Today's our final day! Good luck to everyone on the final and on your further endeavors at UW-Madison and beyond!
I am pleased to announce that the online encyclopedia created by our class is now available for viewing.
Thursday, August 9, 2007
Wednesday, August 8, 2007
Today's our last day of regular class, before Thursday's final exam. Mainly, we will review for the exam and do some administrative things (e.g., course evaluations). Here are a couple of topics that we didn't get to cover formally during the class (and won't be on the exam), but are still worth discussing briefly.
(1) Public policies and laws can be formulated to help families alleviate stress. Examples include the federal Family and Medical Leave Act to allow parents to spend time with newborn or sick children. Another example is the New Jersey state law requiring screening of pregnant women and new mothers for postpartum depression. These are discussed in our class encyclopedia, which still has a little way to go before all of the entries are posted on the web.
I teach a graduate course at Texas Tech called "Family Law and Public Policy." If you'd be interesting in checking out the resources there, here is the link.
Also, right here in HDFS at UW-Madison, Prof. Karen Bogenschneider is one of the nation's leading experts on family policy. The website for her Family Impact Seminars, which she provides to policymakers, is available here.
(2) The other topic is what Harvard political scientist Robert Putnam (and others) call "social capital." The idea is that by getting to know one's neighbors and getting involved in the community, quality of life can be improved (e.g., people looking out for each other's houses). The website associated with Putnam's book Bowling Alone, which deals with the decline of social capital in the U.S. in recent decades, is available here.
(1) Public policies and laws can be formulated to help families alleviate stress. Examples include the federal Family and Medical Leave Act to allow parents to spend time with newborn or sick children. Another example is the New Jersey state law requiring screening of pregnant women and new mothers for postpartum depression. These are discussed in our class encyclopedia, which still has a little way to go before all of the entries are posted on the web.
I teach a graduate course at Texas Tech called "Family Law and Public Policy." If you'd be interesting in checking out the resources there, here is the link.
Also, right here in HDFS at UW-Madison, Prof. Karen Bogenschneider is one of the nation's leading experts on family policy. The website for her Family Impact Seminars, which she provides to policymakers, is available here.
(2) The other topic is what Harvard political scientist Robert Putnam (and others) call "social capital." The idea is that by getting to know one's neighbors and getting involved in the community, quality of life can be improved (e.g., people looking out for each other's houses). The website associated with Putnam's book Bowling Alone, which deals with the decline of social capital in the U.S. in recent decades, is available here.
Monday, August 6, 2007
Tuesday, for our final substantive topic before Wednesday's review session and Thursday's final exam, will we look at how stress may lead to physical illness. Here is an overall conceptual model I created, which you can click on to enlarge (I can really get going with clip art!). The studies we look at will feature variations on this basic model, tailored to the health phenomena being studied.
Specifically, we will look at...
Stress and the immune system (Cohen & Williamson, 1991, from Cohen's lab page)
Stress/depression and cardiovascular disease (from here)
Stress/anxiety and pregnancy (from research by one of my faculty mentors when I was an undergraduate at UCLA, Christine Dunkel-Schetter)
During some earlier units, when we were talking about racism, I mentioned how there had been a lot of recent research on racism as a stressor, and its health consequences. Here's an article I found from the Boston Globe. It mentions both major pathways from stress to disease, physiological and behavioral. It also talks about how researchers have used the “controlled conditions of the laboratory.”
Finally, several general sources on stress, hormones, and disease progression are available from the Wikipedia, Society for Neuroscience, News Target, Medical News Today, and the Mayo Clinic.
Specifically, we will look at...
Stress and the immune system (Cohen & Williamson, 1991, from Cohen's lab page)
Stress/depression and cardiovascular disease (from here)
Stress/anxiety and pregnancy (from research by one of my faculty mentors when I was an undergraduate at UCLA, Christine Dunkel-Schetter)
During some earlier units, when we were talking about racism, I mentioned how there had been a lot of recent research on racism as a stressor, and its health consequences. Here's an article I found from the Boston Globe. It mentions both major pathways from stress to disease, physiological and behavioral. It also talks about how researchers have used the “controlled conditions of the laboratory.”
Finally, several general sources on stress, hormones, and disease progression are available from the Wikipedia, Society for Neuroscience, News Target, Medical News Today, and the Mayo Clinic.
Sunday, August 5, 2007
On Monday, students will be e-mailing me their entries for our class's online encyclopedia project, which I will be posting on the web in the coming days. For the first half of class, each student will say a few words about his or her write-up.
