Healthy Adjustment Research Articles

OP01.03: Pregnancy termination due to fetal anomaly; women's reactions, satisfaction and experiences of care

abstract Objective: to explore what women who have had a pregnancy terminated due to a detected fetalmalformation perceived as having been important in their encounters with caregivers for promotingtheir healthy adjustment and well-being.Method: an exploratory descriptive design was used. Semi-structured interviews were audiotaped, and theinformation pathway described. The text was processed through qualitative content analysis in six steps.Setting: four fetal care referral centres in Stockholm, Sweden.Participants: 11 women opting for pregnancy termination due to fetal malformation.Findings: in-depth understanding and compassion are impor tant factors in providing the feeling of supportpeople need so they are able to adapt to crisis. The women emphasised that the caregivers have tocommunicate a sense of responsibility, hope and respect and provide on-going care for them to feel assured ofreceiving good medical care and treatment. Aside from existing psychological conditions, the women identi !edas having emotional distress directly after termination and for at least the following three months. Mostwomen experienced a range of negative emotions after pregnancy termination, including sadness, mean-inglessness, loneliness, tiredness, grief, anger and frus tration. Still some of this group had positive reactionsbecause they experienced empathy and well-organised care.Conclusion and implications for practice: The most important factors associated with satisfaction regardingpregnancy termination due to a fetal malformation are the human aspects of care, namely state-dependentcommunication and in-depth understanding and compassion. The changes in care most often asked for wereimprovements in the level of standards and provision of adequate support through state-dependentcommunication, in-depth understand ing and compassion, and complete follow-up routines and increasedresources. Targeted education for the caregivers may be suited to ensuring that they properly meet needs oftheir patients.& 2013 Elsevier Ltd. All rights reserved.

Caring for people with early and advanced chronic obstructive pulmonary disease: how do family carers cope?

To examine the coping strategies of family carers of people with early and advanced chronic obstructive pulmonary disease and how those relate to their subjective health. Caring for a family member with chronic obstructive pulmonary disease can be a stressful experience. Understanding how carers cope with this is critical for improving outcomes. However, this topic has received little attention in the literature, particularly considering the care-giving experience with early chronic obstructive pulmonary disease. A cross-sectional study with a convenience sample of family carers of people with chronic obstructive pulmonary disease. A structured questionnaire was used to collect data on socio-demographics and care-giving characteristics. Self-rated physical and mental health was measured by two items from the International Classification of Functioning, Disability and Health checklist. Coping strategies were assessed with the Carers' Assessment of Managing Index. Descriptive and inferential analyses were performed. A total of 158 family carers participated: 109 caring for people with early and 49 with advanced chronic obstructive pulmonary disease. The two groups differed significantly on self-rated mental health and on problem-solving, emotional-cognitive and managing stress coping type. Significant correlations between self-rated physical health and problem-solving coping and between self-rated mental health and emotion-cognitive and managing stress coping were found for carers of patients with advanced chronic obstructive pulmonary disease. This study provides a unique insight into family carer coping strategies at different stages of chronic obstructive pulmonary disease. Carers of people with early and advanced chronic obstructive pulmonary disease cope differently with their caring demands. Nevertheless, problem-focused coping strategies were perceived as the most helpful by both groups. The findings are relevant to informing early supportive interventions aiming to prevent burden and promote healthy adjustment to care-giving demands within the specific context of chronic obstructive pulmonary disease.

Predictors and Characteristics of Successful Aging among Men: A 48-Year Longitudinal Study

To explore dimensions of successful aging, 71 men were selected for healthy adjustment and were prospectively studied in young adulthood (average age 20) and reassessed in 32-year and 48-year follow-ups. Despite an increase of medical problems, most men maintained healthy adjustment in early old age. At both follow-ups, successful young adult predictors of favorable overall outcome included good peer social adjustment, an absence of troubled parental discipline, and an absence of immature defensive behaviors when angry. However, young adult factors were more predictive of outcomes in middle age than in early old age, as predictor effect sizes decreased between the first follow-up and the second follow-up 16 years later. Findings support the possibility of both favorable and unfavorable changes in the second half of life that may diminish the impact of some young adult characteristics and family environments on adjustment in early old age.

