Mapping the uninsured using secondary data: an environmental justice application in Dallas

Over the last 5 years, environmental justice (EJ) researchers have been calling for incorporation of health outcomes more directly into spatial studies of socio-demographics and environmental hazards. To date, researchers have not incorporated insurance status (an access to health care variable) in their models although access to care likely has an important association with the probability of health effects due to environmental exposures. As such, insurance status represents an important variable within spatial EJ studies focused on health, and the lack of spatially explicit access to care data is a critical limitation in the field. As a solution, we offer a method of using uninsured appendicitis cases, acquired secondarily from state hospital admissions data, to estimate rates of uninsurance at the zip-code level. We apply the technique to explore relationships between cancer risk from hazardous air pollutants and estimated rates of uninsurance, a previously unexplored phenomenon. Then, we compare the uninsurance findings to those related to poverty to illustrate how uninsurance, as a variable, compares to a more traditional socio-economic predictor used in EJ studies. The relationship between cancer risk from hazardous air pollutants and uninsurance is weaker than the relationship between risk and poverty, but both are statistically significant. As such, we conclude with a discussion of the importance of considering insurance status in spatial studies of EJ focused on health.     

Fathers' birth experience in relation to midwifery care

The aim was to identify the proportion of fathers having a positive experience of a normal birth and to explore factors related to midwifery care that were associated with a positive experience.

Background

Research has mainly focused on the father's supportive role during childbirth rather than his personal experiences of birth.

Methods

595 new fathers living in a northern part of Sweden, whose partner had a normal birth, were included in the study. Data was collected by questionnaires. Odds Ratios with 95% confidence interval and logistic regression analysis were used.

Results

The majority of fathers (82%) reported a positive birth experience. The strongest factors associated with a positive birth experience were midwife support (OR 4.0; 95 CI 2.0–8.1), the midwife's ongoing presence in the delivery room (OR 2.0; 1.1–3.9), and information about the progress of labour (OR 3.1; 1.6–5.8).

Conclusion

Most fathers had a positive birth experience. Midwifery support, the midwife's presence and sufficient information about the progress of labour are important aspects in a father's positive birth experience. The role of the midwife during birth is important to the father, and his individual needs should be considered in order to enhance a positive birth experience.     

Testing for qualitative interaction of multiple sources of informative dropout in longitudinal data

Longitudinal studies suffer from patient dropout. The dropout process may be informative if there exists an association between dropout patterns and the rate of change in the response over time. Multiple patterns are plausible in that different causes of dropout might contribute to different patterns. These multiple patterns can be dichotomized into two groups: quantitative and qualitative interaction. Quantitative interaction indicates that each of the multiple sources is biasing the estimate of the rate of change in the same direction, although with differing magnitudes. Alternatively, qualitative interaction results in the multiple sources biasing the estimate of the rate of change in opposing directions. Qualitative interaction is of special concern, since it is less likely to be detected by conventional methods and can lead to highly misleading slope estimates. We explore a test for qualitative interaction based on simultaneous confidence intervals. The test accommodates the realistic situation where reasons for dropout are not fully understood, or even entirely unknown. It allows for an additional level of clustering among participating subjects. We apply these methods to a study exploring tumor growth rates in mice as well as a longitudinal study exploring rates of change in cognitive functioning for Alzheimer's patients.     

One Decade of Self Exclusion: Missouri Casino Self-Excluders Four to Ten Years after Enrollment

For more than a decade, casinos around the world have offered self-exclusion programs (SEPs) to gamblers seeking help with their gambling behavior. Despite the proliferation of SEPs, little is known about the long-term outcomes for gamblers who utilize these programs. The current study assessed the experiences of a sample (N = 113) of Missouri self-excluders (SEs) for as long as 10 years after their initial enrollment in the Missouri Voluntary Exclusion Program (MVEP). Most SEs had positive experiences with MVEP and reduced their gambling and gambling problems after enrollment. However, 50% of SEs who attempted to trespass at Missouri casinos after enrollment were able to, indicating that the benefit of MVEP was attributable more to the act of enrollment than enforcement. SEs who engaged in complementary treatment or self-help groups had more positive outcomes than those who did not, suggesting that SEPs ought to encourage and provide information about additional support and treatment options to participants.     

