Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.     

Culture and Organization: The Case of Transmanche-Link

The relationship between culture and organization has often been discussed, but rarely explored directly. This paper implements a cultural values instrument taken from Hofstede together with a behavioural instrument derived from Van de Ven to matched samples of British and French managers working on the Channel Tunnel project. The results largely replicate the findings of Hofstede regarding cultural values, but do not support the predicted implications for behaviour. In essence, the British were found to be more bureaucratic and more team-oriented than their French counterparts, who tended to be more fonceur and competitive. This indicates that the relationship between culture and behaviour might be more complicated than research to date suggests.     

Comparison of Modes of Administration and Response Options in the Assessment of Subjective Health Using the First Question of SF-36

To compare two modes of administration (self-administered; by interviewer) and two response options format (using words; images of “facial-expressions”) of the first question of SF-36 (Q1SF-36), and to test its validity. We included 825 participants (20–90 years). Q1SF-36, using words or images, was included in a global questionnaire interview and at the end participants filled the SF-36. The agreement was tested by weighted kappa coefficients (WKappa). Classification Trees were used in the calibration of Q1SF-36 responses, with the physical (PDSF36) and mental dimensions of SF-36. Polyserial correlation coefficients and areas under the ROC curves (AUC) were used for validation. After categorization, using PDSF36 classification trees, the WKappa were 0.770 (self-administered vs. interviewer), 0.569 (self-administered vs. facial-expressions) and 0.566 (interviewer vs. facial-expressions). The WKappa between the PDSF36 and the modes (self-administered, interviewer and facial-expressions) were 0.784, 0.713 and 0.579 and the corresponding polyserial correlation coefficients were 0.784, 0.713 and 0.579. A good discriminatory power was found comparing the modes with the PDSF36 (AUC = 0.907, 0.923 and 0.827), but not with mental dimension (AUC = 0.538, 0.501 and 0.629). The Q1SF-36, by self-administration or interviewer, may be a valid alternative for assessment of subjective physical health, but not mental health.     

Disruptive Organisation

Organizations are driven by continuous change. Global, socio-economic and technological megatrends – demographic changes and digitalization – are the reasons for transformation. Traditional organization forms are not in line with customers‘ need. Disruptive modes of development and innovations have been intensively discussed elsewhere. The topic of disruptive organization have not been discussed towards internal and external customer relations, although of high relevance. 129 Managers answered on communication ways and the purpose of upcoming meaning for the working place/office. Two new models and five concrete recommendations have been established for upcoming future organization.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.

What is Happening with Quality of Life Among the Oldest People in Southern European Countries? An Empirical Approach Based on the SHARE Data

Population aging in developed countries has created new challenges to improve the well-being of individuals at different age cohorts. This issue is especially significant for Southern European countries, were aging societies have worse health and less socio-economic resources. The aim of this study is to contribute to this body of literature and to estimate the effect of aging on quality of life of oldest people. This paper uses the latest available data (6th wave) from the Survey on Health, Ageing and Retirement in Europe (SHARE). Specifically, robust ordinary least squares and multilevel regressions are employed to analyse the effects of socioeconomic, health, and community factors on quality of life among the oldest population for Southern European countries. Our findings confirm the significance of several factors on life satisfaction among the oldest population in this group of countries. Moreover, we show that the determinants which are correlated with quality of life include predisposing, health, geographic area and social isolation factors.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

The perception of pleasantness in a product of collective use: the bus shelter

This article presents a study on the identification of a setting whose arrangement of attributes could lead to the perception of pleasantness of a bus shelter: a product that should welcome people while waiting for the bus. Two different bus shelters typologies in the city of Porto Alegre, state of Rio Grande do Sul, Brazil, were evaluated, where four attributes were under consideration. The relation between the shelters subject of the study and the surroundings was significant for defining the attributes. The setting with curve shaped cover, bench, rear wall, and surrounding vegetation was considered the most pleasant one. The seats and the rear wall were associated with the practical function of the product while the curve shaped cover and the surrounding vegetation were associated with the aesthetical function according to the participant users.