Reflections on the Connections Between Work and Health

Describes approaches that TCWF is using to improve health through employment-related strategies, and identifies some of the challenges the foundation has experienced in the cross-disciplinary endeavor. Part of TCWF's Reflections series

Historical Perspective: S. Leonard Syme's influence on the development of social epidemiology and where we go from there

This article accompanies Len Syme's "Historical Perspective: The social determinants of disease – some roots of the movement." It describes some of Len's role in the development of social epidemiology through mentoring investigators and influencing training programs. It also discusses some challenges for the field and ways to move forward

Small food stores and availability of nutritious foods: a comparison of database and in-store measures, Northern California, 2009.

IntroductionSmall food stores are prevalent in urban neighborhoods, but the availability of nutritious food at such stores is not well known. The objective of this study was to determine whether data from 3 sources would yield a single, homogenous, healthful food store category that can be used to accurately characterize community nutrition environments for public health research.MethodsWe conducted in-store surveys in 2009 on store type and the availability of nutritious food in a sample of nonchain food stores (n = 102) in 6 predominantly urban counties in Northern California (Alameda, Contra Costa, Marin, Sacramento, San Francisco, and Santa Clara). We compared survey results with commercial database information and neighborhood sociodemographic data by using independent sample t tests and classification and regression trees.ResultsSampled small food stores yielded a heterogeneous group of stores in terms of store type and nutritious food options. Most stores were identified as convenience (54%) or specialty stores (22%); others were small grocery stores (19%) and large grocery stores (5%). Convenience and specialty stores were smaller and carried fewer nutritious and fresh food items. The availability of nutritious food and produce was better in stores in neighborhoods that had a higher percentage of white residents and a lower population density but did not differ significantly by neighborhood income.ConclusionCommercial databases alone may not adequately categorize small food stores and the availability of nutritious foods. Alternative measures are needed to more accurately inform research and policies that seek to address disparities in diet-related health conditions

Gentrification and Displacement in the San Francisco Bay Area: A Comparison of Measurement Approaches.

Gentrification may play an important role in influencing health outcomes, but few studies have examined these associations. One major barrier to producing empirical evidence to establish this link is that there is little consensus on how to measure gentrification. To address this barrier, we compared three gentrification classification methodologies in relation to their ability to identify neighborhood gentrification in nine San Francisco Bay Area counties: the Freeman method, the Landis method, and the Urban Displacement Project (UDP) Regional Early Warning System. In the 1580 census tracts, 43% of the population had a bachelor's degree or higher. The average median household income was $79,671 in 2013. A comparison of gentrification methodologies revealed that the Landis and Freeman methodologies characterized the vast majority of census tracts as stable, and only 5.2% and 6.1% of tracts as gentrifying. UDP characterized 46.7% of tracts at risk, undergoing, or experiencing advanced stages of gentrification and displacement. There was substantial variation in the geographic location of tracts identified as gentrifying across methods. Given the variation in characterizations of gentrification across measures, studies evaluating associations between gentrification and health should consider using multiple measures of gentrification to examine the robustness of the study findings across measures

Ensuring Mobility-Supporting Environments for an Aging Population: Critical Actors and Collaborations

Successful aging takes on an array of attributes, including optimal health and community participation. Research indicates that (1) persons with disabilities, including age-related disabilities, report frequent barriers to community participation, including unsuitable building design (43%), transportation (32%), and sidewalks/curbs (31%), and (2) many seniors report an inability to cross roads safely near their homes. This paper attempts to define mobility-related elements that contribute to optimal health and quality of life, within the context of successful aging. It then examines the impacts of community design on individual mobility, delving into which traditional and nontraditional actors—including architects, urban planners, transportation engineers, occupational therapists, and housing authorities—play critical roles in ensuring that community environments serve as facilitators (rather than barriers) to mobility. As America ages, mobility challenges for seniors will only increase unless both traditional aging specialists and many nontraditional actors make a concerted effort to address the challenges

Patient Experiences in a Linguistically Diverse Safety Net Primary Care Setting: Qualitative Study

Background: The patient-centered medical home model intends to improve patient experience and primary care quality. Within an urban safety net setting in Northern California, United States, these desired outcomes are complicated by both the diversity of the patient community and the care continuity implications of a residency program. Objective: The objective of our study was to understand the patient experience beyond standardized satisfaction measures. Methods: We conducted a qualitative study, interviewing 19 patients from the clinic (English-, Spanish-, or Mien-speaking patients). Results: Some themes, such as the desire to feel confident in their doctor, emerged across language groups, pointing to institutional challenges. Other themes, such as distrust in care being provided, were tied distinctly to speaking a language different from one’s provider. Still other themes, such as a sense of powerlessness, were related to cultural differences and to speaking a language (Mien) not spoken by staff. Conclusions: Findings illuminate the need to understand cultural behaviors and interactional styles in a diverse patient population to create a high-quality medical home

Flowsheet Design and Simulation of Carbon Dioxide Removal System via Reactive Absorption Using Mixed (AMP + MEA) Solvent

Currently, around 90 % of the world’s primary energy requirement is supplied by fossil fuels in which causes rising in the emission of greenhouse gases (GHGs) that contributes to global warming effects and climate change. Carbon dioxide gas is the largest component of greenhouse gas. Moreover, carbon dioxide lowers the heating value of natural gas as well as is corrosive to pipelines and equipments. Therefore, removal of carbon dioxide from natural gas stream is crucial. There are several technologies for carbon dioxide removal available commercially. Chemical solvent absorption is the most common and extensively used in existing natural gas processing and liquefaction plants nowadays

