Perceived Racial Discrimination and Nonadherence to Screening Mammography

Objective. We examined whether African American women were as likely as White women to receive the results of a recent mammogram and to self-report results that matched the mammography radiology report (i.e., were adequately communicated). We also sought to determine whether the adequacy of communication was the same for normal and abnormal results. Methods. From a prospective cohort study of mammography screening, we compared self-reported mammogram results, which were collected by telephone interview, to results listed in the radiology record of 411 African American and 734 White women who underwent screening in 5 hospital-based facilities in Connecticut between October 1996 and January 1998. Using multivariate logistic regression, we identified independent predictors of inadequate communication of mammography results. Results. It was significantly more common for African American women to experience inadequate communication of screening mammography results compared with White women, after adjustment for sociodemographic, access-to-care, biomedical, and psychosocial factors. Abnormal mammogram results resulted in inadequate communication for African American women but not White women (PAfrican American women may not be receiving the full benefit of screening mammograms because of inadequate communication of results, particularly when mammography results are abnormal

Neighborhood and Individual Level Socioeconomic Variation in Perceptions of Racial Discrimination

In approaching the study of racial discrimination and health, the neighborhood and individual-level antecedents of perceived discrimination need further exploration. We investigated the relationship between neighborhood and individual-level socioeconomic position (SEP), neighborhood racial composition, and perceived racial discrimination in a cohort of African-American and White women age 40-79 from Connecticut, USA. Design. The logistic regression analysis included 1249 women (39% African- American and 61% White). Neighborhood-level SEP and racial composition were determined using 1990 census tract information. Individual-level SEP indicators included income, education, and occupation. Perceived racial discrimination was measured as lifetime experience in seven situations. Results. For African-American women, living in the most disadvantaged neighborhoods was associated with fewer reports of racial discrimination (odds ratio (OR) 0.44; 95% confidence interval (CI) 0.26, 0.75), with results attenuated after adjustment for individual-level SEP (OR 0.54, CI: 0.29, 1.03), and additional adjustment for neighborhood racial composition (OR 0.70, CI: 0.30, 1.63). African-American women with 12 years of education or less were less likely to report racial discrimination, compared with women with more than 12 years of education (OR 0.57, CI: 0.33, 0.98 (12 years); OR 0.51, CI: 0.26, 0.99 (less than 12 years)) in the fully adjusted model. For White women, neither neighborhood-level SEP nor individual-level SEP was associated with perceived racial discrimination. Conclusion. Individual and neighborhood-level SEP may be important in understanding how racial discrimination is perceived, reported, processed, and how it may influence health. In order to fully assess the role of racism in future studies, inclusion of additional dimensions of discrimination may be warranted

Padronização de uma bateria para a avaliação de fatores de risco psicossociais trabalhistas em trabalhadores colombianos

