Contextualizing Gender and Migration: Galician Immigration to Switzerland

Focusing on two main aspects of the Spanish‐Galician migration experience, this article attempts to analyze how migrants' actions and discourses are shaped by notions of gender. First, the discourse of returning will question notions of family and how differently men and women define their positions as members of a family. While men seem to link their social identity to immovable goods of prestige back in Galicia, women are able to redefine their social identity as they base it on social relations. The second aspect deals with the fact that cleaning is defined as women's work, but at the same time it is — under certain conditions — performed by men.     

Associations Between Psychological,Physical, and Sexual Intimate Partner Violence and Health Outcomes Among Women Veteran VA Patients

Women veterans experience high rates of lifetime intimate partner violence (IPV) and suffer a variety of trauma-related health conditions. The purpose of this study was to identify health status and health risk behaviors associated with experiences of psychological, physical, or sexual IPV among women veterans receiving care at a Veterans Affairs (VA) medical center. We conducted surveys with 249 women veteran patients and examined health factors associated with each form of violence. Sexual IPV victimization had the most pronounced associations with adverse health. In multivariate analysis, controlling for age, race, and income, women veterans who experienced sexual violence victimization were close to or more than three times as likely as those who experienced no IPV to report poor or fair overall health, a diagnosis of post-traumatic stress disorder or depression, bipolar disorder, or anxiety, difficulty sleeping, cigarette smoking, and problem drinking. Those who reported psychological violence only (without physical or sexual violence) also reported greater odds of self-rated poor or fair health. These findings are consistent with findings from studies with non-veteran populations and serve to further identify the unique contributions of sexual IPV to health outcomes. The integrated VA health care system offers opportunities for IPV identification and response including a coordinated team-based care model with social work integrated within primary care.     

Women's Accounts of Organizational Politics as a Gendering Process

Organizational politics is implicated in all levels of organizational functioning, from power structures and informal interaction to individual identity. This study argues that organizational politics provides an approach to examining professional women's experiences of organizations as gendered. Women graduates in male‐dominated organizations claimed not to be limited by explicit discrimination, but they construct organizational politics as being masculine in character and as a barrier to their careers. These women represent organizational politics as irrational, aggressive, competitive and instrumental, leading to individual, not organizational, success. Their accounts undermine the stereotypical dichotomy of masculine rationality and feminine emotion by claiming that women behave reasonably and by focusing on emotion in men's political game playing. However, claiming to be rational and rejecting politics, while acknowledging its role in career success, is uncomfortable for ambitious women. They risk sabotaging their own position by appearing too sensitive to engage in the less savoury aspects of organizational life. Organizational political processes are seen as fundamental to gender in organizations, first, because political activity is seen as gendered and masculine and contrary to female identity; secondly, because politics is part of the informal system which constructs organization from which outsiders are excluded; and finally, because political activity is linked to the performance, achievement and maintenance of power.     

Development and validation of an instrument to assess institutionalization of health promotion in faith-based organizations

Institutionalization of health promotion interventions occurs when the organization makes changes to support the program as a component of its routine operations. To date there has not been a way to systematically measure institutionalization of health promotion interventions outside of healthcare settings. The purpose of the present study was to develop and evaluate the initial psychometric properties of an instrument to assess institutionalization (i.e., integration) of health activities into faith-based organizations (i.e., churches). This process was informed by previous institutionalization models led by a team of experts and a community-based advisory panel. We recruited African American church leaders (N = 91) to complete a 22-item instrument. An exploratory factor analysis revealed four factors: 1) Organizational Structures (e.g., existing health ministry, health team), 2) Organizational Processes (e.g., records on health activities; instituted health policy), 3) Organizational Resources (e.g., health promotion budget; space for health activities), and 4) Organizational Communication (e.g., health content in church bulletins, discussion of health within sermons) that explained 62.3 % of the variance. The measure, the Faith-Based Organization Health Integration Inventory (FBO-HII), had excellent internal consistency reliability (α = .89) including the subscales (α = .90, .82, .81, and .87). This measure has promising initial psychometric properties for assessing institutionalization of health promotion interventions in faith-based settings.     

Hospital social workers' assessment processes for children at risk: positions in and contributions to inter-professional teams

This article explores hospital social workers' assessment processes for children at risk within the context of inter-professional teams working in child hospital care in Sweden. Based on qualitative interviews, the study discusses how assessment processes for children at risk can be understood from a professionalism perspective. Three institutionalized norms—juridical, therapeutic, and medical, building on different knowledge systems—are analyzed in relation to the three positions taken by hospital social workers as team members—active, reflective, or passive—leading to different kinds of actions in the assessment processes. The outlined norms and the positions taken involve consequences for the children and their families, but also pose questions for the future professionalization efforts of hospital social work.     