Sociocultural and Mental Health Adjustment of Black Student-Athletes: Within-Group Differences and Institutional Setting

Research has shown that African American college students have a difficult time adjusting at predominately White institutions (PWIs) in comparison with historically Black colleges and universities (HBCUs) with regard to both general and race-related stressors (Neville, Heppner, Ji, & Thye, 2004; Prillerman, Myers, & Smedley, 1989; Sedlacek, 1999). For college student-athletes, the campus environment can challenge their capacity to ft in and adhere to academic and social expectations, perhaps especially for Black student-athletes (BSA). The current study therefore examined the sociocultural and mental health adjustment of 98 BSA based on their perceived social support, perceived campus racial climate, team cohesion, and life events using latent profle analysis (LPA). Results indicated three distinct profile groups: Low Social Support/Cohesion, High Minority Stress, and High Social Support/Cohesion. Profiles were predictive of adjustment concerns and campus setting (PWIs vs. HBCUs), highlighting within-group differences among BSA. Implications for interventions to facilitate and support healthy adjustment and success for BSA are discussed.

Making room for sleep: The relevance of sleep to psychology and the rationale for development of preventative sleep education programs for children and adolescents in the community.

AbstractSleep plays a key role in the way that people think, feel, and behave and is a component of each of these domains. A substantial body of evidence indicates that an appropriate level of sleep is necessary for optimization of physical, cognitive, and emotional functioning, which are key domains of healthy adjustment and are at the heart of the science and the practice of psychology. Conversely, fatigue and insufficient sleep negatively affect these life domains, each of which must function well to ensure optimal development. However, a considerable proportion of children and adolescents do not achieve adequate sleep, in terms of either quantity or quality. Appropriate use of the knowledge regarding the importance of sleep for optimization of physical, cognitive, and emotional functioning may significantly improve youth performance and health. Despite this need for optimal sleep health, extensive translation of available knowledge for the benefit of Canadian youth is currently lacking. This is important, because it is likely that a key means of using existing information to improve the health and success of children is being overlooked. The objectives of this article are therefore to discuss the relevance of sleep to psychology, to provide information regarding sleep and its impact on daytime functioning and development, and to discuss the rational for developing preventative sleep education programs, as well as major barriers to effective sleep education and strategies that can be used to overcome such problems.Keywords: sleep, prevention, children, adolescents, community, developmentIn the present article, I first discuss the relevance of sleep to psychology. I next provide information regarding sleep and its impact on daytime functioning and development. I then discuss the rational for developing preventative sleep education programs. Finally, I discuss the major barriers to effective sleep education and strategies that can be used to overcome such problems; I include examples of the successful use of such strategies to facilitate healthy sleep education.Why Is Sleep Relevant to Psychology?Psychology is defined in the Concise Edition of the Encyclopedia Britannica to be a Scientific discipline that studies mental processes and behaviour in humans and other animals. [:] 'the study of the mind' (psychology, 2013). The Canadian Psychological Association (CPA; n.d., para. 2) states that Psychologists engage in research, practice and teaching across a wide range of topics having to do with how people think, feel and behave.Sleep plays a key role in the way that people think, feel, and behave and is a component of all of the psychological domains mentioned previously. A substantial body of evidence indicates that an appropriate level of sleep is necessary for optimization of physical (Hasler et al., 2004; Nixon et al., 2008), cognitive (Alhola & Polo-Kantola, 2007; Durmer & Dinges, 2005; Nilsson et al., 2005; Wimmer, Hoffmann, Bonato, & Moffitt, 1992), and emotional functioning (Gregory & Sadeh, 2012), which are key domains of healthy adjustment and are at the heart of the science and the practice of psychology. Study of sleep is interdisciplinary in nature and overlaps with several domains of psychology, including neuroscience, developmental psychology, clinical child psychology educational and school psychology, and health psychology.Sleep deprivation is very prevalent in children at all stages of development, from infancy to late adolescence. Sizable proportions of children and adolescents obtain less sleep than they need and are thus chronically sleep-deprived (National Sleep Foundation, 2006; Spilsbury et al., 2004). Because the significance of chronic sleep insufficiency is underrecognized in terms of the influence thereof on the mental and physical health of youth, I will focus below on pediatric sleep, that is, sleep in children and adolescents. …