Older adults' perspectives on key domains of childhood social and economic experiences and opportunities: a first step to creating a multidimensional measure

ObjectivesAlthough research has found that childhood socioeconomic status (SES) is associated with physical and mental health in mid- and later life, most of these studies used conventional, single dimension SES measures for the childhood period such as household income or educational attainment of parents. Life course and health disparities research would benefit from identification and measurement of a variety of childhood social and economic experiences and opportunities that might affect health in later life.DesignThis study utilized qualitative research methods to identify key dimensions of childhood experiences related to SES. We conducted in-depth interviews with 25 adults age 55 to 80 years from diverse economic and ethnic backgrounds. Topics included home, neighborhood, school, and work experiences during early childhood and adolescence. Interviews were audio-taped and transcripts were coded to identify thematic domains.ResultsWe identified eight thematic domains, many of which had clear subdomains: home and family circumstances, neighborhood, work and money, potential for advancement through schooling, school quality and content, discrimination, influence and support of adults, and leisure activities. These domains highlight individual characteristics and experiences and also economic and educational opportunities.ConclusionThese domains of childhood social and economic circumstances add breadth and depth to conventional conceptualization of childhood SES. When the domains are translated into a measurement tool, it will allow for the possibility of classifying people along multiple dimensions, such as from a low economic circumstance with high levels of adult support

Understanding How National Cultures Affect Organisational Cultures and the Impact of this on the Performance of Businesses in Different Countries

������� With rapid globalization, it is important that management be prepared to customize their businesses according how the people in that country operate.�������  The project attempts to investigate the impact of national cultural influences on the organisational culture of international businesses.�������  This paper will leverage on Hofstede���¢��������s theory of the four dimensions of organisational culture.�������  The project focuses its analysis of the cultures in four countries, namely Japan, China, Germany and the United States.�������  The analysis includes a study of the history of leadership and beliefs, the typical family and work culture, as well as the working relationship amongst organisation members in the four countries.�������  Hofstede���¢��������s dimensions in each of these four countries are discussed.�������  The literature is then applied to three case studies.�������  IBM, Honda and Volkswagen are chosen.�������  IBM is chosen because although it is the subject of study in Hofstede���¢��������s research, the organisational culture was not discussed.�������  Using IBM US���¢��������s cultural dimensions as a basis for its original corporate culture, the country with a large difference in the values will be analysed and see how IBM has performed and what it did to achieve cultural alignment in those countries and whether it has been successful in doing so.�������  The case study of Honda and Volkswagen will start with an analysis of their organisational culture in terms of Hofstede���¢��������s four dimensions.�������  An analysis will be done to see if their cultures are different from those of the four countries discussed.�������  The discussion will focus on two countries in which the cultural dimensions are significantly different from the companies.�������  Finally research on how these companies can manage the organisational culture of the businesses in different countries and overcome their difficulties if any.�������  ������� The final chapter includes a discussion on the importance for an organisation to adjust rules and procedures in order to fit the organisational culture of various businesses in different countries.�������  Employees���¢�������� stress or workplace conflict can be reduced if the rules and procedures in an international business can be adjusted to suit the culture in that country.�������  Also, leadership effectiveness can be enhanced if again, cultural influences are being considered in managing the business.�������  Lastly, the discussion will conclude on how the knowledge of cultural influences on organisational cultures can help businesses manage globalization and to make their international businesses sustainable and adaptive to the country of residence of these companies.�������

A Lumped Parameter Model to Study Atrioventricular Valve Regurgitation in Stage 1 and Changes Across Stage 2 Surgery in Single Ventricle Patients

Goal: This manuscript evaluates atrioventricular valve regurgitation (AVVR) in babies born with an already very challenging heart condition, i.e. with single ventricle physiology. Although the second surgery that single ventricle patients undergo is thought to decrease AVVR, there is much controversy in the clinical literature about AVVR treatment. Methods: The effect of atrioventricular valve regurgitation (AVVR) on Stage 1 haemodynamics and resulting acute changes from conversion to Stage 2 circulation in single ventricle patients are analysed through lumped parameter models. Several degrees of AVVR severity are analysed, for two types of valve regurgitation: incomplete leaflet closure and valve prolapse. Results: The models show that increasing AVVR in Stage 1 induces the following effects: i) higher stroke volume and associated decrease in ventricular end-systolic volume; ii) increase in atrial volumes with V-loop enlargement in pressure-volume curves; iii) pulmonary venous hypertension. The Stage 2 surgery results in volume unloading of the ventricle thereby driving a decrease in AVVR. However, this effect is offset by an increase in ventricular pressures resulting in a net increase in regurgitation fraction (RF) of approximately 0.1 (for example, in severe AVVR, the pre-operative RF increases from ~60% to ~70% post-operatively). Moreover, despite some improvements to sarcomere function early after Stage 2 surgery, it may deteriorate in cases of severe AVVR. Conclusion: In patients with moderate to severe AVVR, restoration of atrioventricular valve competence prior to, or at the time of, Stage 2 surgery would likely lead to improved haemodynamics and clinical outcome as the models suggest that uncorrected AVVR can worsen across Stage 2 surgery. This was found to be independent of the AVVR degree and mechanisms