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

Deinstitutionalization: A Review of the Literature with Implication for Social Work Training and Practice in Rural Areas

The manuscript reviews the social, legal, and political background of the deinstitutionalization movement, reviews successful programs for deinstitutionalized chronic mental patients in the major problem areas of socialization skills training, supportive living, interventions with families, vocational rehabilitation, and medication monitoring. Problems which prevent the successful replication of these programs in rural areas, such as differing characteristics of rural and urban clients, distance and travel, and staff attitudes are discussed. Implications for social work training and practice in rural areas include the increased need for paraprofessional staff development and supervision skills, ability to utilize and mobilize existing community helping networks, and training in behavior modification techniques

Blue Crabs in the Chesapeake - An introduction to the Blue Crab

A classroom resource covering crab anatomy and glossary, life cycle of Callinectes sapidus, data tables, data analysis guides, and illustrations

Implementing evidence in order to promote freedom of movement for women in labour

Background/Aims: There is clear and important evidence that upright positions in the first stage of labour reduces the duration of labour, the risk of caesarean birth and the need for epidural. Despite this evidence, conventional hospital labour management continues to restrict mobility and confine women to birthing beds. The aim of this study was to find evidence based, new and innovative ways of promoting the use of upright and mobile positions for women who labour in conventional hospital settings. Methods: A literature review was conducted. The areas of focus included the reasons why, where, when and how promoting freedom of movement for women during labour could be achieved. Gaps and trends in research knowledge were considered. Strategies to overcome the theory-practice gap were developed for consultation and implementation. Results: Results indicate that optimising freedom of movement for women in labour requires a twopronged approach. Firstly, research evidence must inform birth policies and guidelines. Secondly, policies and guidelines must inform labour ward design and midwifery intrapartum care. Each stage is equally important, as freedom of movement for women in labour can be restricted because of intrapartum policy and/or environment and/or care. Conclusion: As midwives, we are obliged to inform women of the benefits to themselves and their babies of being upright and mobile during labour. In order to optimise freedom of movement for women during labour, we must actively promote and implement mobility-friendly birth policies and practices in our conventional labour ward settings

Closing the achievement gap : the implementation of direct instruction in Whiteville City schools

In Whiteville City Schools, beginning third grade students have a reading achievement gap as evidenced by students who score Level 3 or 4 on the Third Grade Pre-Test. Historically, the largest gap has been between African American males and White females. The achievement gap also extends to a gap in mathematics proficiency. In addition to having achievement gaps by race and gender, overall third grade students in Whiteville City Schools have proficiency levels that are lower that the state average and lower than those of comparable local schools. This thesis reports on an effort to close and eventually eliminate the achievement gap and raise proficiency overall; specifically, at the primary school, Direct Instruction was implemented as the reading program. Direct Instruction has proven successful as an effective method of instructing all children, particularly African American, in reading. The research has shown that success in reading is effective in closing achievement gaps. Findings show that, after adopting Direct Instruction at this one school, student achievement and proficiency increased and the achievement gap closed

Application of theoretical domains framework to explore the enablers and barriers to physical activity among university staff and students: a qualitative study

Background Physical inactivity is one of the major risk factors for developing several chronic illnesses. However, despite strong evidence indicating the health benefits of physical activity, many university staff and students tend to be physically inactive. University settings provide a stable environment where behaviour change interventions can be implemented across multiple levels of change. The aim of this study is to examine the perceived barriers and enablers to physical activity among staff and students in a university setting, using the Theoretical Domains Framework (TDF), a precursor of COM-B behaviour model. Methods This was a qualitative study carried out at a Midlands University in the United Kingdom. Eight group interviews were conducted with the sample (n = 40) consisting of 6 male and 15 female university staff (mean age = 40.5 ± 10.6 years) with different job roles (e.g., academic, administrative, cleaning and catering staff), and 12 male and 7 female students (mean age = 28.6 ± 4.7 years) at different stages of study (e.g., undergraduate, postgraduate, and international students). Interviews were audio recorded, transcribed verbatim and imported into NVivo12 software, responses were mapped using the TDF where theory-driven deductive content analysis was used for data analysis. Results Six prominent domains were identified from the group interviews as enablers and/or barriers to physical activity among university staff and students: Environmental context and resources; intentions; social influences; knowledge; beliefs about capabilities; and social/professional role and identity. The themes emerging from the group interviews fit into all 14 domains of the TDF; however, 71% of the themes fit into the six most prominent domains. Conclusions These findings suggest that several enablers and barriers influence university staff and students’ capability, opportunity, and motivation to engage in physical activity. This study, therefore, provides a theoretical foundation to inform the development of bespoke interventions to increase physical activity among inactive university staff and students

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

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

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