Use of structural equation modeling to examine the association between breast cancer risk perception and repeat screening mammography among United States women

Breast cancer is the second leading cause of cancer death in United States women, estimated to be diagnosed in 1 out of 8 women in their lifetime. Screening mammography detects breast cancer in its pre-clinical stages when treatment strategies have the greatest chance of success, and is currently the only population-wide prevention method proven to reduce the morbidity and mortality associated with breast cancer. Research has shown that the majority of women are not screened annually, with estimates ranging front 6% - 30% of eligible women receiving all available annual mammograms over a 5-year or greater time frame. Health behavior theorists believe that perception of risk/susceptibility to a disease influences preventive health behavior, in this case, screening mammography The purpose of this dissertation is to examine the association between breast cancer risk perception and repeat screening mammography using a structural equation modeling (SEM) framework. A series of SEM multivariate regressions were conducted using self-reported, nationally representative data from the 2005 National Health Interview Survey. Interaction contrasts were tested to measure the potential moderating effects of variables which have been shown to be predictive of mammography use (physician recommendation, economic barriers, structural barriers, race/ethnicity) on the association between breast cancer risk perception and repeat mammography, while controlling for the covariates of age, income, region, nativity, and educational level. Of the variables tested for moderation, results of the SEM analyses identify physician recommendation as the only moderator of the relationship between risk perception and repeat mammography, thus the potentially most effective point of intervention to increase mammography screening, and decrease the morbidity and mortality associated with breast cancer. These findings expand the role of the physician from recommendation to one of attenuating the effect of risk perception and increasing repeat screening. The long range application of the research is the use of the SEM methodology to identify specific points of intervention most likely to increase preventive behavior in population-wide research, allowing for the most effective use of intervention funds.^

The moderate voice of John Sherman and the Republican agenda 1855-1898

Republican John Sherman, United States Congressman, Senator, Treasury Secretary, and Secretary of State had a political career of major importance from 1855 to 1898, yet there have been only casual references by historians and only two biographies of him, with the most recent published in 1902. From a strong Whig Party background, he was first elected to the United States House of Representatives in 1854; switching to the Republicans that same year. Then elevated to the Senate in 1861, he served in that body throughout the Civil War and Reconstruction when he was the most important voice of party unity and moderation. In 1877, the new President Rutherford Hayes appointed Sherman Secretary of the Treasury. He returned to the Senate after the Hayes administration where he sat for the following 15 years. In this particularly notable period, he not only led the upper house, but he engineered more bills in Congress which bore his name than any other member of either house. These included the critically important Sherman Silver Purchase Act, the Sherman Anti-Trust Act and Sherman Inter-State Commerce Act. In 1897 he left the Senate finally when William McKinley appointed him Secretary of State. ^ Through this long, distinguished career, Sherman was involved in all the important legislation that brought the country through the Civil War and Reconstruction and into the post-war world of the Gilded Age of rapid industrialization, and urban growth, Politically, he never strayed far from the nationalistic and economic principles of the Whig Party, and brought both these values to bear in the Republican Party that dominated American political life from 1860 to 1900. Similarly, party loyalty and loyalty to the President always characterized his service. He was indeed, an exemplar of political and statesmanship. ^ While research for this dissertation included review of both journal and monographic literature, its basis lies more critically in primary research in unpublished archival material in repositories from Maine to Ohio, in particular the Library of Congress. ^

The effects of parental nurturance and involvement on peer relationships and psychosocial functioning of young adults

