases in personal mastery mediated placement-related reductions in caregiver depressive symptoms. In a 5-year longitudinal study of 126 spousal Alzheimer's disease caregivers, we used multilevel models to evaluate placement-related changes in depressive symptoms (short form of the Center for Epidemiologic Studies Depression scale), activity restriction (Activity Restriction Scale), and personal mastery (Pearlin Mastery Scale) in 44 caregivers who placed their spouses into long-term care relative to caregivers who never placed their CRs. The Monte Carlo method for assessing mediation was used to evaluate the significance of the indirect effect of activity restriction and personal mastery on postplacement changes in depressive symptoms. Placement of the CR was associated with significant reductions in depressive symptoms and activity restriction and was also associated with increased personal mastery. Lower activity restriction and higher personal mastery were associated with reduced depressive symptoms. Furthermore, both variables significantly mediated the effect of placement on depressive symptoms. Placement-related reductions in activity restriction and increases in personal mastery are important psychological factors that help explain postplacement reductions in depressive symptoms. The implications for clinical care provided to caregivers are discussed.

Labeling in the Classroom: Teacher Expectations and their Effects on Students' Academic Potential

The transition to high school can be challenging for some adolescents, resulting in drops of academic functioning (Barber & Olsen, 2004; Smith, 2006). While changes in academic demands and the disparity between adolescent needs and the environmental characteristics of high school have both been cited as possible contributors to this decrease in academic and personal functioning (Barber & Olsen, 2004), it is possible that teachers may play an even larger role in undermining these students’ functioning, specifically through labeling. Although labeling, and how it can lead to self-fulfilling prophesies, is a concept that has been thoroughly researched and applied to the field of criminology and deviant behavior, it is the goal of this current study to investigate if labeling also occurs in the classroom setting and how such labels ultimately effect the academic potential of high school students.

Determinants of cervical cancer screening among women workers in Monterrey, Mexico

Introduction. Cervical cancer is the most common and lethal cancer among Mexican women. A nationwide cervical cancer screening program established in 1974 has had little impact on cervical cancer incidence or mortality rates. This case-control study was designed to determine the association between knowledge factors and structural, organizational, and sociocultural perceptions related to adherence to cervical cancer screening guidelines among women living and working in Monterrey, Mexico.^ Methods. Cases were defined as sexually active female store clerks ages 18-64 who do not adhere to cervical cancer screening guidelines in accordance with the Official Mexican Standard (Norma Oficial Mexicana, NOM 014-SSA2-1994). Controls were defined as sexually active female store clerks ages 18-64 who do adhere to cervical cancer screening guidelines in accordance with the NOM. Participants (N = 229) answered survey questions regarding cervical cancer screening practices as well as their knowledge and perceptions about screening for cervical cancer. Two multivariate logistic regression models were built to analyze (1) knowledge factors and (2) perceptions significantly associated with adherence in univariate analysis.^ Results. Having no or inaccurate knowledge of national cervical cancer screening guidelines (OR = 11.05, 95%CI: 4.28, 28.54) and no knowledge of the utility of the Papanicolaou (Pap) exam (OR = 6.77, 95%CI: 0.99, 46.43) were risk factors for non-adherence to cervical cancer screening guidelines. Perceptions of fear or embarrassment of the Pap exam (OR = 16.17, 95%CI: 5.08, 51.49) and lower levels of spousal or partner acceptance of the Pap exam (OR = 5.82, 95%CI: 1.34, 25.31) were risk factors for non-adherence to cervical cancer screening guidelines.^ Conclusion. Knowledge factors and sociocultural perceptions related to cervical cancer screening were strong predictors of adherence to screening guidelines. Future studies may be able to further explore these findings with larger sample sizes and in other populations in Mexico. By identifying these factors, future population-specific recommendations and interventions to increase screening rates can be formulated with the long-term goal of reducing morbidity and mortality from cervical cancer among Mexican women.^

"Un acto más de la agricultura". Nostalgia y crítica del pasado franquista en Tranvía a la Malvarrosa de Manuel Vicent

