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PubMed2006

Race/ethnicity and nativity differences in alcohol and tobacco use during pregnancy.

OBJECTIVES: We examined race/ethnicity and nativity correlates of prenatal substance use. METHODS: Using data on a nationally representative cohort of pregnant women in US cities (N=4185), we evaluated the relative importance of socioeconomic status, paternal health behaviors, social support, and maternal stress and health history in explaining variations in prenatal substance use by race/ethnicity and nativity. RESULTS: Maternal stress and health history appeared to fully explain differences in alcohol use by nativity, but these and other factors could not explain differences in prenatal smoking. For all races/ethnicities, paternal health behaviors were most strongly associated with maternal substance use. Except among Black women, socioeconomic background bore little relation to prenatal substance use after adjustment for more proximal risk factors (e.g., paternal and maternal health behaviors). Social support was most protective among Hispanic women. CONCLUSIONS: Foreign-born immigrant women are at equal risk of prenatal alcohol use compared with similarly situated US-born women and should not be overlooked in the design of interventions for at-risk women. Furthermore, the inclusion of fathers and the development of social support structures for at-risk women can strengthen interventions.

Adult↗
PubMed1992

Legal requisites for social workers in child abuse and neglect situations.

Societal efforts to protect endangered children have resulted in increased responsibilities for social workers, who are expected to identify, report, and provide testimony in suspected cases of abuse and neglect. Their decisions in these cases may have profound consequences for children, families, and themselves. This article increases social workers' knowledge of legal requisites and system realities in child protection to help them make high-quality decisions.

Adolescent↗
PubMed2006

Ethical issues in social research.

There are numerous ethical issues that one must consider when developing a research project; however, much discussion about ethics in health research has focused on experimental studies such as clinical trials. As a result, there remains some ambiguity as to the ethical issues that need to be considered in health-related social research. This paper outlines a number of important ethical issues that CAM researchers should be aware of when developing, running and writing up social research. Maintaining high ethical standards is extremely important in social research as it protects participants and researchers, improves the quality of the data retrieved and ensures that future researchers will have access to participants within the community.

Complementary Therapies↗
PubMed2003

A practical guideline for identifying research intent with projects that collect private, identifiable health information.

Radiation oncologists frequently engage in activities that involve the collection and analysis of data from medical records. Access to health information is an ethical issue because, if not done according to appropriate guidelines, it constitutes an invasion of privacy or breach in confidentiality. To protect patients for the social harm that may result from medical record review, our society has established laws and regulations that apply to projects that require medical record review. A major branch point in the guidelines for such projects is whether private information will be collected for research or nonresearch purposes. However, a problem with discussing privacy protection in terms of a research versus nonresearch model is that it is difficult to make this distinction for many kinds of projects. The purpose of this paper is to establish a practical guideline that can be used to decide if a project that involves analysis of private, identifiable medical information should be considered research from the regulatory standpoint.

Access to Information↗
PubMed2006

Direct observation of neighborhood attributes in an urban area of the US south: characterizing the social context of pregnancy.

BACKGROUND: Neighborhood characteristics have been associated with poor maternal and child health outcomes, yet conceptualization of potential mechanisms is still needed. Census data have long served as proxies for area level socioeconomic influences. Unique information captured by neighborhood inventories, mostly conducted in northern US and Canadian urban areas, has shown important aspects of the community environment that are not captured by the socioeconomic and demographic aggregated individual statistics of census data. In this paper, we describe a neighborhood data collection effort tailored to a southern urban area. METHODS: This study used data from the Pregnancy, Nutrition and Infection (PIN) prospective cohort study to describe neighborhoods where low- and moderate-income pregnant women reside. Women who participated in the PIN study and who resided in Raleigh, NC and its surrounding suburbs were included (n = 703). Neighborhood attributes captured by the inventory included litter, housing condition, road condition, and social interactions that informed theoretical constructs of physical incivility, territoriality and social spaces. US Housing and Population Census 2000 data at the block group level were also assessed to identify the unique contribution of directly observed data. We hypothesize that neighborhood environments can influence health through psychosocial mediated pathways that lead to increased stress, or through disadvantage leading to poor neighborhood resources, or by protective attributes through increased social control. RESULTS: Findings suggest that directly observed neighborhood attributes distinguished between different types of areas in which low-income pregnant non-Hispanic white and non-Hispanic black women lived. Theoretically informed scales of physical incivilities, territoriality and social spaces were constructed and found to be internally consistent. Scales were weakly associated indicating that these constructs capture distinct information about these neighborhoods. Physical incivilities, territoriality and social spaces scales were poorly explained by traditional census variables used to proxy neighborhood environment. CONCLUSION: If neighborhoods influence health through psychosocial mediated pathways then careful detailing of neighborhood attributes that contribute to stress or deterioration, beyond traditional socioeconomic status, are needed. We believe that measuring physical incivility, territoriality and social spaces as expressions of underlying issues of maintenance and social communication make important contributes to this field.