Education on Sexual Life in Spinal Cord Injury Patients: A Missing Link in Physiotherapy

Sexuality, a decisive aspect of human life is inimitable to each individual and continues to progress throughout one’s life. The World Health Organization defines sexuality as “A central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction” [1]. Following the spinal cord injuries (SCI), sexual function is affected and the goal for such individuals, as for all people, is to have a gratifying and productive life. During the initial phase following a spinal cord injury, it is expected for individuals to be focused on physical recovery and rehabilitation. However, impending to stipulations with sexuality is a key step towards making a healthy adjustment. Sex is the module that identifies human being as male or female thus expressing sex is a fundamental part of human. It is often the choice after SCI people to become sexually active or not.

Psychological Characteristics of Applicants to the Jesuit Order

This study summarizes the test results of 89 applicants to the Society of Jesus, a religious order of Roman Catholic priests and brothers. Applicants were above average in intelligence and educational attainment. Applicants’ highest vocational theme score was Social, with subtest profiles most strongly suggesting interests in the areas of Religious Activity and Teaching. Applicants obtained MMPI profiles generally indicative of healthy psychological adjustment. Test scores did not clearly predict whether applicants remained in any of the training periods for the priesthood or the priesthood itself. This paper identified four psychological characteristics, defined by clusters of MMPI scores, which may be useful in screening applicants to the Jesuit Order.

Predictors of Relationship Adjustment in Female Survivors of Childhood Sexual Abuse

The current study investigated: (1) the relationship between childhood sexual abuse (CSA) and four relationship adjustment variables (consensus, cohesion, affection, and satisfaction); (2) whether finding meaning in CSA and using mature defenses would predict relationship adjustment; and (3) whether meaning and mature defenses would moderate the association between CSA severity and relationship adjustment. The sample consisted of 287 undergraduate women, 95 of whom reported a history of CSA. All participants were involved in a romantic relationship at the time of the study. Results indicated a significant relationship between CSA history and dyadic consensus, whereby abused women reported less agreement with their partners than nonabused women. In the abused sample, CSA severity significantly predicted affection and mature defenses significantly predicted both affection and consensus in relationships. Furthermore, mature defenses moderated the relationship between CSA severity and dyadic cohesion (i.e., joint activities with one's partner). Contrary to hypotheses, meaning was not related to relationship adjustment and did not moderate the association between CSA severity and relationship adjustment. These findings advance the CSA literature by elucidating factors that predict healthy adjustment to CSA.

Changes in Parents After the Death of a Child From Cancer

ContextFew studies have compared multiple perspectives of changes experienced by parents after a child's death. ObjectivesThis study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. MethodsMothers (n=36), fathers (n=24), and siblings (n=39) from 40 families were recruited from three hospitals in the U.S. and Canada three to 12 months after the death (M=10.7, SD=3.5). Semistructured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother vs. sibling, father vs. sibling, and mother vs. father). ResultsParents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of the mothers, 87% of the fathers, and 69% of the siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. ConclusionPositive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child's death on bereaved parents over time and to develop strategies to promote healthy adjustment.