Risk and Protective Factors Associated with Personal Mastery Among Sexual Minority African-American Female Sex Workers

Research among sexual minorities has traditionally examined problems such as substance use, HIV risk, mental health problems, and victimization. Among sexual minority street-based female sex workers, these vulnerabilities can be magnified. Grounded in theories of resilience, this study examines risk and protective factors associated with a high level of personal mastery among a vulnerable population of women. Data are drawn from baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial in Miami, Florida. We compare sexual minority (N = 197) and heterosexual (N = 365) women on measures of risk and protective factors; among sexual minority women we present logistic regression analyses which reveal that severe mental distress and HIV transmission risk are associated with low levels of personal mastery, while protective factors of transportation access and social support are associated with high levels of personal mastery. These findings suggest that these protective factors may potentially facilitate the development of personal mastery and represent beneficial avenues for intervention efforts.     

Ethics at Work

ABSTRACT

This study examined the influence on substance use of organizational wellness and of attitudes toward the EAP. We developed the Organizational Wellness Scale (OWS) to assess perceptions of healthy (e.g., respectful) and addictive (e.g., workaholic) work climates. Employees from a municipal organization (N = 780) who scored high on the OWS reported less personal and co-worker substance use and enabling behaviors, and more favorable attitudes towards substance use policies. Results suggest that, beyond the influence of the EAP, work site health may effect both individual and work group substance use. Using the OWS, health service providers could benefit from monitoring die impact of organizational wellness on individual and work group health.     

How SES May Figure in Perceptions of Zika Risks and in Preventive Action

abstract

The present study intended to determine how the socioeconomic status (SES) of citizens and public health communications help explain citizens’ risk perception and actions taken during Zika virus outbreaks in 2016. We used data from a nationally representative study conducted in March 2016 by the Associated Press–National Opinion Research Center to analyze 831 American adult responses regarding Zika. We found that respondent risk perception and actions taken diminished as SES level rose. Risk perception was also found to mediate preventive actions’ associations. To quell the global spread of emerging infectious diseases (EIDs) like Zika, health organizations worldwide must understand how SES contributes to Zika (and other future EIDs) risk perception and preventive action. A more compelling form of public health communications must be developed that takes into account the impact made on future outbreaks and infections by these higher-SES “risk assessments.”     

Expanded answers to bureaucratic questions: Negotiating access to public healthcare

This article analyzes expanded responses to statistical‐epidemiological questions at a mental health outpatient service at a public hospital in Buenos Aires, Argentina. Bureaucratic questioning is a highly routine activity which supplies information to the biopolitical apparatus of the modern State. We understand that expanded answers are meaningful actions which not only serve individual, local tactics (such as raising personal concerns), but also index higher contextual levels. In this sense, resisting the constraints of a question may also imply resisting State‐defined policies of biopolitical classification and exclusion. We examine, from a discursive interactional point of view, 41 admission interviews held at the outpatient mental health care service. We observe four types of expanded answers which: (a) display competence in bureaucratic discourse; (b) move from the sphere of the public to the private; (c) deal with potential face‐threats; and (d) pre‐empt rejection. Although the former is actually an optimized way of collaboration with the biopolitical order, the latter three types can be seen as actions of resistance to classification, not only symbolically but also in material terms: resisting statistical criteria of exclusion allows clients to negotiate access to mental healthcare.     

Well-being and occupational roles among middle-aged women

One purpose of the present study is to explore the stability of the pattern of health/work and sickness absence among middle-aged women over a period of three years. This study tested two hypotheses: (a) that enduringly healthy working women would perceive more valued occupational roles and higher well-being than long-term sick-listed women; (b) that high levels of well-being at baseline would predict enduring health and occupational role value at a 3-year follow-up. Middle-aged women (n = 208) answered a postal survey with the Role checklist, a well-being scale and questions about work and sickness situation. The results showed that there was a considerable variability in the pattern of health/work and sickness absence. The variability was greatest among the women who were long-term sick-listed at baseline, and the internal drop out was great among them. The results showed that the enduringly healthy women experienced a more valued worker role and higher well-being than the long-term sick-listed women. Furthermore, high levels of well-being concerning health and work predicted enduring health in the studied sample, and high well-being concerning work was predictive of a valued worker role. Interventions that enable women to develop valuable worker and leisure roles, as well as harmony between different roles, may be important constituents of health promotion/rehabilitation programmes.     