Just as a miscellaneous item, today's (Sunday) Wisconsin State Journal has an article entitled "Grandparents Get the Kids." The article discusses the stress and coping aspects of being the primary caregiver for one's grandchild, particularly in situations where the child has special needs.
The last hour or so of class, we will have our discussion of Chapter 4, pertaining to coping with death and dying, plus pp. 60-64 of Chapter 3, on caregiving. As the questions from Group C come in, I will post them below...
Do you think losing a parent or caregiver at different stages in your life would be more stressful (i.e. losing a parent/caregiver during childhood versus losing a parent/caregiver during adolescence or emerging adulthood, etc.)? How could this impact different age groups’ lives?
It may be more difficult for a child who does not understand death to deal with a loss. They are perhaps too young to understand it -- however, do you think some sort of "death/grief education" is important at a young age so as to structure better coping and beliefs in young/emerging adulthood? Who is in the best position to "provide" such education to the young?
I believe that everyone has their own relationship with the idea of death, that forms from a young age -- from one's own experiences (or lack thereof) with death. Do you think that a single incident of death is able to completely change one's entire relationship with death? Why or why not?
Families in the United States deal with conflicting notions of death: Death is invisible and privatized versus death is shoved in our face by media. What factors contributed to the construct of these two concepts and what affect do they have on families? (p.77-78).
In the book, it talks about many reports on the deaths of famous people and how those tragedies leave viewers with illusions of intimacy and grieving. It says that, "Individuals who did not personally know the deceased can go through rituals of mourning…" (p. 77). So, how does this virtual grief differ from the actual grief? And how do these two affect people differently?
With the desensitization of death, illness, and violence in the media, how is it possible that death is still a taboo subject in Western culture?
Just as a miscellaneous item, today's (Sunday) Wisconsin State Journal has an article entitled "Grandparents Get the Kids." The article discusses the stress and coping aspects of being the primary caregiver for one's grandchild, particularly in situations where the child has special needs.
The last hour or so of class, we will have our discussion of Chapter 4, pertaining to coping with death and dying, plus pp. 60-64 of Chapter 3, on caregiving. As the questions from Group C come in, I will post them below...
Do you think losing a parent or caregiver at different stages in your life would be more stressful (i.e. losing a parent/caregiver during childhood versus losing a parent/caregiver during adolescence or emerging adulthood, etc.)? How could this impact different age groups’ lives?
It may be more difficult for a child who does not understand death to deal with a loss. They are perhaps too young to understand it -- however, do you think some sort of "death/grief education" is important at a young age so as to structure better coping and beliefs in young/emerging adulthood? Who is in the best position to "provide" such education to the young?
I believe that everyone has their own relationship with the idea of death, that forms from a young age -- from one's own experiences (or lack thereof) with death. Do you think that a single incident of death is able to completely change one's entire relationship with death? Why or why not?
Families in the United States deal with conflicting notions of death: Death is invisible and privatized versus death is shoved in our face by media. What factors contributed to the construct of these two concepts and what affect do they have on families? (p.77-78).
In the book, it talks about many reports on the deaths of famous people and how those tragedies leave viewers with illusions of intimacy and grieving. It says that, "Individuals who did not personally know the deceased can go through rituals of mourning…" (p. 77). So, how does this virtual grief differ from the actual grief? And how do these two affect people differently?
With the desensitization of death, illness, and violence in the media, how is it possible that death is still a taboo subject in Western culture?
Wednesday, August 1, 2007
The first part of Thursday's class will introduce the subject matter on aging, family caregiving, death and dying. During the second half, UW-Madison HDFS Department Chair and Professor Linda Roberts will speak regarding some of her research. Dr. Roberts is a longtime friend and colleague of mine, going back to the early 1990s when we were both working on alcohol studies at the Research Institute on Addictions, in Buffalo, NY.
The following article presents an excellent overview of many relevant issues:
Haley, W.E., Allen, R.S., Reynolds, S., Chen, H., Burton, A., & Gallagher-Thompson, D. (2002). Family issues in end-of-life decision making and end-of-life care. American Behavioral Scientist, 46, 284-298.
The article begins with the statement that, “Family members are involved in every aspect of end-of-life decision making and care,” and goes on to discuss several areas. Two areas I want to examine are caregiving and end-of-life decision-making. Here are some excerpts from the article:
ON CAREGIVING
Families have been found to provide the majority of care for individuals with chronic illness.