Lesbian Friendships: An Exploration of Lesbian Social Support Networks

Lesbians may face unique challenges when building friendships. The intersection of culturally sanctioned discrimination and familial rejection may intensify the role friendships play for lesbians and the development of social support networks. The author discusses existing research and qualitative findings and provides suggestions for counselors working with their clients. Keywords: lesbians, social support, friendship development, social relationships ********** Throughout the literature addressing overall wellness and optimal functioning, strong social support networks are consistently noted as protective and productive of both psychological and physiological well-being (see Degges-White & Borzumato-Gainey, 2011, for a review). In studies specifically addressing the well-being of sexual minority individuals, the presence of a strong social support network is frequently underscored as one of the most essential components of healthy adjustment (Badgette, 2001; Kurdek, 1988, 2003; Kurdek & Schmitt, 1987; Solomon, Rothblum, & Balsam, 2005; Witte, 2003). It is clear that everyone needs a little help from friends to survive and thrive, to paraphrase the Beatles. However, the development of same-sex friendships for lesbians may present unique challenges and provide unique benefits for these women. The value and need for social support and human connection have been validated through empirical studies in both the hard sciences and the social sciences. Perhaps the most widely researched theory developed to explain the formation and deepening of relationships is Altman and Taylor's (1973) social penetration theory, which has been used to explain both platonic and romantic relationships. Invoking the metaphor of an onion, Altman and Taylor observed that everyone of us has defensive layers that are peeled away one by one as we allow others to become emotionally closer to us. As we get to know potential friends, we give them deeper access into our lives and our inner selves. As we grow more deeply connected with new friends, additional layers of our defenses and protection are peeled away just as the layers of an onion might be. We are able to shed layers of self-protection and expose our authentic selves so long as our trust in others grows as we reveal ourselves. Generally contingent on mutual self-disclosure and honesty, both parties must be willing to be open and vulnerable for genuine friendship to develop. For many lesbians, however, the freedom to engage in this process with either or heterosexual women is not always guaranteed. The need for circumspection and guarded self-disclosure may affect the willingness of lesbians to attempt to develop deep friendships with new acquaintances. This may lead lesbians to lean heavily on the members of their existing social support systems, which, in turn, may lead to strained relationships and further narrowing of their social circle. Although the cultural stigma of being an out lesbian appears to be lessening, many women may still be hesitant to invest significant energy into potentially tenuous platonic relationships that may not last past a certain level of self-disclosure. Galupo (2007) found that the historical pattern of lesbians' preference for other sexual minority women as friends continues today. Whereas some women may seek to surround themselves with a support network consisting solely of other lesbians, other women may prefer to cultivate heterosexual women as friends to avoid their identities. Just as there is a wide range of individual and societal acceptance of sexual minority individuals, there is a wide range of relationship types that may be influenced by the environment in which women develop. In this article, the topic of friendship is addressed. Following a review of the literature addressing friendships, a discussion of findings from qualitative interviews with 31 women who ranged in age from 19 to 73 years will be presented. …

Psycho-Social Functioning in an Individual with Gender Identity Disorder

An adult transsexual male with presenting complaints of substance dependence was taken up for the study at the All India Institute of Medical Sciences. Past history covering substance use and transsexualism was followed by psychological assessment comprising of Verbal Adult Intelligence Scale, Draw-A-Person Test, Sentence Completion Test, The Adjustment Inventory and Rorschach Psychodiagnostics. The patient presented with interpersonal difficulties and distress owing to substance use. He reported being personally comfortable with his transsexual status and sought help for sex reassignment surgery. The study directs attention towards the fact that individuals with GID are at a risk for healthy adjustment with respect to their socio- cultural set up and in coping with situations. Hence, detailed assessment of distress related to GID, the social milieu leading to acceptance/isolation of the person and co-morbid conditions (if any) is productive.

