We evaluated 197 patients with predominantly late-onset Alzheimer's disease (AD) who belonged to several ethnic groups and analyzed the relationship of age of onset of AD to the presence or absence of several risk factors in this entire group of patients. The apolipoprotein E (apoE) epsilon 4 allele frequency, which was 29% in all patients (compared with the reported population mean of 13.7%, p < 0.001, did not vary significantly between ethnic groups but declined significantly with increasing age. The apoE epsilon 2 allele frequency was 3%, compared with the reported population mean of 7.4% (p = 0.001). The frequency of a positive family history of dementia in first-degree relatives (FH +) (overall 45%) did not vary significantly between ethnic groups. ApoE epsilon 4-positive (epsilon 4+) patients tended to have a higher FH + rate (58%) than apoE epsilon 4-negative (epsilon 4-) patients (40%) (p = 0.02). When the potential risk factors of gender, education, FH+ status, and epsilon 4+ status were examined together in a multiple linear-regression analysis, FH+ and epsilon 4+ status (but not gender or education) were significant (they were both associated with an earlier age of onset of AD). In a post-hoc analysis, we found a reduced age of onset in women, but not men, who were both FH + and epsilon 4+. Additionally, those probands who were epsilon 4+ were more likely to inherit the disease from their mothers than their fathers. The mechanism by which epsilon 4+ and FH+ status operate as risk factors may be by their effect on the age of onset of AD.

This pilot study employed qualitative interviews to assess nursing home residents' perceptions of their "best" and "worst" experiences in the nursing home. Findings suggest residents are least satisfied with the care provided by nurse aides, and most satisfied with that provided by professional staff members. The quality of interpersonal relationships with staff was the basis for the majority of both residents' best and worst experiences. Qualitative analyses identified specific "adaptive responses" that were associated with how residents interpreted and responded to negative experiences with care.

This qualitative study describes how forty-one perimenopausal and postmenopausal women with coronary heart disease (CHD) perceive their illness experience. Five focus groups were conducted by a professional facilitator at two community hospitals in New Jersey. All data were collected and analyzed based on the grounded theory approach. Findings indicate that participants often failed to recognize the significance of risk factors and symptoms, and even denied the presence of disease following diagnosis and treatment. Consequences of illness centered on women's efforts to maintain control over their health and their lives. Findings also indicate that there is a gap between the desire for knowledge and the ability to access and assimilate information in key areas regarding CHD and personal health behaviors. The insights provided by these women have several implications for future research and contribute valuable information related to the needs of this population.

The high rate of turnover among nurse aides employed in nursing homes has been associated with the low job status and the poor job benefits accorded workers. However, this is not always the case. Competitive benefit packages and limited labor market opportunities increase the likelihood that nurse aides in some nursing homes may stay on the job despite their dissatisfaction with it. The present study investigated "institutional loyalty," an attitudinal proxy for job turnover, among 219 nurse aides for its relationship to a number of job-related factors. Somewhat unexpectedly, the quality of the social environment of the nursing home was found to be as important as attitudes toward job benefits in accounting for institutional loyalty.

This study examines demoralization among a sample of sons, daughters, spouses, and other relatives of nursing home residents. Various aspects of the caregiving situation-caregiver burden and family members' feelings of guilt and worry about the placement-as well as social support, were significantly related to morale for the sample as a whole. However, when each group of family members was analyzed separately, the predictors of demoralization were found to vary. Spouses were the most vulnerable group, experiencing the highest demoralization. Caregiving-related factors had the greatest impact on demoralization among spouses and relatives other than spouses and adult children.