Disparities in Infant Mortality Due to Congenital Anomalies on Guam

In the 1970's and 1980's, there were large inter-village disparities in infant mortality due to congenital anomalies on Guam. A village-level analysis was conducted to determine if these disparities can be explained by behavioral (ie, median age of village females, village fertility ratio), structural (ie, population density, persons per household, single mother households per village, married females per village), and environmental (ie, living in a village where Agent Orange (AO) spraying was conducted) factors. Village-level data for live births and infant mortality due to congenital anomalies (1970–1989) was collected from Guam's Office of Vital Statistics. Data on median age of village females, village fertility ratio, population density, persons per household, single mother households, and married females were obtained from the 1980 US Census. Estimates of village-level AO use were provided through personal communications, and villages were dichotomized into AO and non-AO spray areas. Village location was classified by usual residence of the mother. Linear regression was used to determine associations between infant mortality due to congenital anomalies and the behavioral, structural, and environmental factors. The association between AO spray area and infant mortality due to congenital anomalies was statistically significant under univariable (B [95%CI] = 1.88 [0.64,3.11], P = .005) and multivariable conditions (B [95%CI] = 2.02 [0.08,3.96], P = .042). These results suggest that infants born to mothers whose usual residence was in an AO spray area on Guam are at an increased risk of mortality due to congenital anomalies. Further studies using individual-level data are needed to validate these results

Analyzing The Impact Of Social Factors On Homelessness: A Fuzzy Cognitive Map Approach

Background The forces which affect homelessness are complex and often interactive in nature. Social forces such as addictions, family breakdown, and mental illness are compounded by structural forces such as lack of available low-cost housing, poor economic conditions, and insufficient mental health services. Together these factors impact levels of homelessness through their dynamic relations. Historic models, which are static in nature, have only been marginally successful in capturing these relationships. Methods Fuzzy Logic (FL) and fuzzy cognitive maps (FCMs) are particularly suited to the modeling of complex social problems, such as homelessness, due to their inherent ability to model intricate, interactive systems often described in vague conceptual terms and then organize them into a specific, concrete form (i.e., the FCM) which can be readily understood by social scientists and others. Using FL we converted information, taken from recently published, peer reviewed articles, for a select group of factors related to homelessness and then calculated the strength of influence (weights) for pairs of factors. We then used these weighted relationships in a FCM to test the effects of increasing or decreasing individual or groups of factors. Results of these trials were explainable according to current empirical knowledge related to homelessness. Results Prior graphic maps of homelessness have been of limited use due to the dynamic nature of the concepts related to homelessness. The FCM technique captures greater degrees of dynamism and complexity than static models, allowing relevant concepts to be manipulated and interacted. This, in turn, allows for a much more realistic picture of homelessness. Through network analysis of the FCM we determined that Education exerts the greatest force in the model and hence impacts the dynamism and complexity of a social problem such as homelessness. Conclusions The FCM built to model the complex social system of homelessness reasonably represented reality for the sample scenarios created. This confirmed that the model worked and that a search of peer reviewed, academic literature is a reasonable foundation upon which to build the model. Further, it was determined that the direction and strengths of relationships between concepts included in this map are a reasonable approximation of their action in reality. However, dynamic models are not without their limitations and must be acknowledged as inherently exploratory

Evaluating the Effectiveness of a Parent Training Protocol Based on an Acceptance and Commitment Therapy on Happiness and Mental Adjustment among Mothers with Slow Paced Children