This study examined peer relationships and psychosocial functioning as a function of maternal and paternal involvement and nurturance along with the moderating effects of gender, family form, and ethnicity. Prior research has shown the influence of mother’s involvement on peer relationship quality but not of fathers. Further, previous studies did not examine moderation by family form, gender, or ethnicity. The sample consisted of 1359 students who identified their biological mother and father as the most influential parental figures in their lives. Their ages ranged from 18 to 26; Sixty-one percent of the sample was Hispanic, 13% non-Hispanic Black, 25% non-Hispanic White; 76% female and 70% from intact families. The analytical strategy included using bivariate correlations and structural equation modeling to examine these relationships. ^ All dimensions of maternal and paternal nurturing and involvement were positively related to positive characteristics of peer relationships, self-esteem and life satisfaction consistent with the multicultural findings of PARTheory (Rohner, Khalique, & Cournoyer, 2005). A structural model was developed that was able to adequately account for the relationship between parental influence, peer relationships, and psychosocial functioning. These effects of both maternal and paternal influence were strongly moderated by culture, family form, and gender. Finally, a differential effect was found among parental influence with fathers having a greater influence on friendship quality and importance than mothers, despite greater maternal involvement. ^ These findings have theoretical, clinical, and social implications as they call for a socially based theoretical perspective within which to study these relationships. Such a perspective would better inform clinicians when using impaired social functioning as indicative of axial diagnosis, and for the implementation of social policy to encourage paternal involvement. ^

The utility of an Integrated Qualitative /Quantitative Data Analytic Strategy (IQ -DAS) to evaluate the impact of youth development interventions to positive qualitative change in the life course

This study reports one of the first controlled studies to examine the impact of a school based positive youth development program (Lerner, Fisher, & Weinberg, 2000) on promoting qualitative change in life course experiences as a positive intervention outcome. The study built on a recently proposed relational developmental methodological metanarrative (Overton, 1998) and advances in use of qualitative research methods (Denzin & Lincoln, 2000). The study investigated the use the Life Course Interview (Clausen, 1998) and an integrated qualitative and quantitative data analytic strategy (IQ-DAS) to provide empirical documentation of the impact the Changing Lives Program on qualitative change in positive identity in a multicultural population of troubled youth in an alternative public high school. The psychosocial life course intervention approach used in this study draws its developmental framework from both psychosocial developmental theory (Erikson, 1968) and life course theory (Elder, 1998) and its intervention strategies from the transformative pedagogy of Freire's (1983/1970). ^ Using the 22 participants in the Intervention Condition and the 10 participants in the Control Condition, RMANOVAs found significantly more positive qualitative change in personal identity for program participants relative to the non-intervention control condition. In addition, the 2X2X2X3 mixed design RMANOVA in which Time (pre, post) was the repeated factor and Condition (Intervention versus Control), Gender, and Ethnicity the between group factors, also found significant interactions for the Time by Gender and Time by Ethnicity. ^ Moreover, the directionality of the basic pattern of change was positive for participants of both genders and all three ethnic groups. The pattern of the moderation effects also indicated a marked tendency for participants in the intervention group to characterize their sense of self as more secure and less negative at the end of the their first semester in the intervention, that was stable across both genders and all three ethnicities. The basic differential pattern of an increase in the intervention condition of a positive characterization of sense of self relative to both pre test and relative to the directionality of the movement of the non-intervention controls, was stable across both genders and all three ethnic groups. ^

Investigating group processes in a positive youth development program for multi -problem youth

This study investigated group processes as potential mediators or moderators of positive development outcome and negative reduction intervention response by evaluating the utility of a group measure modified from a widely known measure of group impact found in the group therapy research literature. Four group processes were of primary interest, (1) Group Impact; (2) Facilitator Impact; (3) Skills Impact; and (4) Exploration Impact as assessed by the Session Evaluation Form (SEF). Outcome measures included the Personally Expressive Activities Questionnaire (PEAQ), Erikson Psycho-Social Index (EPSI) and the Zill Behavior Items, Behavior Problem Index (ZBI (BPI)). The sample consisted of 121 multi-ethnic participants drawn from four alternative high schools from the Miami-Dade County Public School system. Utilizing a Latent Growth Curve Modeling approach with Structural Equation Modeling (SEM) statistics, preliminary analyses were conducted to evaluate the psychometric properties of the SEF and its role in the mediation or moderation of intervention outcome. Preliminary results revealed evidence of a single higher order factor representing a "General" global reaction, which was hypothesized to be a "Positive Group Climate" construct to the program as opposed to the four distinct group processes that were initially hypothesized to affect outcomes. The results of the evaluation of the mediation or moderation role of intervention outcome of the single "General" global latent factor ("Positive Group Climate" construct) did not significantly predict treatment response on any of the outcome variables. Nevertheless, the evidence of an underlying "General" global latent factor ("Positive Group Climate" construct) has important future directions for research on positive youth development programs as well as in group therapy research.

