In this paper we review the self-expansion model in the context of close relationships, focusing primarily on work in the last 20 years, considering throughout variation in our samples across cultures and other demographics—both in existing studies and in potential implications for future research. The self-expansion model has two key principles. The first half of the paper focuses on the motivational principle: The model theorizes that people have a fundamental desire to expand the self—that is, to increase their self-efficacy, perspectives, competence, and resources, and this often occurs through relationships in general. The second half of the paper focuses on the inclusion-of-other-in-the-self principle, in that a major means of self-expansion is through close relationships, when one’s partner’s identities, perspectives, skills, and resources become to some extent “included in the self” as also one’s own. For each principle we briefly describe its foundational research support and then explore the extensive, significant work of the last 20 years substantially expanding and deepening the implications of the model. The majority (although with some interesting exceptions) of studies have fallen short of testing the universal breadth of the model. As we review the research, we consider where the studies were conducted and with what kinds of populations. Where there are data from diverse populations, the overall pattern of results are generally similar. However, there were individual differences found within the populations studied, such as in attachment style, that affected the operation of both principles. Since there are well known differences in the distribution of such individual differences across populations of many types, it is quite likely that while the basic patterns may not differ, future research will show different degrees of operation in different populations.

Abstract Post-acute care (PAC) is a component of health-care utilization and spending that is subject to the discretion of providers. Prior research has demonstrated that Accountable Care Organizations (ACOs) recognize PAC as a logical target for increased efficiency and cost savings. As part of the evaluation of the Centers for Medicare & Medicaid Services (CMS) Next Generation ACO (NGACO) Model, we investigated NGACOs’ approaches to PAC services and the impact of these efforts on utilization and cost using a mixed-methods study design. We conducted interviews and surveys with NGACO leadership and providers and performed a difference-in-differences analysis of utilization and spending based on Medicare claims data. We found that NGACOs focused specifically on establishing partnerships with skilled nursing facilities (SNF) to facilitate transitions in care by establishing new channels of communication, sharing performance data, embedding staff in SNFs, and (in some cases) sharing financial risk. We observed a statistically significant decrease in SNF spending, a trend toward fewer SNF days, and statistically significantly lower expenditures for other PAC settings (e.g., inpatient rehabilitation and long-term acute care facilities). These findings suggest that NGACOs have contributed to improving transitions in care and diverting beneficiaries from intensive PAC settings. Nonetheless, the reduction in PAC spending alone did not translate to a decline in total cost of care. Future ACOs may need to expand their focus to the inpatient utilization and spending that precedes PAC in order to impact total cost of care.

This article surveys scholarship on the self-expansion model principle of inclusion of other in the self (IOS) as it relates to long-term pair-bonding (i.e., enduring adult romantic monogamous relationships). First, we introduce the concept of IOS and then provide a brief overview of prior research. We then review compelling extensions and findings related to relational concepts such as perspective taking (Bernstein et al., 2015), social comparison (Thai and Lockwood, 2015), self-determination (Weinstein et al., 2016), humor (Treger et al., 2013), and pain contagion (Martire et al., 2013). Next, we explore two recent theoretical directions of the principle—the two-dimensional model of relational self-change (McIntyre et al., 2015) and the perceived inclusion of the other in the self (IOS-perceived) construct (Tomlinson and Aron, 2013). Considering these findings and their relation to pair-bonding, we propose important future directions of the IOS principle of the self-expansion model.

Background and Objectives: Care coordination and palliative care supports are associated with reduced anxiety, fewer hospital admissions, and improved quality of life for patients and their families. Early palliative care can result in savings in the end-of-life period, but there is limited evidence that larger-scale models can improve both utilization and the cost of care. Three models that received Health Care Innovation Awards from the Centers for Medicare & Medicaid Services aimed to improve quality of care and reduce cost through the use of innovative care coordination models. This study explores the total cost of care and selected utilization outcomes at the end-of-life for these innovative models, each of which enrolled adults with multiple chronic conditions and featured care coordination with advance care planning as a component of palliative care. These included a comprehensive at-home supportive care model for persons predicted to die within a year and two models offering advance care planning in nursing facilities and during care transitions.Research Design and Methods: We used regression models to assess model impacts on costs and utilization for high-risk Medicare beneficiaries participating in the comprehensive supportive care model (N = 3,339) and the two care transition models (N = 587 and N = 277) who died during the study period (2013-2016), relative to a set of matched comparison patients.Results: Comparing participants in each model who died during the study period to matched comparators, two of the three models were associated with significantly lower costs in the last 90 days of life ($2,122 and $4,606 per person), and the third model showed nonsignificant differences. Two of the three models encouraged early hospice entry in the last 30 days of life. For the comprehensive at-home supportive care model, we observed aggregate savings of nearly $19 million over the study period. One care transition model showed aggregate savings of over $500,000 during the same period. Potential drivers of these cost savings include improved patient safety, timeliness of care, and caregiver support.Discussion and Implications: Two of the three models achieved significant lower Medicare costs than a comparison group and the same two models also sustained their models beyond the Centers for Medicare & Medicaid Services award period. These findings show promise for achieving palliative care goals as part of care coordination innovation.