Background: The birth of a mentally retarded child can have a profound impact on the entire family; parents face many logistical and emotional difficulties that can impact their happiness and mental adjustment. We aimed to investigate the effectiveness of the parent training protocol based on an acceptance and commitment therapy on happiness and mental adjustment among mothers with slow paced children.Methods: The population of this quasi-experimental included all the mothers with slow-paced children in Tehran, Iran, from 2020. Samples of the study were selected using purposive sampling and randomly divided into an experimental group (Parent training protocol) (n=15), and a control group (n=15). Each of the experimental participants was trained for ten 90-minute sessions, while no therapy was provided to the control group.  The subjects were assessed before and after treatment using the Persian Version of the Mini-MAC and Oxford happiness questionnaire (OHQ). The data was analyzed Using version 18.0.Results: The total sample was 30 mothers with slow-paced children, among whom the highest frequency was for the age group of 37-45 years with the mean age of 43.3. The results showed that the acceptance and commitment therapy had significant effects on happiness (F= 83.4; P=0.04) and mental adjustment (F = 80.9; P=0.06) of the mothers with slow-paced children.Conclusion: Parent training protocol based on an acceptance and commitment therapy increased the happiness of mothers with slow-paced children and improved their mental adjustment

An Examination of the Impact of Work and Family Stressors on Correctional Supervisors’ Family Life and Mental Health

The corrections workplace presents many risk factors for its employees’ family life and mental health. However, studies on correctional employee health are limited. This dissertation focused on correctional supervisors (i.e., lieutenants, captains, and counselor supervisors) and examined various work and non-work factors impacting their family life and mental well-being. Three separate cross-sectional studies were conducted. First, Study 1 examined the association between work demands (i.e., overtime work and shift work) and family caregiving responsibilities (i.e., child care and adult care) with depressive symptoms and with the mediating roles of work-to-family conflict (W-FC) and family-to-work conflict (F-WC). Study 2 examined the association of correctional supervisors’ style of interpersonal interactions (i.e., dominating/ “masculinity,” caring/ “femininity”) with emotional suppression and home stress and with the mediating role emotional suppression. Study 2 also examined the moderating role of a perceived masculine organizational culture and behavior-based work-to-family conflict. Lastly, Study 3 examined the association of correctional supervisors’ perceived effect of work-related trauma with W-FC and depressive symptoms and with the mediating role of W-FC. The moderating roles of coworker and supervisor social support were also examined. Key findings from Study 1 were: the amount of overtime hours worked was positively associated with W-FC and W-FC was positively associated with depressive symptoms. Overtime hours had an indirect effect on depressive symptoms mediated through correctional supervisors’ experience of W-FC. In Study 2, key findings included: having a caring interpersonal style in this male majority workforce reduced perceived levels of stress at home and led to lower levels of reported emotional suppression for correctional supervisors who perceive their organizational culture as highly masculine. Lastly, results from Study 3 indicated that the perceived effect of work-related trauma was positively associated with depressive symptoms. W-FC fully mediated the relationship between the perceived effect of work-related trauma and depressive symptoms. Additionally, social support from coworkers and supervisors moderated the association between the perceived effect of work-related trauma and depressive symptoms. The results from these studies have important implications for correctional agencies in terms of developing interventions that can help protect and promote correctional supervisors’ family life and mental health

Impact of a Total Worker Health® Mentoring Program in a Correctional Workforce

(1) Background: Correctional Officers show signs of adverse health early in their careers. We evaluated the impact of a one-year peer health mentoring program for new officers based on a Total Worker Health® approach; (2) Methods: Cadets (n = 269) were randomly assigned to a mentored or control group. Cadets in this mixed methods design completed physical assessments, and surveys at three time points to assess demographics, health, mentoring, and workplace variables. Physical testing included several health markers. Surveys and physical data were analyzed as repeated measures. Regression analyses were used to analyze the relationship between mentoring characteristics and outcomes. A semi-structured interview of mentors was analyzed qualitatively. (3) Results: Higher mentoring frequency was associated with lower burnout. Health behaviors and outcomes declined over time in all groups, but mentees displayed slower decline for body mass index (BMI) and hypertension compared to controls. (4) Conclusions: A continuous peer health mentoring program seemed protective to new officers in reducing burnout and also declines in BMI and hypertension. Short-term physical health markers in younger officers may not be an index of psycho-social effects. A participatory design approach is recommended for a long-term health mentoring program to be both effective and sustainable