Hispanic Adolescents With Severe Substance Abuse Issues: Parental Involvement, Acculturation-Related Factors and Attachment

The main objective of the study was to investigate the relationship between parent-related, acculturation-related, and substance use-related variables found within individual, familial/parental, peer and school adolescent ecological domains, in a clinical sample (i.e. adolescents who met criteria for a Diagnostic Statistical Manual-IV [DSM-IV] clinical diagnosis of substance abuse/dependence) of Hispanic adolescents from Miami, Florida. The sample for this study consisted of 94 adolescent-mother pairs. The adolescent sample was 65% male, and 35% female, with a mean age of 15 years. More than half of the adolescents were born in the United States (60%) and had resided in the U.S. for an average of 12 years; 80% of the caregivers (primarily mothers) were foreign-born and lived in the U.S. for an average of 21 years. Correlation and hierarchical regression were used to answer the research questions. The findings indicate that the hypothesized model and corresponding anticipated effect of the relationship between parental school and peer involvement on adolescents’ frequency of alcohol, marijuana and cocaine use was not supported by the data. Parental “acculturation-related” variables did not explain any of the variance in adolescent substance use frequency in this sample. Mediation and moderation models were not supported either. However, some interesting relationships were found: The larger the acculturation gap, the lower the parental involvement in school tended to be (r = -.21, p < .05). Adolescents who experienced a greater acculturation gap with their parents (-.81, p >.01) had an earlier onset of marijuana (-.33, p < .01) and cocaine use (r = -.24, p .05), they also reported using marijuana more frequently than females (.21, p >.05).

The utility of an integrated qualitative/quantitative data analytic strategy (IQ-DAS) to evaluate the impact of youth development interventions on positive qualitative change in the life course

This study reports one of the first controlled studies to examine the impact of a school based positive youth development program (Lerner, Fisher, & Weinberg, 2000) on promoting qualitative change in life course experiences as a positive intervention outcome. The study built on a recently proposed relational developmental methodological metanarrative (Overton, 1998) and advances in use of qualitative research methods (Denzin & Lincoln, 2000). The study investigated the use the Life Course Interview (Clausen, 1998) and an integrated qualitative and quantitative data analytic strategy (IQDAS) to provide empirical documentation of the impact the Changing Lives Program on qualitative change in positive identity in a multicultural population of troubled youth in an alternative public high school. The psychosocial life course intervention approach used in this study draws its developmental framework from both psychosocial developmental theory (Erikson, 1968) and life course theory (Elder, 1998) and its intervention strategies from the transformative pedagogy of Freire's (1983/1970). Using the 22 participants in the Intervention Condition and the 10 participants in the Control Condition, RMANOVAs found significantly more positive qualitative change in personal identity for program participants relative to the non-intervention control condition. In addition, the 2X2X2X3 mixed design RMANOVA in which Time (pre, post) was the repeated factor and Condition (Intervention versus Control), Gender, and Ethnicity the between group factors, also found significant interactions for the Time by Gender and Time by Ethnicity. Moreover, the directionality of the basic pattern of change was positive for participants of both genders and all three ethnic groups. The pattern of the moderation effects also indicated a marked tendency for participants in the intervention group to characterize their sense of self as more secure and less negative at the end of the their first semester in the intervention, that was stable across both genders and all three ethnicities. The basic differential pattern of an increase in the intervention condition of a positive characterization of sense of self relative to both pre test and relative to the directionality of the movement of the non-intervention controls, was stable across both genders and all three ethnic groups.