Chapter 24 The Well-Being of Teachers and Professors Brittany Branand, Brittany BranandSearch for more papers by this authorJeanne Nakamura, Jeanne NakamuraSearch for more papers by this author Brittany Branand, Brittany BranandSearch for more papers by this authorJeanne Nakamura, Jeanne NakamuraSearch for more papers by this author Book Editor(s):Lindsay G. Oades, Lindsay G. OadesSearch for more papers by this authorMichael F. Steger, Michael F. StegerSearch for more papers by this authorAntonella Delle Fave, Antonella Delle FaveSearch for more papers by this authorJonathan Passmore, Jonathan PassmoreSearch for more papers by this author First published: 19 November 2016 https://doi.org/10.1002/9781118977620.ch24Citations: 4 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary Educators perform an important role in cultures across the world, as the generative nature of their work provides them a unique opportunity. This chapter examines character strengths and personality traits that positively relate to well-being. It reviews what attempts at intervention have been advanced, highlighting mentoring, and suggest future directions that might lead to improved work environments and increased teacher well-being. The education literature has documented the generative gifts of teachers, showing that the success and well-being of students is influenced by the success and well-being of their teachers. Many theoretical frameworks inform the study of well-being in teachers; however, from a positive psychology perspective four warrant highlighting in the context of the chapter: the social cognitive career theory, the job demands-resources model (JD-R), the self-determination theory and the theory of flow. The JD-R model posits that every job has two classes of characteristics: job demands and job resources. Citing Literature The Wiley Blackwell Handbook of the Psychology of Positivity and Strengths-Based Approaches at Work RelatedInformation

Well-being theory (WBT) proposes five indicators of well-being [i.e., positive emotion, engagement, relationships, meaning, achievement (PERMA)] that are, independently, empirically supported predictors of flourishing (i.e., an optimal level of well-being; Seligman in Flourish: a visionary new understanding of happiness and well-being. Free Press, NY, 2011). However, there is limited empirical support for the multidimensional model suggested by WBT. Two studies sought to test and validate the higher-order factor structure of the five components of PERMA and PERMA's ability to predict concurrent and prospective flourishing outcomes (e.g., physical health, college success). In Study 1, a longitudinal examination of college students, participants completed measures of well-being (including four of the five PERMA indicators), physical health, and college success at the end of their sophomore, junior, and senior years. In Study 2, a larger, cross-sectional study was conducted online to further validate the PERMA model with a broader sample and all five PERMA indicators. Participants completed measures similar to those administered at Study 1 and other measures used to validate Study 1 measures. Results from Study 2 further validated the PERMA model by comparing Study 1 measures to established measures and by adding meaning to the model. Study 1 and Study 2 PERMA models predicted markers of well-being (e.g., vitality, life satisfaction) and flourishing (e.g., physical health). The two studies reported here provide cross-sectional and longitudinal support that WBT is useful for predicting flourishing.

Consistent with predictions derived from the self-expansion model, this 3-year longitudinal study found that participation in more college groups during sophomore year predicted increases in inclusion of the college community in the self at the end of junior year, which further predicted increases in satisfaction with the college experience at the end of senior year (full mediation). This study offers college community connectedness as a theoretically grounded mechanism to explain why extracurricular involvement is such an important piece of the college experience, confirming what student affairs professionals already know: connectedness matters.

Age is a basic source of difference, conditioning what “the positive” means in human functioning. In the life-worlds of infants, children, and adolescents, the nature and conditions of optimal functioning differ in many respects. Significant differences also exist in the nature of “the positive” during emerging, young, middle, and older adulthood. Furthermore, age and the individual life periods are experienced and valued differently across cultures. In this chapter, age differences in optimal functioning are viewed through the lens of positive lifespan developmental psychology. The chapter first briefly discusses age and life period from a lifespan perspective. Subsequent sections illustrate the perspective by outlining the lifespan trajectory of three important and widely studied positive-psychology phenomena, drawn from the affective, interpersonal, and cognitive domains, respectively: well-being, romantic relationships, and wisdom.