Friendship support patterns of older American women

Research during the past decade has firmly established the informal support of family, friends, and neighbors as critical in older people's health and well-being. The decade has also seen increasing attention to informal supports in social policy and services addressing the needs of older people. The support of friends in particular is agreed to be important but the details of its nature and consequence require more research. This article draws on field research of friendship among a population of older American women to ask: (1) How do older women themselves perceive their friendship involvement and its significance as a source of support?; (2) How do the friendship support patterns of later life compare and connect with those of earlier stages?; (3) How do friends relate to other sources of informal support in terms of support exchanged?; and (4) What are the implications for human service professionals concerned with effective use of informal support in later life?     

A Comparative Analysis of Durkheim's Theory of Egoistic Suicide*

This paper reports a comparative cross-national test of Durkheim's theory of egoistic suicide, involving indicators of religious, family, and political integration. Linear and nonlinear multiple regression analysis showed that the relationships between religious integration and suicide and between political integration and suicide are inverse exponential functions of the form Y = ae^bX, while the relationship between family integration and suicide is linear. The relationships between the independent and dependent variables are strong and highly significant. Together, our indicators of religious, family, and political integration explain about 76 percent of the variation in international rates of suicide.     

Work stressors and cardiovascular disease

Over the past 20 years, an extensive body of research evidence has documented that psychosocial work stressors are risk factors for hypertension and cardiovascular disease. These stressors, which appear to be increasing in prevalence, include job strain (the combination of psychological job demands and low job control), imbalance between job efforts and rewards, threat-avoidant vigilant work, and long work hours. This article reviews the evidence linking these stressors with hypertension and CVD, and the physiological and social psychological mechanisms underlying the associations. Also described are methods for measuring work stressors and new, more accurate techniques for measuring blood pressure. Finally, strategies for reducing work stressors and preventing hypertension and CVD are reviewed. These include clinical assessment, worksite health promotion, work organization interventions, legal approaches and work site surveillance.     

The unexpected influence of physician attributes on clinical decisions: results of an experiment

This experiment was designed to determine: (1) whether patient attributes (specifically a patient's age, gender, race, and socioeconomic status) independently influence clinical decision-making; and (2) whether physician characteristics alone (such as their gender, age, race, and medical specialty), or in combination with patient attributes, influence medical decision-making. METHODS: An experiment was conducted in which 16 (= 2(4)) videotapes portraying patient-physician encounters for two medical conditions (polymyalgia rheumatica (PMR) and depression) were randomly assigned to physicians for viewing. Each video presented a combination of four patient attributes (65 years or 80 years of age; male or female; black or white; blue or white collar occupation). Steps were taken to enhance external validity. One hundred twenty-eight eligible physicians were sampled from the northeastern United States, with numbers balanced across 16 (= 2(4)) strata generated from the following characteristics (male or female; < 15 or > or = 15 years since graduation; black or white; internists or family practitioners). The outcomes studied were: 1) the most likely diagnosis; 2) level of certainty adhering to that diagnosis; and 3) the number of tests that would be ordered. RESULTS: Patient attributes (namely age, race, gender, and socioeconomic status) had no influence on the three outcomes studied (the most likely diagnosis, the level of certainty, and test ordering behavior). This was consistent across the two medical conditions portrayed (PMR and depression). In contrast, characteristics of physicians (namely their medical specialty, race, and age) interactively influenced medical decision-making. CONCLUSION: Epidemiologically important patient attributes (which Bayesian decision theorists hold should be influential) had no effect on medical decision-making for the two conditions, while clinically extraneous physician characteristics (which should not be influential) had a statistically significant effect. The validity of idealized theoretical approaches to medical decision making and the usefulness of further observational approaches are discussed.     

Developing a manualized couples treatment for domestic violence: overcoming challenges

This paper describes challenges faced in a four-year project to develop a manualized couples treatment program for domestic violence. The couples treatment program is an add-on to a male batterer program where the male partner has perpetrated mild-to-moderate violence, yet both partners want to remain together. The project involved the cooperation of a variety of community agencies and referrals from key domestic violence programs. While some anticipated challenges did not materialize over the course of the project, unanticipated challenges did. Qualitative data collected from therapists and clients throughout the project was used to refine the treatment approach.     

The gap between exposure and implementation of computer workstation ergonomics in the workplace

The population of people using computers is increasing in home, school and work environments [20,21]. Research suggests that more computer usage may lead to increased incidence of upper extremity cumulative trauma disorder (UECTD) and other work related musculoskeletal injuries [8]. Yet, proper computer workstation ergonomics training is not readily available. This pilot study attempts to better understand the gap between ergonomic interventions and the initiation of work-practice change. The pilot study used self-report through an anonymous Internet survey to explore university faculty and staff training in computer workstation ergonomics, assess UECTD and other computer-use related symptoms, and learn about the respondents' success implementing their knowledge of computer workstation ergonomics. The 55 respondents ranged in age from 21 to 65, and spent an average of 5.3 hours at the computer during a typical workday. Over 70% of respondents experienced symptoms associated with excessive computer use. Although 60% of respondents had exposure to computer workstation ergonomics information, less than 10% reported implementing their knowledge of computer workstation ergonomics in their tasks. This paper looks at organizational and individual issues preventing the implementation of computer workstation ergonomics in the workplace. The Transtheoretical Model for Health Behavior Change [25,27] is used to further evaluate effectiveness of ergonomic interventions. Recommendations for interventions and future evaluations are presented.