…projects [focusing on care of patients with either cancer or dementia] found rates of psychological distress in caregivers to be two to three times higher than those in general community populations regardless of the nature of the illness for which care was being provided
Although providing extensive caregiving is certainly more stressful than providing occasional caregiving, studies of primary caregivers of patients with dementia and cancer generally find that objective measures of the amount of care provided do not explain much of the variability in caregiver distress…
…despite the large number of studies on caregiving and its associated stresses, it should be noted that very little of the research literature to date has focused on caregiving near the end of life.
ON END-OF-LIFE DECISION-MAKING
Concerning end-of-life decisions… individuals may make formal advance directives, specifying their wishes for end-of-life care and/or designating someone (usually a family member) as their surrogate decision maker in the event that they are incapacitated. Even with a formal advance directive, it is necessary for family members to be aware of this document and insist that it is implemented when patients face a health crisis.
Family members are often key decision makers regardless of patients' prior preferences concerning end-of-life care... Dying patients may even prefer that family members make final decisions. Terry and colleagues (1999) found that a majority (54%) of terminally ill patients would select their surrogate's treatment decision rather than the treatment outlined in their own advance directive.
Family members are often asked by health care professionals to propose a decision that is based on what they believe the patient would have wanted. A growing body of research, however, shows that surrogate preferences can be an inaccurate reflection of the patient's actual treatment wishes…. Specifically, familial surrogates tend to overestimate the frequency with which patients would like to receive aggressive or invasive treatment near the end of life…
This separate PowerPoint slide show by Haley has a lot of background on caregiving, and death and dying (see slide 29, in particular). Much of the rest of the slideshow pertains to interventions to help caregivers.
The Wikipedia has some informative pages on advance directives and hospice/palliative care.
On the topic of bereavement, two useful resources are the University of Michigan’s Changing Lives of Older Couples (CLOC) study, and the stage-theory study we discussed earlier (Maciejewski and colleagues, “An empirical examination of the stage theory of grief”, for which there’s a link in the bibliography section below).
The following article presents an excellent overview of many relevant issues:
Haley, W.E., Allen, R.S., Reynolds, S., Chen, H., Burton, A., & Gallagher-Thompson, D. (2002). Family issues in end-of-life decision making and end-of-life care. American Behavioral Scientist, 46, 284-298.
The article begins with the statement that, “Family members are involved in every aspect of end-of-life decision making and care,” and goes on to discuss several areas. Two areas I want to examine are caregiving and end-of-life decision-making. Here are some excerpts from the article:
ON CAREGIVING
Families have been found to provide the majority of care for individuals with chronic illness.
…projects [focusing on care of patients with either cancer or dementia] found rates of psychological distress in caregivers to be two to three times higher than those in general community populations regardless of the nature of the illness for which care was being provided
Although providing extensive caregiving is certainly more stressful than providing occasional caregiving, studies of primary caregivers of patients with dementia and cancer generally find that objective measures of the amount of care provided do not explain much of the variability in caregiver distress…
…despite the large number of studies on caregiving and its associated stresses, it should be noted that very little of the research literature to date has focused on caregiving near the end of life.
ON END-OF-LIFE DECISION-MAKING
Concerning end-of-life decisions… individuals may make formal advance directives, specifying their wishes for end-of-life care and/or designating someone (usually a family member) as their surrogate decision maker in the event that they are incapacitated. Even with a formal advance directive, it is necessary for family members to be aware of this document and insist that it is implemented when patients face a health crisis.
Family members are often key decision makers regardless of patients' prior preferences concerning end-of-life care... Dying patients may even prefer that family members make final decisions. Terry and colleagues (1999) found that a majority (54%) of terminally ill patients would select their surrogate's treatment decision rather than the treatment outlined in their own advance directive.
Family members are often asked by health care professionals to propose a decision that is based on what they believe the patient would have wanted. A growing body of research, however, shows that surrogate preferences can be an inaccurate reflection of the patient's actual treatment wishes…. Specifically, familial surrogates tend to overestimate the frequency with which patients would like to receive aggressive or invasive treatment near the end of life…
This separate PowerPoint slide show by Haley has a lot of background on caregiving, and death and dying (see slide 29, in particular). Much of the rest of the slideshow pertains to interventions to help caregivers.
The Wikipedia has some informative pages on advance directives and hospice/palliative care.
On the topic of bereavement, two useful resources are the University of Michigan’s Changing Lives of Older Couples (CLOC) study, and the stage-theory study we discussed earlier (Maciejewski and colleagues, “An empirical examination of the stage theory of grief”, for which there’s a link in the bibliography section below).
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