Life course socioeconomic position, depressive symptoms, and cardiovascular disease mortality in the Alameda County Study 1965-2000.

Background: Lower socioeconomic position (SEP) over the life course has been posited as a contributing factor in the development of chronic illnesses, including cardiovascular disease (CVD) and subsequent mortality (CVDM). Lower SEP has also been shown to be associated with an increased risk of mental health problems, such as multiple depressive symptoms (MDS). The ways in which SEP has been measured have varied, but examination of the variability in associations of measures based on a single SEP indicator such as household income (HI) with health outcomes is limited, especially within gender. Methods: Data from the Alameda County Study was used to study the relationships of interest. Using three measures of HI to capture SEP- HI in 1994 (HI94), average HI (AHI), and HI trajectory groups (HITG), associations between each HI measure and CVDM (Chapter 2) and MDS (Chapter 3) were studied. Chapter 4 examined cumulative socioeconomic disadvantage (CSD) based on HI, education, father’s education, and father’s occupation in relation to CVDM. Results: Chapter 2 analyses suggested inverse associations between lower quartiles of HI94 and the hazards of CVDM among men, and between higher AHI and the hazards of CVDM among women. In chapter 3, results showed inverse associations between quartiles of HI94 and AHI, lower HITG, HI94 and AHI with the odds of MDS for men. Associations were of greatest magnitude for HITG and HI94 compared to the quartile measures and AHI, respectively. Among women, those in the lowest HITG had increased odds of MDS. Chapter 4 analyses revealed that being most disadvantaged was associated with increased hazards of CVDM among women but not men. Associations were of greatest magnitude for CSD scores that included HITG. Conclusions: Men and women with higher SEP or lower CSD were less likely to experience CVDM or MDS, but the magnitude of these associations varied with changes in the HI measure utilized. These results show the need to consider gender-specific SEP measures, as well as to carefully select the SEP measures as the associations with different health outcomes may vary dependent upon the specific measure examined.Ph.D.Epidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/77881/1/vickij_1.pd

A qualitative comparison of DSM depression criteria to language used by older church-going African Americans

Objective: Depression in late life is associated with substantial suffering, disability, suicide risk, and decreased health-related quality of life. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a depression diagnosis is derived from a constellation of symptoms that may be described differently by different people. For example, the DSM language may be inadequate in capturing these symptoms in certain populations such as African-Americans, whose rates of depression misdiagnosis is high. Methods: This study reports the findings from a church-based, qualitative study with older African Americans (n = 50) regarding the language they use when discussing depression and depression treatment, and how this compares to the DSM-IV depression criteria. Content analyses of the in-depth discussions with African-American male and female focus group participants resulted in a deeper understanding of the language they used to describe depression. This language was then mapped onto the DSM-IV depression criteria. Results: While some words used by the focus group participants mapped well onto the DSM-IV criteria, some of the language did not map well, such as language describing irritability, negative thought processes, hopelessness, loneliness, loss of control, helplessness, and social isolation. Conclusions: The focus group setting provided insight to the language used by older, church-going African-Americans to describe depression. Implications include the advantages of using qualitative data to help inform clinical encounters with older African-Americans.This project was supported by the Program for Positive Aging in the Department of Psychiatry at the University of Michigan, and the original study was titled ‘Attitudes, perceptions, and beliefs pertaining to mental health, depression, and depression care of elder African-American church attendees’ (Principal Investigator: Helen Kales, MD, UM Department of Psychiatry).Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152353/1/Akinyemi Watkins Kavanagh Johnson-Lawrence Lynn Kales_2017_A qualitative comparison of DSM depression criteria to language used by older church going African Americans.pd

Masculinity, socioeconomic status, and self-reported health among African American men

The purpose of this study was to examine the influence of masculinity and socioeconomic status (i.e., income) on the self-reported health of a sample of African American men. Study participants (n = 122) were barbershop patrons from Chicago, Illinois, who ranged in age from 18 to 66. We used logistic regression to assess the relationship between masculinity and self-reported health. Masculinity was measured as the average of responses to a subset of 10 items from the Male Role Norms Inventory and the Male Attitude Norms Inventory II. Self-reported health was measured with a five point Likert scale and dichotomized as excellent versus other health status. Analyses suggested that masculinity, but not socioeconomic status, was positively associated with excellent self-reported health. Such results offer understanding of how masculinity and self-reported health impact health outcomes in African American men.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167002/1/Thompson_Watkins_2016 masculinity SES and selfrated health AA men.pdfDescription of Thompson_Watkins_2016 masculinity SES and selfrated health AA men.pdf : Main Article doi:10.2979/spectrum.4.2.0

Beyond Race and Gender: Measuring Behavioral and Social Indicators of Pain Treatment Satisfaction in Older Black and White Cancer Patients

There are a number of factors that influence compliance with prescribed plans of care. However, there remains a need to identify the collective source health, behavioral, and social constructs have on treatment satisfaction. This study aimed to identify indicators of pain treatment satisfaction among older adults receiving outpatient treatment from a comprehensive cancer center in the southeast region of the United States. Data included a sample of 149 Black and White patients diagnosed with cancer, with the majority being White (85%) and female (57%). Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. A series of multivariate models were specified, whereby patients reporting multiple chronic conditions, poor communication, and perceived discrimination were less satisfied with treatment. Positive communication, higher self-efficacy, and fewer perceived discriminatory acts were significant among the female patients only. These findings suggest the need to develop clinical models that assess how these factors influence the degree of treatment satisfaction, while providing a comprehensive mechanism by which to service the long-term needs of older adults

Coming unmoored: Disproportionate increases in obesity prevalence among young, disadvantaged white women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109980/1/oby20913.pd

Self-rated health and health care access associated with African American men’s health self-efficacy

Health self-efficacy, a measure of one’s self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, “Overall, how confident are you in your ability to take good care of your health?” Responses ranged from 1 (not confident at all) to 5 (completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/164711/1/Thompson et al 2017 Self-rated health and health care access.pdfDescription of Thompson et al 2017 Self-rated health and health care access.pdf : Main articl

Staphylococcus aureus colonization and infection in New York State Prisons

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55479/1/Staphylococcus aureus Colonization and Infection in New York Prisons - Larson et al 2007pdf.pd

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29