Adolescent↗
PubMed2005

Social class, gender and psychosocial predictors for early sexual debut among 16 year olds in Oslo.

BACKGROUND: Variations in early sexual debut among 16 year olds were investigated by social level variables, parental occupation, gender, ethnicity, family structure, family functioning, and individual level variables, future aspirations, academic and social self-perception, and depressed moods. METHODS: The variations in sexual debut were investigated by examining proportions of 16 year olds reporting their first intercourse before age 16. The data were collected by self-reporting questionnaires administered to in-school-youth, in Oslo. Multivariate logistic regression analyses were used to test for associations. Gender interactions with all variables were tested. RESULTS: Overall, 25% reported early debut. Independent effect of social class on differences in proportions in early sexual debut were found. Gender interaction with social class, ethnicity and academic self-perception as they associate to proportions having had early sexual debut, were found. For girls the pattern of social class differences was linear and the highest proportions were found among working classes. For boys the pattern was U-shaped and upper managerial and manual working class youth had similar, higher proportions of early debutants. High scores of parental monitoring, future aspirations and academic self-concept and low scores of depressed moods, are protective factors. While high social self-perception is positively associated with early debut for both genders. CONCLUSION: Early sexual debut varies according to social class, following gender-specific patterns, among 16 year olds in Oslo. The negative association between early debut and academic self-perception are for boys less influenced by other social and individual level factors, than for girls.

Adolescent↗
PubMed2006

[Psychosocial stress as a risk- and prognostic factor in coronary artery disease and myocardial infarction].

Cardiovascular diseases (CVD) challenge patients and social systems alike. Epidemiologic and economic data underscores demands for additional knowledge and therapeutic options. As recent data shows, psychosocial stress is underestimated as a risk- and prognostic factor in CVD. Cardiac mortality rises sharply whithin a small time-frame after a catastrophic event. But even common daily hassles, anxiety, depression or personality traits can impair cardiac health. Social networks are thought of being cardio-protective. However, if not perceived as supportive, social networks may influence cardiac health negatively. Therefore new approaches emerge against one of the most relevant disease of our time.

Anxiety↗
PubMed2004

The effects of social networks on disability in older Australians.

OBJECTIVE: To investigate the effects of total social networks and specific social networks with children, relatives, friends, and confidants on disability in mobility and Nagi functional tasks. METHODS: Six waves of data from the Australian Longitudinal Study of Ageing were used. Data came from 1,477 participants aged 70 years or older. The effects of total social networks and those with children, relatives, friends, and confidants on transitions in disability status were analyzed using binary and multinomial logistic regression. RESULTS: After controlling for a range of health, environmental, and personal factors, social networks with relatives were protective against developing mobility disability (OR = 0.89; 95% CI = 0.79 to 1.00) and Nagi disability (OR = 0.85; 95% CI = 0.74 to 0.96). Other social subnetworks did not have a consistent effect on the development of disability. DISCUSSION: The effects of social relationships extend beyond disability in activities of daily living. Networks with relatives protect against disability in mobility and Nagi tasks.

Aged↗
PubMed2006

[The principles of protection of work and workers' health of Tbilisi metro in modern social-economic conditions].

At the present stage of development of the country, at the time of total social-economical changes, providing the employed part of the population with safe work conditions and qualified health protection system plays an important role and it needs corresponding legislative basis. In the system of these measures the most important thing is organizing a comprehensive research with the aim of studying the work conditions and the state of health of workers engaged in national economy and working out complex sanitary actions. The comprehensive research has manifested the unfavourable state of factors of work and industrial environment (mental and emotional exertion, high level of dustiness). This exerts a significant influence on the functional state of Tbilisi metro workers. Cardiovascular and nervous system pathologies are the main factors in the state of health. On the grounds of clinico-hygienic comparison they can be related to industrial conditional diseases. On the basis of conducted the complex research recommendations about the improvement of work factors and the health state of Tbilisi metro workers (particularly those of organizational character) have been developed.

Georgia (Republic)↗
PubMed1983

Multiple personality disorder as perpetrator of child abuse.

An eighteen-month-old Alaskan girl suffered transient coma with multiple superficial contusions when injured by her multiple personality disturbed caretaker. The relative disinterest in multiple personality disorder as a psychiatric diagnosis among American trained practitioners is reflected in the great difficulty encountered by child protection workers while seeking psychotherapy for this disturbed family. The public health nurse, pediatrician, and social workers of the child protection team were unsuccessful in attempting to secure psychiatric therapy for this child batterer. Multiple factors, other than psychiatric community disinterest in multiple personality disorders, influenced these unsuccessful attempts. Legal process delays, strongly punitive community attitudes, tired and nearly "burned out" child protection workers, and conflicting psychological and psychiatric consultant opinions are described. A brief review of multiple personality disorder traits is given with emphasis on the common childhood exposure to abuse and violence among reported multiple personality subjects. Despite the obvious hope by the eighteen-month-old child's parents for effective help to reconstitute her family, the multiple factors described show institutional neglect and abuse which has made such recovery impossible to date. A plea is made to all persons involved with child abuse and neglect to more accurately diagnose and treat multiple personality disorders in abusive parents.