SGM Workplace Discrimination and Unemployment

The sexual and gender minority (SGM) population often faces discrimination in daily life, in healthcare, and in the workplace. This discrimination can cause negative health outcomes or harm career trajectory. This study examines the association between workplace discrimination and unemployment among sexual and gender minorities. This cross-sectional study of n=918 SGMs was conducted in 2022 with recruitment on Reddit. All individuals had to be 18 years of age or older, reside in the United States, and identify as a sexual and/or gender minority. Multivariable logistic regression was used to identify predictors of unemployment among SGMs. A total of 28.43% were unemployed. With each additional point in the workplace discrimination score, there was an increased odds of being unemployed (AOR: 1.03, 95%CI: 1.01, 1.05). Individuals who receive non-traditional payment, were not a regular permanent employee, and experienced greater workplace discrimination were more likely to be unemployed. Among SGMs, workplace discrimination contributes to employment insecurity. Workplace policies, interventions, and education are needed to address SGM discrimination in the workplace

Association of Psoriasis Severity with Serum Prolactin, Thyroid Hormones, and Cortisol before and after Treatment

Background. Prolactin (PRL) level is proposed to be associated with the severity of psoriasis although the previous studies reported different results. Objective. To find the association between PRL levels and severity of psoriasis before and after treatment. In addition, we aimed to find a difference in prolactin, thyroid stimulating hormone (TSH), thyroid hormones (T3 and T4), and cortisol levels between patients with psoriasis and normal controls. Methods. First, the levels of hormones were measured in 30 patients with psoriasis and 30 matched controls. The severity was assessed by psoriasis area and severity index (PASI). Then, patients were treated, and PASI was assessed every week until achieving PASI-75 response. At this time, the hormones were measured again and compared to the baseline. Results. No statistical significant difference was observed in the mean PRL, T3, T4, TSH, and cortisol levels between cases and controls. Comparing to the baseline, a significant decrease in PRL levels and a significant increase in T3 and serum cortisol levels were observed after treatment (P<0.05), while the changes in other hormones were not significant. Conclusion. After treatment, PRL significantly decreased, and T3 and cortisol levels significantly increased. No correlation between hormone levels and improvement of PASI score existed

Evaluation of the HearWell Pilot Program: A Participatory Total Worker Health® Approach to Hearing Conservation

Our objective was to pilot test HearWell, an intervention created to preserve hearing among highway maintainers, by using a participatory Total Worker Health® (TWH) approach to designing, implementing and evaluating interventions. Regional maintenance garages were randomized to control (n = 6); HearWell (n = 4) or HearWell Design Team (n = 2) arms. Maintainer representatives from the HearWell Design Team garages identified barriers to hearing health and collaborated to design interventions including a safety leadership training for managers, a noise hazard management scheme to identify noise levels and indicate the hearing protection device (HPD) needed, and a comprehensive HearWell training video and protocol. These worker-designed interventions, after manager input, were delivered to the HearWell Design Team and the HearWell garages. Control garages received standard industry hearing conservation training. Periodic surveys of workers in all 12 garages collected information on the frequency of HPD use and a new hearing climate measure to evaluate changes in behaviors and attitudes over the study period and following interventions. An intention-to-treat approach was utilized; differences and trends in group HPD use and hearing climate were analyzed using a mixed-effects model to account for repeated measures from individual participants. The HearWell Design Team maintainers reported the highest frequency of HPD use. Hearing climate improved in each group 6 months following intervention implementation, with the largest increase and highest value for the HearWell Design Team workers. The HearWell pilot intervention showed promising results in improving HPD use through a participatory TWH approach to hearing conservation. Furthermore, results suggest that employee participation in hearing conservation programs may be necessary for maximal effectiveness