A battery of questionnaires to assess psychosocial risk factors at work was developed in 2010 in response to Resolution 2646 created by the Colombian Ministry of Social Protection. However, this battery presents some theoretical and practical limitations. A new battery of instruments has been designed and validated that includes instruments and risk indicators of the demand-control-social support and the effort-reward imbalance models. Other factors, not included in these models, but that Resolution 2646 suggests should be assessed, have also been added, and with this additional information, the new battery allows us to also calculate a “global indicator” of demand, control, and social support; family and social risk conditions, coping and personality; and health and wellbeing. The new battery was administered to a sample of 16,095 workers from different occupations and representative Colombian regions. An analysis of the various domains indicates that internal consistency of the various scales is high. The new battery has the following properties: it is simple to use in paper format or when administered by computer, it enables comparison between occupations, it offers unified scores for each variable, and provides information to assess the risk factors suggested by Resolution 2646. In addition, it will make it possible to compare the results obtained when analyzing Colombian workers with those obtained from studies of workers from other countries.Em 2010, desenvolveu-se uma bateria de instrumentos para avaliar fatores psicossociais trabalhistas de risco para a saúde, em resposta à Resolução 2 646 do Ministério da Proteção Social da Colômbia. Contudo, esta conta com algumas limitações que, a partir da construção e da validação de uma nova bateria, neste estudo se pretendem superar. Além disso, a nova bateria oferece recursos adicionais para a avaliação desses fatores: a presente bateria incorpora os instrumentos e os indicadores centrais dos modelos demanda-controle-apoio social e desiquilíbrio esforço-recompensa e os fatores internos do trabalho não considerados nesses modelos, mas que a Resolução considera necessários, mediram-se com testes preexistentes ou desenvolvidos pelos autores. Com os dados coletados, é possível calcular indicadores globais de demanda, controle e apoio social; além de condições familiares e sociais de risco, enfrentamento, personalidade e indicadores de saúde e bem-estar. Para a validação, a bateria foi aplicada a uma amostra de 16 095 trabalhadores de diferentes cargos e municípios colombianos. As anál i ses de consistência interna e validade permitem afirmar que a bateria é simples de aplicar em papel ou digital, permitirá comparar cargos, obter pontuações unificadas por variável, oferecer um diagnóstico de um número importante das variáveis sugeridas na Resolução bem como permitirá comparar os resultados dos trabalhadores colombianos com os de outros países. Palavras-chave: fatores trabalhistas de risco psicossocial, Resolução 2 646 de 2008, modelo demanda-controle-apoio social, modelo desiquilíbrio esforço-recompensa, estresse profissional, avaliação.En 2010 se desarrolló una batería de instrumentos para evaluar factores psicosociales laborales de riesgo para la salud, en respuesta a la Resolución 2646 de 2008 del Ministerio de la Protección Social de Colombia. Sin embargo, esta cuenta con algunas limitaciones que, a partir de la construcción y validación de una nueva batería, en el presente estudio se buscan superar. La nueva batería ofrece recursos adicionales para la evaluación de estos factores: incorpora los instrumentos e indicadores centrales de los modelos demanda-control-apoyo social y desequilibrio esfuerzo-recompensa, y los factores intralaborales no contemplados en dichos modelos, pero que la Resolución considera necesarios, se midieron con pruebas preexistentes o desarrolladas por los autores. Con los datos recolectados es posible calcular indicadores globales de demanda, control y apoyo social; además de condiciones familiares y sociales de riesgo, afrontamiento, personalidad e indicadores de salud y bienestar. Para la validación, la batería se aplicó a una muestra de 16.095 trabajadores de diferentes ocupaciones y municipios colombianos. Los análisis de consistencia interna y validez permiten afirmar que la batería es sencilla de aplicar en papel o por computador, permitirá comparar ocupaciones, obtener puntuaciones unificadas por variable, ofrecer un diagnóstico de un número importante de las variables sugeridas en la Resolución y comparar los resultados de los trabajadores colombianos con los de otros países

The intrafamilial transmission of rheumatoid arthritis--VII : Why do wives with rheumatoid arthritis have husbands with peptic ulcer?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32910/1/0000290.pd

Supporting citizen inquiry: an investigation of Moon rock

Citizen inquiry is an innovative way for non-professionals to engage in practical scientific activities, in which they take the role of self-regulated scientists in informal learning contexts. This type of activity has similarities to inquiry-based learning and to citizen science, but also important differences. To understand the challenges of supporting citizen inquiry, a prototype system and activity has been developed: the Moon Rock Explorer. Based on the nQuire Toolkit, this offers people without geology expertise an open investigation into authentic specimens of Moon rock, using a Virtual Microscope. The Moon Rock Explorer inquiry has been evaluated in an informal learning context with PhD students from the Open University. Results of the evaluation raise issues related to motivation and interaction between inquiry participants. They also provide evidence that the integration of scientific tools was successful and that the nQuire Toolkit is suitable to deploy and enact citizen inquiries

