Black and White Perceptions of Quality of Life in Boston

It is difficult, probably impossible, to compare objectively the seriousness of racial problems and tensions in Boston with those in other cities. However, there can be little doubt that there is a widespread perception that relationships between blacks and whites in Boston constitute a serious problem. Specifically, one image is that Boston is a community in which blacks are not welcome and in which they are treated with unusual hostility and abuse. Another image is that whites in Boston are unfairly maligned as racists and bigots. In 1980, following several race-related incidents, The Boston Committee was formed. The purpose of the Committee is to direct an integrated effort to address the problems that contribute to racial tension and conflict in Boston. A needed first step was a clear, factually-based definition of the real problems in Boston

Watchful Waiting vs. Immediate Transurethral Prostatectomy for Symptomatic Prostatism

The rate of resection for benign prostatic hypertrophy shows considerable variability among small geographic areas. To help inform the decision to recommend prostatectomy to men with prostatism without signs of chronic retention, we performed a decision analysis to compare the expected outcomes with immediate transurethral resection and watchful waiting. Data used in the model originated from the medical literature, Medicare claims data, and patient interview studies. In our base-case for 70-year-old men, immediate surgery resulted in the loss of 1.01 months of life expectancy, but when adjustments were made for quality of life, immediate surgery was favored with a net utility benefit of 2.94 quality-adjusted life-months. However, the analysis was particularly sensitive to the degree of disutility attributed to the index symptoms of prostatism. We conclude that patient preferences should be the dominant factor in the decision whether to recommend prostatectomy

The American Public’s Perception of Illegal Steroid Use: A National Survey, 2013

Through the surge of news about doping scandals in the media, it is expected that the public is aware of the magnitude of the problem among professional athletes; however, it is uncertain whether the public is aware that the problem often starts when athletes are younger. To this end, the National Baseball Hall of Fame and Museum, the Taylor Hooton Foundation, and the Professional Baseball Athletic Trainers Society partnered with the Center for Social Development and Education and the Center for Survey Research at the University of Massachusetts Boston to conduct the most comprehensive national opinion survey to date to assess the public’s knowledge, perceptions, and beliefs about the use of performance enhancing drugs among adolescents. It is hoped that the findings obtained through this survey will provide a foundation for a national dialogue about this problem

The role of perceived benefits and costs in patients’ medical decisions

Background  Many decisions can be understood in terms of actors’ valuations of benefits and costs. The article investigates whether this is also true of patient medical decision making. It aims to investigate (i) the importance patients attach to various reasons for and against nine medical decisions; (ii) how well the importance attached to benefits and costs predicts action or inaction; and (iii) how such valuations are related to decision confidence. Methods  In a national random digit dial telephone survey of U.S. adults, patients rated the importance of various reasons for and against medical decisions they had made or talked to a health‐care provider about during the past 2 years. Participants were 2575 English‐speaking adults age 40 and older. Data were analysed by means of logistic regressions predicting action/inaction and linear regressions predicting confidence. Results  Aggregating individual reasons into those that may be regarded as benefits and those that may be regarded as costs, and weighting them by their importance to the patient, shows the expected relationship to action. Perceived benefits and costs are also significantly related to the confidence patients report about their decision. Conclusion  The factors patients say are important in their medical decisions reflect a subjective weighing of benefits and costs and predict action/inaction although they do not necessarily indicate that patients are well informed. The greater the difference between the importance attached to benefits and costs, the greater patients’ confidence in their decision.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102701/1/hex739.pd

Worcester Model Cities Resident Attitude Survey

In January of 1972, the staff and resident representatives of the Worcester Model Cities neighborhood contracted the Survey Research Program to work with them to conduct a survey of neighborhood residents. The purpose of the project was to collect data that would assist those in the Model Cities area to systematically measure residents\u27 perceptions and feelings, to identify problems and needs, to plan programs, and, perhaps, at a later date to have a basis against which to measure change. The project, as it was designed and as it was carried out, was a joint effort. A committee of residents and staff outlined the study objectives. Program staff prepared several drafts of the interview schedule for review, incorporating the committee\u27s suggestions at each stage. The committee interviewed and helped to screen applicants for interviewers, who were then trained by Survey Research Program staff. When field work was in progress. Model Cities staff monitored the interviewers\u27 day-by-day progress, while Program staff met with interviewers for more intensive review sessions on a weekly basis. And so it is appropriate that the analysis of the data, too, is a cooperative effort rather than simply a document prepared by a consultant. Once the basic distributions of answers had been tabulated, Model Cities staff met with Survey Research Program staff to jointly decide on what further tabulations should be prepared. Copies of all tabulations were provided to Model Cities, so that residents and staff could begin to review and use the findings. This document is not intended to be the product of the project, or to be the report. If we have done our job properly, there should be many products and many reports which in part make use of the study data over the next year or two. The data should be a resource that can be drawn on continuously. Consistent with this orientation, we have tried primarily to put together some of the most basic and interesting tables in a form that is accessible. For the most part, the data have only been summarized, without any attempt to derive implications or conclusions from them. Our goal was to prepare a working document, which could be used by Model Cities residents and staff as one important resource in the planning and assessing of Model Cities programs in Worcester