Depression and Quality of Life in Terms of Personal Resources in Heart Transplant Recipients

Background Heart transplantation is the first option for treatment of heart failure engendering increased survival and quality of life among recipients. However, this surgical intervention causes many psychological problems such as depression and anxiety. Protective factors and personal recourses are significant forces behind healthy adjustments to life stresses. Purpose The aim of this study was to estimate the prevalence of depression among heart transplant recipients. Procedure The study consisted of a sample of 46 patients after heart transplantation. Standardized instruments used to measure the key constructs were Beck Depression Inventory Short Form for the prevalence of depression, World Health Organization Quality of Life - BREF for quality of life, Sense of Coherence (SOC-29), and Coping Orientation to Problems Experienced BREF to identify coping strategies. The data were analyzed statistically. Results We found that sense of coherence and coping strategies were significant predictors for quality of life and prevalence of depression, which were significantly associated with each others. Strategies focused on the problem are moderate quality of life with an age of recipient. Recipients who have a tendency to use emotion-focused strategies and are older showed a poorer quality of life, were less satisfied with their health, and displayed a prevalence of depression. Conclusions These results suggested that assessment of coping strategies and sense of coherence should be explored in heart transplant recipients with skills training in this domain.

Physiological Responses Of Adult Women To Hydro-gymnastics Exercises In And Out Of The Water

Human aging is an inevitable process. It is full of biological changes, times of growth, development and declines that occur throughout adulthood and it should be reviewed envisioning changes in the lifestyle of people of all ages. Physical activity is considered an essential factor that supplies momentary and future health gain aiming at a successful aging that corresponds to the reduction or postponement of the changes. Among physical activities, hydro-gymnastics has become a strong and excellent opportunity to exercise and get benefits without harm, since it is held in liquid environment in which very helpful and healthy adjustments to human occur. PURPOSE: The aim of this research was to analyze the heart rate (HR) and blood lactate in hydro-gymnastics exercises protocol, in and out of the water, in women in three different stages of adulthood. METHODS: The study was approved by the Research Ethics Committee of PUCRS, Letter No. 946/05, and it has been taken directly from the field and focused on quantity-descriptive statistical analysis (test "t" of Student, ANOVA and Correlation with Pearson's coefficient). The sample consisted of 72 women and the data collection was based on checking the HR and blood lactate levels before and after the implementation of hydro-gymnastics basic exercises protocol in and out of the water. RESULTS: A significant decrease in HR at rest in the water (70.38 ± 9.80 bpm) compared with out of the water (77.40 ± 11.02) in the total sample (p = 0.00); lower HR in the exercise in the water, and lower lactate levels in the water, both at rest (1.85 ± 0.39 in the water and 2.06 ± 0.42 out of the water, with a difference of 10%) and on exercise (2.89 ± 1.38 in the water and 3.64 ± 1.06 out of the water) highlighting the significant decrease, p = 0.002 (rest) and p = 0.000 (exercise). At the third age, lactate was twice out of the water showing the intensity increased to that public which will generate greater care during an exercise session. CONCLUSION: Nevertheless, it is clear that lower physiological parameters decrease when exercising in the water, but we still need more study this area.

Attitudes and adjustment to the parental role in mothers following treatment for postnatal depression

BackgroundFew intervention studies of postnatal depression (PND) have evaluated accompanying changes in parenting, in spite of mounting evidence that exposure to chronic depression is detrimental to infant development. This study examined maternal attitudes and adjustment over the first postnatal year within a treatment trial. The aim was to examine whether maternal adjustment improved with earlier remission, and with combined medical and psychological treatment. MethodsAs part of a multicentre pragmatic randomised controlled trial of treatment for PND, mothers completed a measure of maternal adjustment and attitudes and the Edinburgh Postnatal Depression Scale at an initial home visit (week 0) and three follow-ups (weeks 4, 18 and 44). ResultsMaternal attitudes and adjustment improved with PND remission; earlier remission conferred no additional benefit by 44-week follow-up. In line with previous studies, no particular treatment modality (antidepressant or health-visitor delivered non-directive counselling), or combination of treatments, was more effective for improving adjustment to parenthood. However, the earlier start of antidepressant treatment provided a short-term advantage for improving attitudes and reducing perceived stress. LimitationsAs a result of the study's pragmatic trial design, there was high treatment non-compliance and no ‘pure’ control group. More depressed mothers may have been less likely to complete the maternal adjustment and attitudes measure. ConclusionsEffective treatment of PND is important not only for the mother's wellbeing but also for healthy adjustment to parenthood. Provision of treatment choice and early antidepressant treatment are suggested for optimising maternal attitudes and adjustment.