Alaska↗
PubMed1996

Usefulness of the protection motivation theory in explaining hearing protection device use among male industrial workers.

The present study examined the usefulness of personal variables: noise annoyance, and components of the protection motivation theory (R. W. Rogers, 1983) along with social-organizational factors in explaining hearing protection device (HPD) use among Israeli manufacturing workers. Participants were 281 men exposed to harmful noise levels for which routine HPD use is required by regulation. In practice, 3 HPD user groups were identified: nonusers (n = 38), occasional users (n = 125), and regular users (n = 118). HPD use was objectively verified. HPD use was primarily related to the personal variables but not to management pressure, coworker pressure, or family support. The most powerful predictors of HPD use were perceived self-efficacy (for long-term HPD use), perceived susceptibility (to hearing loss), and noise annoyance, together explaining 48% of the outcome variance. These findings have implications for interventions aimed at motivating workers to use HPDs regularly.

Adolescent↗
PubMed2006

Going along versus going alone: when fundamental motives facilitate strategic (non)conformity.

Three experiments examined how 2 fundamental social motives--self-protection and mate attraction--influenced conformity. A self-protective goal increased conformity for both men and women. In contrast, the effects of a romantic goal depended on sex, causing women to conform more to others' preferences while engendering nonconformity in men. Men motivated to attract a mate were particularly likely to nonconform when (a) nonconformity made them unique (but not merely a member of a small minority) and when (b) the topic was subjective versus objective, meaning that nonconformists could not be revealed to be incorrect. These findings fit with a functional evolutionary model of motivation and behavior, and they indicate that fundamental motives such as self-protection and mate attraction can stimulate specific forms of conformity or nonconformity for strategic self-presentation.

Adult↗
PubMed2002

Disability examinations: a look at the Social Security Disability Income System.

Disability income protection is an important part of a worker's safety net. U.S. workers who pay into Social Security are eligible for coverage under the federal government, and additional coverage is available in the free market. However, the costs to taxpayers and disability insurance policyholders are high, and a great deal of responsibility rests on the physician providing information on disability issues. A neutral attitude toward a patient requesting disability allows the physician to collect the facts regarding the patient's impairments. A history of the patient's work duties helps the examiner determine the basis for setting limitations or restrictions at work or home. The physician's knowledge base of treatment options assists in determining maximal medical improvement. Records released to the adjudicating body should contain a thorough history, pertinent physical findings, and a review of previous medical records, all of which are to be separated from the opinion of the examiner regarding specific limitations and restrictions. The physician should be aware of symptom magnification and depression as confounders to the patient's perception of disability.

Disability Evaluation↗
PubMed2003

Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions: the SHEEP case-control study.

AIMS: Very few studies indicating that low-moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers. DESIGN: Data came from a case-control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45-70 years old. SETTING: Stockholm County 1992-94. PARTICIPANTS: There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population. MEASUREMENT: Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls. FINDINGS: In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50-69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1-5 g 100% ethanol/day). Men who were abstainers during the previous 1-10 years and with an earlier average consumption of 5-30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations. CONCLUSION: Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1-10-year-long abstainers influenced the risk of MI.

Aged↗
PubMed1995

Pets, attachment, and well-being across the life cycle.

Using an ethological framework of attachment developed by Bowlby and the social provisions of relationships delineated by Weiss, this article explores the ways in which family pets, in particular dogs and cats, provide certain components of attachment that contribute to emotional and social well-being throughout the life cycle. Pets may supply ongoing comfort and reduce feelings of loneliness during adversity or stressful transitions such as divorce or bereavement. They can also provide an opportunity to nurture others. In clinical practice it helps to be aware of how significant a pet may be to a client. Implications are identified for social policies that will protect and maintain this bond for particular populations, such as elderly people in nursing homes or retirement communities and individuals going through a life transition.

Animals↗
PubMed2000

Recent life events, social adjustment, and suicide attempts in patients with major depression and borderline personality disorder.

This study investigated the impact of recent life events and social adjustment on suicide attempter status in 34 patients with major depression, 24 patients with borderline personality disorder, and 22 patients with co-morbid major depression and borderline personality disorder. Suicide attempters reported more recent life events and scored lower on a measure of social adjustment in their families and overall social adjustment, compared with non-attempters. Borderline disordered and borderline or depressed patients were more likely to have attempted suicide than patients with major depression only. Recent life events did not predict attempter status. Lower social adjustment in the immediate family and lower overall social adjustment were predictive of suicide attempter classification, regardless of diagnosis. Borderline disordered patients low on overall social adjustment were over 16 times more likely to have attempted suicide than patients diagnosed with major depression only. Recent life events may elevate suicide risk in groups already at high risk for suicide completion, whereas high levels of social adjustment may be protective against stress-related suicidal behavior.

Adult↗