Work ability among nursing personnel in public hospitals and health centers in Campinas--Brazil

Nursing personnel is essential in hospital, health centers and enterprises and is the large work force in health system. A cross-sectional study was conducted in a large city in two public hospitals and five health centre with the objective of to evaluate the work ability and health aspects of nursing staff. The sample was composed by 570 workers. The Work Ability Index - WAI and a questionnaire with socio-demographic, health and life style data was applied. The majority of workers was women (83%), married (50.4%), and was working in night shift work (65.6%); 61.4% was auxiliary nursing, 22.3% was registered nurses (RN). The average age was 38.9 years (SD 7.8) and the Body Mass Index mean was 25.8 (SD 5.3). Only 17.2% referred to practice at least 150 minutes of physical exercise five times per week or more. 26.8% had a second job. The work ability mean was 39.3 (SD 5.3) points. Age had a negative correlation with WAI (p=0.0052). Public hospital and health centre workers had poor work ability score when compared with workers from another branches. Public policies related to workplace health promotion need to be implemented in public hospital and health centre to improve the work ability.     

A consideration of simple measures and organizational structure.

Organizational structure provides the context in which all other measures (either simple or complex) are generated, developed, set in place, related to each other, interpreted, and acted upon. The focus of this article is on the contextual nature of structure and its influence on organizational assessment and learning. Assessment mechanisms are part of the organization's learning system, whereby it reflects on its actions and alters its notions of how the internal and external world work. An organization's philosophy of rationality is an important part of its structure. Notions of cause and effect and standards of desirable performance are given particular attention. The situations of community mental health centers is examined in terms of structure and environment. Hypotheses are offered regarding what constitutes a healthy organizational structure and management system.     

Zest for work? Assessment of enthusiasm and satisfaction with the present work situation and health--a 1.5-year follow-up study

The aim of the study was to investigate whether assessing zest for work is a valuable approach in occupational health work. The term "zest for work" comes from the expression "zest for life" and can roughly be interpreted as the degree of enthusiasm and satisfaction with the present work situation. The measurements comprise three components: listing important factors for the feeling of zest for work, attitude rating and stating whether it is possible to have any influence over the listed factors. Included in this study were 5539 employees, mainly women. Low zest for work was associated with job strain and insufficient social support and imposed an increased risk for poor health for working and long spells of sick leave. The results support that assessing zest for work can be useful in occupational health work.     

Gendered,Invisible Work in Non‐profit Social Service Organizations: Implications for Worker Health and Safety

Nonprofit organizations (NPOs) play an important role in the provision of health and social services. In Canada the nonprofit sector includes 7.5 million volunteers and employs over 1.6 million paid workers. The sector is overwhelmingly female‐dominated — women make up over 80 per cent of workers in these nonprofit services. Work performed by women has traditionally been undervalued and invisible. It has often been considered safe by researchers, employers, policymakers and sometimes even workers themselves. Although there is some indication that jobs in the restructuring social services sector can be characterized by constant demand, high stress and violence, research into the working conditions and health hazards of these types of jobs has not been a priority. Using data from a qualitative study examining work in NPOs, we trace the ways that work performed in these workplaces is both gendered and invisible. We identify three types of invisible labour. ‘Background work’ facilitates and supports more visible and recognized organizational activities. Certain organizational language obscures the full spectrum of work that takes place in the organizations and the risks it may involve. ‘Empathy work’ includes the relationship building, counselling and crisis intervention that comprise key components of social service delivery. ‘Emotional labour’ involves the management of client emotions and workers' own emotions in the process of working with clients and delivering care under conditions of scarcity and contraction. The invisibility of these activities means that much of the day‐to‐day work done in the organizations, while particularly important in the context of social service restructuring, is taken‐for‐granted and undervalued by organizational outsiders. As a result, many of the hazards present in the jobs are hidden from view and workers' health may be compromised. We argue that the invisibility and taken‐for‐grantedness of certain types of work in NPOs is reflected in, and constitutive of, particular exclusions and shortcomings of current occupational health and safety systems designed to protect the health of workers.     