Heinz Kohut and John Bowlby: The Men and Their Ideas

Heinz Kohut and John Bowlby, working independently, contributed to a paradigm shift within psy- choanalysis. Their combined work dramatically changed the way many psychoanalysts understand the effect of parent-child relationships on human development, as well as the very nature of psychopathology. This, in turn, transformed clinical practice as their ideas spread and many analysts became more emotionally responsive, creating a friendlier, more respectful therapeutic ambiance. Essential to both men's thinking is a deep and abiding belief in the central need for relation- ships beginning at birth and lasting throughout life. Further, they recognized how a parent's re- sponsiveness to a child's needs for comfort and protection plays a crucial role in the child's psy- chological development with an outcome of either healthy adjustment or psychopathology hanging in the balance. In articulating these positions, they differed with the mainstream psychoanalytic views of their time. The classical psychoanalytic perspective focused on intrapsychic conflict over a set of drives, libido, and aggression. In both the theory and practice of the prevailing Freudian tradition, the greatest attention was given to exploring a patient's instinctual life as expressed in fantasy, rather than to actual experiences during childhood. Kohut and Bowlby came to see that such an intrapsychic focus on drives and fantasies came at the expense of recognizing important develop- mental needs for relatedness. Also, they saw how an exclusive preoccupation with elucidating a patient's intrapsychic conflicts could interfere with the therapist's ability to grasp the very real and adverse impact of unresponsive (or abusive) parenting during childhood. Kohut's and Bowlby's individual journeys as psychoanalytic clinicians and revolutionary theo- rists were dramatically different, yet both men broke with the predominant psychoanalytic dogma of their time and came to essentially the same viewpoint concerning the deep importance of rela- tionships. Their body of work has proven to have tremendous impact on the clinical practice of psychoanalysts and psychodynamic psychotherapists over the last 40 years as they ushered in new ways of interacting with patients that were more compassionate, engaged, and flexible. Most im- portant to their clinical approach is their acceptance of the patient's desire for an emotional con- nection with the analyst as a basic human need, rather than conceptualizing that need as a defense against instinctual longings that must be relinquished. Further, they saw the new relationship with

Understanding the School Outcomes of Juvenile Offenders: An Exploration of Neighborhood Influences and Motivational Resources

As a group, delinquent youth complete less education and show poor academic outcomes compared to their non-delinquent peers. To better understand pathways to school success, this study integrated individual- and neighborhood-level data to examine academic functioning among 833 White, Black, and Hispanic male juvenile offenders (age 14-17) living in two urban communities. A multilevel path analysis confirmed that youth in relatively more affluent communities report greater access to opportunities in the areas of education and employment, and that these opportunities are associated with higher expectations to succeed and better grades. Findings highlight the importance of taking an ecological approach for understanding processes that shape school effort and achievement. Implications are discussed in the context of promoting academic success among juvenile offenders, specifically, and for understanding pathways to healthy adjustment, more generally.