Aspectos ecogenéticos y legislativos aplicados a la transgénesis de animales y alimentos

Bioethics ecology suggests the birth of a mentality which proposes, among other things: a human certain asceticism in relation to the environment around us, based on moderation; brutal renounce consumerism that is converted into primary need so most of the time is just superfluous. Social and economic developments affecting the existing globalization process in all areas of our existence. Ignorance conditions the quality of our relationship with the people and the environment. Parallel to this, the concept of social justice is not out of the problem of the environment. At present the environmental field has been filled by qualified professionals, resulting in a coprofesionalism, and an openness to the metadiscipline or shares from trades, knowledge and non-formal learning, which should make a concerted effort to be familiar with the delicate aimed at balancing the instability that is the Middle multidisciplinary environment and seem to be witnessing a passive object of global change. It is known as transgenesis process of transferring genes into an organism. Transgenesis is currently used to make transgenic plants and animals. Several methods of transgenesis as using gene guns or the use of virus or bacteria as vectors to transfer genes.

Evaluating the Impact of the Positive Choices Intervention on Substance Use, Psychological, and Care Engagement Outcomes Relevant to Current National HIV Prevention Goals

The HIV epidemic in the United States continues to be a significant public health problem, with approximately 50,000 new infections occurring each year. National public health priorities have shifted in recent years towards targeted HIV prevention efforts among people living with HIV/AIDS (PLWHA) that include: increasing engagement in and retention in care, improving HIV treatment adherence, and increasing screening for and treatment of substance use and psychological difficulties. This study evaluated the efficacy of Positive Choices (PC), a brief, care-based, theory-driven, 3-session counseling intervention for newly HIV-diagnosed men who have sex with men (MSM), in the context of current national HIV prevention priorities. The study involved secondary analysis of data from a preliminary efficacy trial of the PC intervention (n=102). Descriptive statistics examined baseline substance use, psychological characteristics and strategies, and care engagement and HIV-related biological outcomes. Generalized Estimating Equations (GEE) examined longitudinal changes in these variables by study condition. Results indicated that PC improved adherence to HIV treatment, but increased use of illicit drugs, specifically amyl nitrates and other stimulant drugs; additionally, moderation analyses indicated differences in patterns of change over time in viral load by baseline depression status. Implications of the findings and suggestions for future research are discussed.

Facilitating Inclusion: Austrian Wisdom Councils as Democratic Innovation between Consensus and Diversity

Democratic innovations face the challenge of realizing deliberative democratic ideals in the context of structural inequality. Consensus decision making and expertise have been said to have exclusive effects on marginalized groups like women and ethnic and sexual minorities, which obstructs diversity. Wisdom Councils as practiced in Austria attempt to counter inequalities by including marginalized groups through the moderation technique dynamic facilitation. Exploratory participatory observations and interviews with a moderator and the participants of two Wisdom Councils in Austria provide a deeper understanding of the inclusive processes at work in Wisdom Councils facilitating a productive combination of consensus and diversity.

La congruence des valeurs : un facteur à considérer pour rehausser le leadership transformationnel et son efficacité ?

