Eighty subjects from an introductory psychology course rated the desirability of eight course structures that differed according to all combinations of the presence or absence of effort required for success, time pressure, and the provision of feedback. Subjects also completed questionnaire measures of the Type A behavior pattern, test anxiety, and external locus of control. Results showed that the Type A behavior pattern was negatively related to external locus of control and that externals tended to have higher test anxiety scores than internals. Multiple regression analyses that involved the personality variables and age and gender showed that the Type A variable predicted preference for course structures that involved effort and feedback and that external control predicted preference for course structures that were independent of effort and provided little feedback. Test anxiety and desirability ratings were positively correlated for the course structure that was not dependent on effort, had little time pressure, and had little feedback. The results were consistent with the view that individuals seek out and prefer situations that are consistent with their personality characteristics.

Employed and unemployed male and female university graduates completed a questionnaire that included the Backman et al. (1978) self‐esteem scale, the short form of the Beck Depression Inventory (Beck & Beck, 1972) and items designed to measure employment importance and the extent to which time was used in a structured and purposeful way. It was found that graduates in the unemployed sample were less organized and less purposeful in their use of time and reported more depressive symptoms when compared with the employed sample. In both groups structured and purposeful use of time was positively associated with self‐esteem and negatively associated with depressive symptoms. Correlations between employment importance and the use of time measures (total score, engagement, direction, structure and routine) were negative for the unemployed sample and positive for the employed sample, indicating that employment importance functioned as a moderator variable. Female respondents reported higher employment importance and more use of a routine but their self‐esteem scores were lower than those of the male respondents. Results were related to Jahoda's analysis of the latent functions of employment and to other recent studies of employment and unemployment but were seen as extending beyond the Jahoda analysis.

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The aim of this study was to identify differences in the medical management and clinical outcome in a group of elderly patients admitted to a designated geriatric assessment unit (GAU) or to two general medical units (GMUs). A prospective randomised controlled trial was undertaken in 267 patients aged 70 years and over (mean age = 78.3 years). Following discharge from hospital, patients were followed up at three monthly intervals for a total of 12 months. At the time of discharge, no significant differences were found in inpatient management, length of stay, mortality rates, discharge rates to institutional care or utilisation of community services in patients admitted to the GAU and the GMUs. Similarly, no significant differences were found at three, six, nine, and 12 month follow up in case fatality, activities of daily living indices, mental health status, rates of institutional referral and the level of community service support in patients admitted to the GAU and the GMUs studied. These findings do not show any advantage for the unselected 70+ acutely ill elderly patient who is admitted to a designated geriatric assessment unit rather than to a general medical unit. Therefore, an admission policy to GAU, based solely on age 70+ is medically inappropriate and cost-inefficient. Evidence from other sources suggests that an age cohort of acutely admitted patients beyond 80 years may well have returned more optimistic findings for the GAU. In future, GAUs will require a more selective admission policy to maximise the benefits of their rehabilitative and interdisciplinary approach.

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The mechanism by which chronic caregiving stress results in poor health is not well understood. The objective was to determine whether such a mechanism may be allostatic load, a novel concept specifying physiological systems that may suffer cumulative wear and tear following chronic stress, leading collectively to poor health. The study examines the association of allostatic load with environmental and psychological stress in the contexts of dementia caregiving and relinquishment of care, and is a 2-year longitudinal comparison of three groups: 80 new dementia spouse caregivers, 120 veteran caregivers, and 60 non-caregivers. Data comprised allostatic load markers and environmental and psychological stress measures. Cross-lagged analyses produced a statistically significant association between psychological stress and one allostatic load component (primary mediators). Psychological stress was a better predictor of primary mediators than environmental stress. Primary mediators rose with time for caregivers, but not for non-caregivers. A greater rise was evident for caregivers who had relinquished their role by the second year, although the level of psychological stress actually declined. Primary mediators are a key component of the relationship between allostatic load and prior stress. When allostatic load is treated as an outcome of stress, it is important to distinguish environmental and psychological stress.

To investigate what is lost or gained in a psychiatric evaluation when it takes place via telepsychiatry we compared the interrater reliability between two psychiatrists interviewing 63 subjects in an observer/interviewer split configuration in telepsychiatry and same-room settings. The measures used were the BPRS and interviewer ratings from a semi-structured interview. Patients also rated their experience. There were some clear differences between the telepsychiatry and same-room evaluations. Despite these variations, diagnoses were as reliably made by telepsychiatry. Patient acceptance of telepsychiatry was high.

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