Gesundheitsförderliches Führungsverhalten bei un- und angelernten, kulturell diversen Belegschaften

One of the most important factors affecting inequitable health opportunities is the work activity. The respective supervisor exerts influence on the subordinates’ health and well-being. This study investigates health-promoting leadership behavior among low-skilled, culturally diverse workforces through interviews with employees and managers of the lowest hierarchical level (N?=?53). Information and approachability as well as appreciative feedback and showing interest of the supervisor are identified as relevant target group specific leadership behavior. Health-promoting effects of work design, learning opportunities as well as strain the supervisors themselves suffer from were also examined.     

Modeling healthcare costs in simultaneous presence of asymmetry,heteroscedasticity and correlation

Highly skewed outcome distributions observed across clusters are common in medical research. The aim of this paper is to understand how regression models widely used for accommodating asymmetry fit clustered data under heteroscedasticity. In a simulation study, we provide evidence on the performance of the Gamma Generalized Linear Mixed Model (GLMM) and log-Linear Mixed-Effect (LME) model under a variety of data-generating mechanisms. Two case studies from health expenditures literature, the cost of strategies after myocardial infarction randomized clinical trial on the cost of strategies after myocardial infarction and the European Pressure Ulcer Advisory Panel hospital prevalence survey of pressure ulcers, are analyzed and discussed. According to simulation results, the log-LME model for a Gamma response can lead to estimations that are biased by as much as 10% of the true value, depending on the error variance. In the Gamma GLMM, the bias never exceeds 1%, regardless of the extent of heteroscedasticity, and the confidence intervals perform as nominally stated under most conditions. The Gamma GLMM with a log link seems to be more robust to both Gamma and log-normal generating mechanisms than the log-LME model.     

Principal point classification: Applications to differentiating drug and placebo responses in longitudinal studies

Principal points are cluster means for theoretical distributions. A discriminant methodology based on principal points is introduced. The principal point classification method is useful in clinical trials where the goal is to distinguish and differentiate between different treatment effects. Particularly, in psychiatric studies where placebo response rates can be very high, the principal point classification is illustrated to distinguish specific drug responders from non-specific placebo responders.     

Polarization in the Reaction to Health‐Risk Information: A Question of Social Position?

Dissemination of risk information is ubiquitous in contemporary society. We explore how individuals react in everyday life to health-risk information, based on what they report in personal interviews. Health-risk information was without exception recognized as unstable and inconsistent. This conformity, however, did not extend to the narratives regarding how health-risk information should be handled. Two opposite positions (ideal-typical strategies) are presented. Either you tend to process and evaluate new information or you tend to ignore it as a whole. Our attempt to reveal the underlying rationality in these two very different approaches involved the exploration of three different avenues of interpretation and brings together two scientific paradigms--economics and sociology--that provide the framework for our analysis. First, we suggest that a greater long-term experience of explicit choice implies that this kind of action becomes more natural and less resource consuming, whereas a reliance on habits in daily life--a natural adjustment to a lack of resources--makes it is more costly to bother about new information. Second, with fewer resources in the short run, fewer opportunities to mitigate bad outcomes, and greater exposure to social and material risks, one is less likely to devote resources to deal with health-risk information. Third, there are several possible links between a low propensity to take account of risk information and a high relative importance of genuine uncertainty in one's life. These theoretical perspectives provide a viable set of hypotheses regarding mechanisms that may contribute to social differences in the response to health-risk information.     

Relationships between bullying, psychosocial work environment and individual stress reactions

It is frequently assumed that a poor psychosocial working environment will create conditions that encourage bullying. However, few studies have examined this assumption while comparing work environment ratings of bullied and non-bullied employees who work in the same organization and/or department. The objectives of this study were therefore, first, to investigate relationships between bullying and other psychosocial work environment factors within a particular organizational setting and, second, to investigate if bullied employees reported higher levels of stress than non-bullied employees. A total of 186 blue-collar employees from a Danish manufacturing company participated in the study (response rate of 93%). Results showed significant differences in bullied and non-bullied employees' ratings of psychosocial factors such as job control, management style, role clarity, social climate, social contact and work centrality. In order to investigate assumptions that a poor psychosocial work environment creates conditions that encourage bullying, a number of analyses compared the company's manufacturing departments with either high, medium or low levels of bullying. Results showed significant departmental differences. Yet, when bullied employees were removed from the statistical analyses, with regard to the perceived psychosocial environment these same departments could be differentiated only on the basis of rated job demands and management style. The results therefore bring into question the assumption that a generally poor work environment contributes to bullying. None the less, they do suggest that management style may directly or indirectly have contributed to a higher level of bullying. Also, bullied employees reported significantly more symptoms of psychological stress and mental fatigue than non-bullied employees.     

A robust approach to longitudinal data analysis

The author introduces robust techniques for estimation, inference and variable selection in the analysis of longitudinal data. She first addresses the problem of the robust estimation of the regression and nuisance parameters, for which she derives the asymptotic distribution. She uses weighted estimating equations to build robust quasi‐likelihood functions. These functions are then used to construct a class of test statistics for variable selection. She derives the limiting distribution of these tests and shows its robustness properties in terms of stability of the asymptotic level and power under contamination. An application to a real data set allows her to illustrate the benefits of a robust analysis.     

Sufficient Reduction in Multivariate Surveillance

The relation between change points in multivariate surveillance is important but seldom considered. The sufficiency principle is here used to clarify the structure of some problems, to find efficient methods, and to determine appropriate evaluation metrics. We study processes where the changes occur simultaneously or with known time lags. The surveillance of spatial data is one example where known time lags can be of interest. A general version of a theorem for the sufficient reduction of processes that change with known time lags is given. A simulation study illustrates the benefits or the methods based on the sufficient statistics.     

Consensual Versus Heterogeneous Conceptions of Nationhood: The Role of Citizenship Regimes and Integration Policies Across 21 European Countries

Conceptions of nationhood (i.e., who is accepted as a member of the national ingroup) are known to be more open in countries with inclusive citizenship and integration policies. Yet, surprisingly, up to now no research has investigated whether the sharedness of these conceptions is related to national policies. Therefore, relying on data from the 2013 International Social Survey Programme, the present study examined to which extent individuals living in 188 regions of 21 European countries share similar conceptions of who is a “true” member of the nation. Both ethnic (e.g., having national ancestry) and civic (e.g., respecting national laws and institutions) criteria were considered. Multilevel analyses revealed that in countries with more inclusive policies (with inclusive citizenship regimes, and where immigrants are granted more political rights) the average regional importance granted to ethnic criteria was lower, and conceptions were more heterogeneous (i.e., less shared). Civic criteria—that are achievable—were deemed more important. This can explain the lower heterogeneity of civic conceptions of nationhood and the lack of impact of national policies (though the average regional importance of these criteria was higher where immigrants had more rights). Overall, these results suggest that inclusive as opposed to exclusive settings leave more room for differing worldviews.

     

Ghosted Images: Old Lesbians on Screen

Screen images of old lesbians combine modes of representing female gender, lesbian sexuality, and old age, all of which contain layers of otherness within a hetero-patriarchal and youth-centered society. Analyzing a range of films, from independent to mainstream cinema, this article explores how the ghosted lesbian paradigm intersects with narratives of aging as decline in representations of lesbian characters who are over the age of sixty. The spectral matters of illness, death, mourning, and widowhood inevitably culminate in an unhappy ending. Removed from a lesbian community context, intergenerational continuity vanishes and the old lesbian emerges as the cultural other.