Sociodemographic Determinants of Occupational Risks of Exposure to COVID‐19 in Canada

The activities performed by Canadian workers in some occupations may increase the risk of exposure to infectious diseases such as COVID‐19. This research note explores how occupational exposure risks vary by labor force characteristics using publicly available Canadian data in combination with a data set providing information on the level of physical proximity and frequency of exposure to infections or diseases faced by workers in different occupations. The results show important sociodemographic differences. First, women work in occupations associated with significantly higher average risks of exposure to COVID‐19 than men. This is driven by their overrepresentation in high‐risk broad occupational categories such as health occupations. Second, older workers (65 years or more), a group vulnerable to COVID‐19, appear to work in occupations requiring performing activities characterized by a lower level of physical proximity than their younger colleagues, with minimal differences in the frequency of exposure to diseases or infections. Finally, workers in low‐income occupations are employed in occupations that put them at greater risk of exposure to COVID‐19 than other workers. This is especially the case for women, immigrants, and members of visible minority groups in low‐income occupations. More broadly, this research note provides insights into the health‐related dimension of the literature on occupational tasks and labor market stratification.     

Marital status, marital transitions, and health: a gendered life course perspective

We work from a life course perspective to assess the impact of marital status and marital transitions on subsequent changes in the self-assessed physical health of men and women. Our results suggest three central conclusions regarding the association of marital status and marital transitions with self-assessed health. First, marital status differences in health appear to reflect the strains of marital dissolution more than they reflect any benefits of marriage. Second, the strains of marital dissolution undermine the self-assessed health of men but not women. Finally, life course stage is as important as gender in moderating the effects of marital status and marital transitions on health.     

Towards an assessment for organizational participatory research health partnerships: A systematic mixed studies review with framework synthesis

Within the health sciences, organizational participatory research (OPR) is defined as a blend of research and action, in which academic researchers partner with health organization members. OPR is based on a sound partnership between all stakeholders to improve organizational practices. However, little research on the evaluation of OPR health partnership exists. This systematic mixed studies review sought to produce a new theoretical model that structures the evaluation of the OPR processes and related outcomes of OPR health partnerships. Six bibliographic databases were searched together with grey literature sources for OPR health partnership evaluation questionnaires. Six questionnaires were included, from which a pool of 95 OPR health partnership evaluation items were derived. The included questionnaires were appraised for the quality of their origin, development and measurement properties. A framework synthesis was performed using an existing OPR framework by organizing questionnaire items in a matrix using a hybrid thematic analysis. This led to our proposed Organizational Participatory Research Evaluation Model (OPREM) that includes three axes, Trust, Collective Learning and Sustainability (with specific dimensions) and 95 items. This model provides information to help stakeholders comprehensively structure the evaluation of their partnerships and subsequent improvement; thus, potentially helping to improve health organization practices.     

Breast‐Feeding Advocacy,Risk Society and Health Moralism: A Decade’s Scholarship

This article reviews research published this century that engages critically with the mantra ‘Breast is Best’ and the associated expansion of official breast‐feeding promotion programmes. In recent years there has been a marked increase in the number of such studies published. They mostly explore experience in English speaking, industrialised countries (the US, Canada, New Zealand, Australia and Great Britain) which are in some social and cultural respects dissimilar, yet where very similar developments and problems are detected in regards to breast‐feeding promotion. We highlight how this exploration of breast‐feeding promotion internationally has developed understanding of wider sociological themes. This scholarship, we suggest, has provided a powerful illustration of the relation between risk society (more particularly a heightened consciousness of risk) and the evolution of a code of conduct that regulates behaviour, that has been termed ‘health moralizm’. The article covers three themes: ‘Science, risk society, authority and choice’; ‘Public health policy and infant feeding’; and ‘Moralization and women’s identity work’. We conclude that the research discussed shows how the sociological imagination continues to shed light on the relation between private troubles and public issues. We also suggest one conclusion that can be drawn from this research is that official discourse and everyday maternal experience appear increasingly distant from each other.     

Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients

Food insufficiency is a significant problem in the United States, and poor African American women with children are at especially high risk. An inadequate household food supply can potentially affect the well-being of household members, but it is difficult to distinguish the effects of food insufficiency from risk factors for poor health that are also common among the food insufficient, such as poverty. We examined food insufficiency and physical and mental health among African American and white women (n = 676) who were welfare recipients in 1997. Controlling for common risk factors, women who reported food insufficiency in both 1997 and 1998 were more likely to report fair or poor health at the later date. Food insufficiency in 1998 was significantly associated with meeting the diagnostic screening criteria for recent major depression. Food insufficiency at both times and in 1998 only was related to women's sense of mastery. These findings add to growing evidence that household food insufficiency is associated with poor physical and mental health.