Religiosity influences on bereavement adjustments of older widows in Taiwan

To describe difficulties encountered by older widows in Taiwan and the impact of intrinsic or extrinsic religiosity on their coping strategies during early widowhood. There is very limited information about how Taiwan's widows cope with their bereavement and no studies reporting the relationship between religious beliefs and healthy adjustment during this distressing period. Between-method qualitative and quantitative triangulation was used. Semi-structured interviews were conducted and transcribed data were analysed by critical thematic analysis. Twenty women in Taiwan, >65 years old, (mean = 72.95) were interviewed within three years of being widowed. There were two informant groups: those with intrinsic religious beliefs and those with extrinsic religious beliefs. They all reported intrapersonal and interpersonal problems. Several major coping strategies arose: 'practising positive or negative attitudes for adaptation'; 'using person-focused actions'; and 'taking the initiative or passively seeking help from others or helping others'. Informants with intrinsic religious beliefs reported fewer coping problems by holding positive attitudes and taking multiple actions for adaptation. The extrinsic religious group had more negative adaptation attitudes, such as withdrawal and low self-esteem and practised less faith religious activities in worshipping ancestors, experiencing fatalism and using divination. They reported more coping problems than the intrinsic religious group. Widows in Taiwan have different coping problems and strategies in postbereavement adjustment, affected by their different religious beliefs systems. More research is required to establish the generalisabilty of these findings. Widows in Taiwan need to be assessed for their religious belief systems and how this affects their ability to cope during bereavement. Clinicians should actively provide grief support and encourage new methods of social adaptation, especially with widows with extrinsic religious beliefs who may have less self-esteem and negative adaptation behaviours.

Culture-general and -specific associations of attachment avoidance and anxiety with perceived parental warmth and psychological control among Turk and Belgian adolescents

Both the adolescent peer attachment and perceived parenting style literatures emphasize the role of the quality of the parent–child relationship in children's healthy adjustment beyond the family, but few studies have investigated links between adolescents' peer attachment and perceptions of parenting. We investigate relations of adolescents' perceptions of warmth and psychological control from parents with avoidance and anxiety in attachment to close friends in two contrasting cultures. Altogether, 262 Turk and 263 Belgian youth between 14 and 18 years of age participated. Cross-culturally, attachment avoidance was negatively related to maternal warmth, and attachment anxiety positively related to maternal and paternal control and negatively to paternal warmth. Beyond these general relations, attachment avoidance was associated with paternal psychological control in Belgians but not in Turks. The study provides cross-cultural evidence for specific relations between peer attachment and perceived parenting and suggests a culture-specific pathway for the development of attachment avoidance.

The Modern Industrial Revolution, Exit, and the Failure of Internal Control Systems

This article, which is based on the author's Presidential address to the American Finance Association in 1993, argues that squeezing out excess capital and capacity is one of the most formidable ongoing challenges facing not only the U.S. economy, but the economies of all industrialized nations. In making this argument, the article draws striking parallels between the 19th‐century industrial revolution and worldwide economic developments in the last three decades. In both periods, technological advances led to not only sharp increases in productivity and dramatic reductions in prices, but also massive obsolescence and overcapacity. And much as the great M&A wave of the 1890s reduced capacity by consolidating some 1,800 companies into roughly 150, the leveraged takeovers, LBOs, and other leveraged recapitalizations of the 1980s provided “healthy adjustments” to overcapacity that was building in many sectors of the U.S. economy.To help public companies make the necessary adjustments to overcapacity, the author urges them to consider adopting some of the features of private equity, including significant equity stakes for managers, high leverage or payouts, and the recruiting of active investors as “partners in the business.”

Rehabilitation: Long-Term Physical and Functional Changes Following Treatment

To describe the life altering issues that survivors of a head and neck cancer report post treatment and discuss multidimensional rehabilitation approaches. Published journal articles, literature reviews, research reports, book chapters. Survivors and their family caregivers encounter many changes during the first 3 months following treatment for head and neck cancer, placing them at risk of multiple adjustment difficulties. Progressive weight loss, loss of energy, strength, muscle endurance and decreased functioning severely compromise healthy adjustment and quality of life. Nurses can help patients and family identify survivorship issues to be managed at home. Planning, exploring, coaching, practicing skills with survivors and their family caregivers, providing specific information, and linking them with resources can help them bridge this transition into extended survivorship.