Physical and mental health correlates of status incongruence

The report explored the relationship between status incongruence, the degree of similarity of rankings on paired status variables, and diverse interview-based measures of physical and mental health. The subjects in the study were some 169 adult men; one half of them came from a national survey sample, while the other half represented an arthritis clinic sample with patients and controls. Data on education, occupation, income, and perceived social class (PSC) were used to construct several status incongruence indices. The major findings were: 1. Neither rheumatoid arthritis nor ulcer were related to status incongruence. 2. Education-occupation incongruence showed by far the strongest association with poor mental health. Among the two types of incongruence, education > occupation and occupation > education, the former had particularly poor mental health. 3. Education-PSC, occupation-PSC, education-income, and occupation-income types of incongruence showed weaker associations. Direction of incongruence made a difference in the education-PSC comparison: the education > PSC incongruent group had poorer mental health than the PSC > education incongruent group. Ce rapport étudie la relation entre la discordance du status («status incongruence»), le degré de similitude d'évaluation de variables couplées du status et diverses mesures de la santé physique et mentale basées sur des interviews. Les sujets de l'étude étaient 169 hommes adultes dont la moitié provenait d'un échantillon d'une investigation nationale, tandis que l'autre moitié représentait un échantillon d'une clinique d'arthritiques avec des patients et des cas de contrôle. Des données sur l'éducation, l'occupation, le revenu et la classe sociale (perceived social class = PSC) furent utilisées pour l'élaboration de divers indices de discordance de status. Les résultats principaux furent: 1) Ni l'arthrite rhumatoïde ni l'ulcère n'étaient reliés à la discordance du status. 2) La discordance éducation-occupation était de loin la plus étroitement associée à une santé mentale défaillante. Parmi les deux types de discordance, éducation > occupation et occupation > éducation, le premier était caractérisé par une santé mentale particulièrement mauvaise. 3) Les types de discordance éducation-PSC, occupation-PSC, éducation-revenu et occupationrevenu étaient plus faiblement associés. La direction de la discordance faisait une différence dans la comparaison éducationPSC: le groupe de discordance éducation > PSC se distinguait par une santé mentale moins bonne que le groupe de discordance PSC > éducation. Der Bericht gibt die Untersuchung der Beziehung zwischen der Unausgeglichenheit innerhalb des Sozialstands, dem Ausmaß der Ähnlichkeit von Einstufungen durch vorgegebene Gegensatzpaare von Statusmerkmalen und verschiedenen, auf Interviewbasis begründeten Einschätzungen der körperlichen und seelischen Gesundheit wieder. Die Probanden der Studie waren 169 erwachsene Männer; die Hälfte von ihnen stammte aus einer staatlichen Begutachtungsgruppe, die andere Hälfte verkörperten Patienten und Kontrollpersonen aus einer Arthritisklinik. Daten über Erziehung, Beruf, Einkommen und beurteilte Sozialklasse (perceived social class = PSC) wurden verwandt, um mehrere Indices für Statusinkongruenz zu bilden. Die Hauptergebnisse waren: 1) Weder rheumatische Arthritis noch Ulcus standen in Beziehung mit Statusinkongruenz. 2) Ein Mißverhältnis zwischen Erziehung und Beruf zeigte bei weitem die engste Beziehung zu schlechter seelischer Gesundheit. Von den beiden Inkongruenztypen, Erziehung > Beruf und Beruf > Erziehung, hatte der erste eine besonders schlechte seelische Gesundheit. 3) Mißverhältnisse zwischen Erziehung und PSC, Beruf und PSC, Erziehung und Einkommen und Beruf und Einkommen zeigten schwächere Beziehungen. Die Richtung der Inkongruenz bewirkte einen Unterschied im Vergleich zwischen Erziehung und PSC: die inkongruente Gruppe Erziehung > PSC war bei schlechterer seelischer Gesundheit als die inkongruente Gruppe PSC > Erziehung.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41742/1/127_2004_Article_BF00584107.pd

The dropout problem in antihypertensive treatment : A pilot study of social and emotional factors influencing a patient's ability to follow antihypertensive treatment

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32818/1/0000192.pd

Occupation and mental health in a national UK survey

This paper and the analyses it describes were funded by the Health and Safety Executive (HSE)

Psychosocial stress at work and perceived quality of care among clinicians in surgery

Abstract Background Little is known about the association between job stress and job performance among surgeons, although physicians' well-being could be regarded as an important quality indicator. This paper examines associations between psychosocial job stress and perceived health care quality among German clinicians in surgery. Methods Survey data of 1,311 surgeons from 489 hospitals were analysed. Psychosocial stress at work was measured by the effort-reward imbalance model (ERI) and the demand-control model (job strain). The quality of health care was evaluated by physicians' self-assessed performance, service quality and error frequency. Data were collected in a nationwide standardised mail survey. 53% of the contacted hospitals sent back the questionnaire; the response rate of the clinicians in the participating hospitals was about 65%. To estimate the association between job stress and quality of care multiple logistic regression analyses were conducted. Results Clinicians exposed to job stress have an increased risk of reporting suboptimal quality of care. Magnitude of the association varies depending on the respective job stress model and the indicator of health care quality used. Odds ratios, adjusted for gender, occupational position and job experience vary between 1.04 (CI 0.70-1.57) and 3.21 (CI 2.23-4.61). Conclusion Findings indicate that theoretical models of psychosocial stress at work can enrich the analysis of effects of working conditions on health care quality. Moreover, results suggest interventions for job related health promotion measures to improve the clinicians' working conditions, their quality of care and their patients' health.</p