The development of the Solution Building Inventory

Throughout the past 70 years, a great deal of research conducted on defining and testing problem-solving skills has led toward solution-focused practices and philosophies. As a result, some literature exists illustrating the efficacy of solution-focused practices. However, no published research exists on the factors that contribute to solution building. This study tested for components of solution building while creating a solution building inventory. Results from a factor analysis failed to find specific factors within solution building; thus solution building appears to be a unidimensional concept. Implications for using the solution building inventory are discussed.     

Positive Changes in Perceptions and Selections of Healthful Foods by College Students After a Short-Term Point-of-Selection Intervention at a Dining Hall

Abstract

Objective: Determine the effects of a short-term, multi-faceted, point-of-selection intervention on college students’ perceptions and selection of 10 targeted healthful foods in a university dining hall and changes in their self-reported overall eating behaviors. Participants: 104 college students, (age 18–23) completed pre-I and post-I surveys. Methods: Pre-survey collected at dining hall in April 2007, followed by 3-week intervention then post-survey collected via email. Healthy choice indicators, large signs, table tents, flyers and colorful photographs with “benefit-based messages” promoted targeted foods. Response rate to both surveys was 38%. Results: Significantly more participants reported that healthful choices were clearly identified in the dining hall after the intervention. Over 20% of participants reported becoming more aware of healthful food choices in the dining hall after the intervention. Significant increases in self-reported intake were reported for cottage cheese and low-fat salad dressing, with a trend toward increased consumption of fresh fruit. Seven of the 14 assessed eating behaviors had significant changes in the desired direction. Increased awareness of healthful foods was the top reason for self-reported changes in overall eating behaviors. Conclusion: Short-term, multi-faceted, point-of-selection marketing of healthful foods in university dining halls may be beneficial for improving college students’ perceptions and selections of targeted healthful foods in the dining hall and may improve overall eating behaviors of college students.     

Popular music and urban regeneration: The music industries of Merseyside

In this article I address the origins of America's national parks, particularly as they figure in the environmentalist discourse surrounding the institution of Yosemite Valley as a public park. Although technically speaking Yosemite did not become a national park until 1890, its cession to the State of California in 1864 provides an important cultural site for the emergence of environmentalism as part of a broader concern with the relations between aesthetic, social and natural agency. In mapping out these relations in Frederick Law Olmsted's 1865 report on the management of Yosemite, I claim that the preservation of Yosemite reproduces nature as a public park in which human agency can be simultaneously produced and elided by means of the aesthetic agency of nature. I read Olmsted's report as a discursive site on which we can trace the structural parallels between the preservation of Yosemite and several related cultural practices in which the origins of American environmentalism are embedded. I also read it as sketching out the configurations of human and natural agency within which these parallel practices are articulated.

My study operates from the assumption that science and technology need to be understood not simply by explaining how they are socially or culturally constructed, but also by looking at how certain fundamental ideas of metaphors (like natural agency or the reproduction of nature) are worked out at the same historical moment in different discursive practices. In taking up the idea of America as it both defines and is defined by the network of relations among science, technology and culture, I outline certain myths of American environmentalist origins as played out across a number of diverse and heterogeneous discourses and technologies of representation and reproduction. I hope also to illuminate the way in which American cultural origins are simultaneously constructed and destabilized through the act of reproducing nature.     

Teaching Note—Educating Public Health Social Work Professionals: Results From an MSW/MPH Program Outcomes Study

Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master’s of social work (MSW)/master’s of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes associated with 1 group of graduates from an established MSW/MPH program. A 57-question electronic survey was administered to 214 alumni in 2010; the response rate was 71.4% (n = 153). Findings provide a snapshot of public health social work alumni experiences, including diverse employment opportunities, high career satisfaction, and a strong sense of reported public health and social work integration in the workplace.