Should a colon cancer screening decision aid include the option of no testing? A comparative trial of two decision aids

<p>Abstract</p> <p>Background</p> <p>An important question in the development of decision aids about colon cancer (CRC) screening is whether to include an explicit discussion of the option of not being screened. We examined the effect of including or not including an explicit discussion of the option of deciding not to be screened in a CRC screening decision aid on subjective measures of decision aid content; interest in screening; and knowledge.</p> <p>Methods</p> <p>Adults ages 50–85 were assigned to view one of two versions of the decision aid. The two versions differed only in the inclusion of video segments of two men, one of whom decided against being screened. Participants completed questionnaires before and after viewing the decision aid to compare subjective measures of content, screening interest and intent, and knowledge between groups. Likert response categories (5-point) were used for subjective measures of content (eg. clarity, balance in favor/against screening, and overall rating), and screening interest. Knowledge was measured with a three item index and individual questions. Higher scores indicated favorable responses for subjective measures, greater interest, and better knowledge. For the subjective balance, lower numbers were associated with the impression of the decision aid favoring CRC screening.</p> <p>Results</p> <p>57 viewed the "with" version which included the two segments and 49 viewed the "without" version. After viewing, participants found the "without" version to have better subjective clarity about benefits of screening ("with" 3.4, "without" 4.1, <it>p </it>< 0.01), and to have greater clarity about downsides of screening ("with" 3.2, "without" 3.6, <it>p </it>= 0.03). The "with" version was considered to be less strongly balanced in favor of screening. ("with" 1.8, "without" 1.6, <it>p </it>= 0.05); but the "without" version received a better overall rating ("with" 3.5, "without" 3.8, <it>p </it>= 0.03). Groups did not differ in screening interest after viewing a decision aid or knowledge.</p> <p>Conclusion</p> <p>A decision aid with the explicit discussion of the option of deciding not to be screened appears to increase the impression that the program was not as strongly in favor of screening, but decreases the impression of clarity and resulted in a lower overall rating. We did not observe clinically important or statistically significant differences in interest in screening or knowledge.</p

Leukocyte surface biomarkers implicate deficits of innate immunity in sporadic Alzheimer\u27s disease

Introduction: Blood-based diagnostics and prognostics in sporadic Alzheimer\u27s disease (AD) are important for identifying at-risk individuals for therapeutic interventions. Methods: In three stages, a total of 34 leukocyte antigens were examined by flow cytometry immunophenotyping. Data were analyzed by logistic regression and receiver operating characteristic (ROC) analyses. Results: We identified leukocyte markers differentially expressed in the patients with AD. Pathway analysis revealed a complex network involving upregulation of complement inhibition and downregulation of cargo receptor activity and Aβ clearance. A proposed panel including four leukocyte markers – CD11c, CD59, CD91, and CD163 – predicts patients’ PET Aβ status with an area under the curve (AUC) of 0.93 (0.88 to 0.97). CD163 was the top performer in preclinical models. These findings have been validated in two independent cohorts. Conclusion: Our finding of changes on peripheral leukocyte surface antigens in AD implicates the deficit in innate immunity. Leukocyte-based biomarkers prove to be both sensitive and practical for AD screening and diagnosis

The perceptions of social responsibility for community resilience to flooding: the impact of past experience, age, gender and ethnicity

Community resilience to flooding depends, to a large extent, on the participation of community members to take more responsibility for enhancing their own resilience. The perception of social responsibility (SR) which is argued to be one of the antecedents influencing individual’s willingness to undertake resilient behaviours can significantly contribute to community resilience through individual and collective actions. Understanding of factors influencing the perceptions of SR of individuals within community might help with developing strategies to increase the perceptions of SR. This research explores perceptions of SR in relation to flooding for householders and local businesses and establishes their relationships with experience of flooding and demographic factors of age, gender and ethnicity. The data were obtained via a questionnaire survey of three communities in Birmingham and one community in South East London, UK, three with experience of flooding and one without. A total of 414 responses were received and used in the multiple regression analysis. The analysis identified ‘experience of flooding’, ‘age’ and ‘South Asian’ ethnic group as significant variables, suggesting that older individuals from South Asian ethnic groups with previous experience of flooding are likely to be more socially responsible than others without these attributes