La novela Tranvía a la Malvarrosa (1994), de Manuel Vicent, evoca una imagen nostálgica del pasado. Los olores, colores y sonidos de la Valencia de los años 50 hacen que el aprendizaje sentimental, profesional y moral del protagonista quede retratado de una manera profundamente atractiva. Sin embargo, el narrador de la novela critica el régimen franquista de aquellos días al mismo tiempo que los recuerda nostálgicamente. La combinación de un sentimiento crítico con uno nostálgico parece algo paradójica, pero se podría deducir que la crítica del pasado deja que la fuerza emocional de la nostalgia quede contenida y controlada. No obstante, en este caso sucede que la nostalgia termina por desestabilizar el tono crítico. Es más, la insistencia del narrador en los lados oscuros del pasado realzan su nostalgia, ya que sugiere una decadencia atractiva e intrigante

La teoría crítica ante el antisemitismo : La especificidad histórica del iluminismo interrogada

Me propongo revisitar los "Elementos de antisemitismo" en Dialéctica del Iluminismo a la luz del desarrollo posterior de la teoría crítica. Como se sigue de las críticas de Habermas o Wellmer, el texto citado encierra el peligro de caer en una filosofía de la historia universal pesimista, que socava todo potencial de racionalidad, paradójicamente refrendando la dominación de la totalidad (y sus consecuencias, como el antisemitismo). Para evitar esa deriva pesimista, propongo releer la Dialéctica del Iluminismo a la luz de los aportes contemporáneos de Postone, que vincula la dinámica de la totalidad a la especificidad histórica del capitalismo

"Un acto más de la agricultura". Nostalgia y crítica del pasado franquista en Tranvía a la Malvarrosa de Manuel Vicent

La novela Tranvía a la Malvarrosa (1994), de Manuel Vicent, evoca una imagen nostálgica del pasado. Los olores, colores y sonidos de la Valencia de los años 50 hacen que el aprendizaje sentimental, profesional y moral del protagonista quede retratado de una manera profundamente atractiva. Sin embargo, el narrador de la novela critica el régimen franquista de aquellos días al mismo tiempo que los recuerda nostálgicamente. La combinación de un sentimiento crítico con uno nostálgico parece algo paradójica, pero se podría deducir que la crítica del pasado deja que la fuerza emocional de la nostalgia quede contenida y controlada. No obstante, en este caso sucede que la nostalgia termina por desestabilizar el tono crítico. Es más, la insistencia del narrador en los lados oscuros del pasado realzan su nostalgia, ya que sugiere una decadencia atractiva e intrigante

La teoría crítica ante el antisemitismo : La especificidad histórica del iluminismo interrogada

Me propongo revisitar los "Elementos de antisemitismo" en Dialéctica del Iluminismo a la luz del desarrollo posterior de la teoría crítica. Como se sigue de las críticas de Habermas o Wellmer, el texto citado encierra el peligro de caer en una filosofía de la historia universal pesimista, que socava todo potencial de racionalidad, paradójicamente refrendando la dominación de la totalidad (y sus consecuencias, como el antisemitismo). Para evitar esa deriva pesimista, propongo releer la Dialéctica del Iluminismo a la luz de los aportes contemporáneos de Postone, que vincula la dinámica de la totalidad a la especificidad histórica del capitalismo

"Un acto más de la agricultura". Nostalgia y crítica del pasado franquista en Tranvía a la Malvarrosa de Manuel Vicent

La novela Tranvía a la Malvarrosa (1994), de Manuel Vicent, evoca una imagen nostálgica del pasado. Los olores, colores y sonidos de la Valencia de los años 50 hacen que el aprendizaje sentimental, profesional y moral del protagonista quede retratado de una manera profundamente atractiva. Sin embargo, el narrador de la novela critica el régimen franquista de aquellos días al mismo tiempo que los recuerda nostálgicamente. La combinación de un sentimiento crítico con uno nostálgico parece algo paradójica, pero se podría deducir que la crítica del pasado deja que la fuerza emocional de la nostalgia quede contenida y controlada. No obstante, en este caso sucede que la nostalgia termina por desestabilizar el tono crítico. Es más, la insistencia del narrador en los lados oscuros del pasado realzan su nostalgia, ya que sugiere una decadencia atractiva e intrigante