Les théories sous-tendant le leadership transformationnel suggèrent que la congruence des valeurs personnelles et organisationnelles est au cœur du fonctionnement du leadership transformationnel. Or, l’examen de cette proposition soulève certaines questions. Par exemple, il y a lieu de s’interroger quant à l’importance du type (subjective ou objective) et de la cible (équipe, organisation) de congruence considérés, du contenu des valeurs utilisées pour juger de la congruence, des contingences situationnelles modulant l’importance de la congruence, et du rôle de la congruence des valeurs des leaders eux-mêmes. Ainsi, afin d’enrichir les connaissances sur le rôle des valeurs en regard du leadership transformationnel, cette thèse propose trois articles dans lesquels ce rôle des valeurs et de leur congruence est abordé sous trois angles. Les données utilisées dans cette thèse proviennent d’une grande organisation canadienne, et des sous-ensembles de données sont créés pour répondre aux objectifs de chaque article. Le premier article s’intéresse aux liens qu’ont a) les valeurs personnelles des gestionnaires, b) les valeurs qu’ils perçoivent dans leur organisation et c) la congruence de ces deux ensemble de valeurs avec l’émission de comportements de leadership transformationnel tel que perçus par leurs subordonnés. Les résultats suggèrent que la congruence des valeurs n’a pas de lien avec le leadership transformationnel, mais que c’est le cas pour certaines valeurs au niveau personnel et organisationnel qui présentent effectivement un lien. Le deuxième article porte sur le potentiel rôle modérateur de la congruence des valeurs personne-organisation des subordonnés dans la relation entre le leadership transformationnel et les comportements d’habilitation. Les résultats montrent que la congruence des valeurs peut effectivement modérer cette relation, et que la forme de la modération peut dépendre de l’ancienneté des employés. Le troisième article traite du rôle modérateur de la présence de valeurs et de leur congruence au niveau de l’équipe dans la relation entre le leadership transformationnel et les comportements d’habilitation. Les résultats suggèrent que les valeurs et leur congruence dans les équipes peuvent modérer l’efficacité du leadership transformationnel en regard des comportements d’habilitation. De façon générale, la présence et la congruence de cinq valeurs, parmi les sept testées, semblent rehausser la relation entre le leadership transformationnel et les comportements d’habilitation. Ainsi, la présente thèse, en ajoutant des considérations quant aux questions qui avaient été soulevées par l’examen de la proposition théorique du rôle des valeurs et de leur congruence dans le leadership transformationnel, permet d’améliorer la compréhension de ce rôle. Spécifiquement, les résultats de cette thèse suggèrent que globalement, la congruence des valeurs peut être plus importante pour l’efficacité du leadership transformationnel lorsque les valeurs considérées sont plus importantes dans l’équipe de l’individu, et lorsque l’individu a peu d’ancienneté dans son organisation. De plus, en ce qui a trait aux leaders, il semble que la présence de valeurs de bien-être collectif et d’ouverture au changement ait un lien avec l’émission de comportements de leadership transformationnel. Une discussion traite de ces résultats et indique les limites de la thèse ainsi que des pistes de recherche future.

A Monthly Volatility Index for the US Economy

We estimate the monthly volatility of the US economy from 1968 to 2006 by extending the coincidentindex model of Stock and Watson (1991). Our volatility index, which we call VOLINX, hasfour applications. First, it sheds light on the Great Moderation. VOLINX captures the decrease in thevolatility in the mid-80s as well as the different episodes of stress over the sample period. In the 70sand early 80s the stagflation and the two oil crises marked the pace of the volatility whereas 09/11 is themost relevant shock after the moderation. Second, it helps to understand the economic indicators thatcause volatility. While the main determinant of the coincident index is industrial production, VOLINXis mainly affected by employment and income. Third, it adapts the confidence bands of the forecasts.In and out-of-sample evaluations show that the confidence bands may differ up to 50% with respect to amodel with constant variance. Last, the methodology we use permits us to estimate monthly GDP, whichhas conditional volatility that is partly explained by VOLINX. These applications can be used by policymakers for monitoring and surveillance of the stress of the economy.

The effect of maternal employment on adolescents' transition to young adulthood

The purpose of this study was to examine relationships between multiple characteristics of maternal employment, parenting practices, and adolescents’ transition outcomes to young adulthood. The research addressed four main research questions. First, are the characteristics of maternal work (i.e., hours worked, multiple jobs held, work schedules, earnings, and occupation) related to adolescents’ enrollment in post-secondary education, employment, or involvement in neither of these types of activities as young adults? Second, are the work characteristics related to parental involvement and monitoring, and are the parenting practices related to adolescents’ transition outcomes? Third, do parental involvement and monitoring mediate any relationships between the characteristics of maternal employment and adolescents’ transition outcomes? Finally, do any associations between characteristics of maternal employment and parenting practices and adolescents’ transition outcomes vary by poverty status, race/ethnicity, or gender? To address these research questions, secondary data analysis was conducted, using data from the National Longitudinal Survey of Youth (NLSY) from 1998 through 2004. The study sample consisted of 849 youths who were 15 through 17 years of age in either 1998 or 2000, and were 19 through 21 years of age when their transition outcomes in young adulthood were measured four years later. Multinomial logistic and ordinary least squares regression models were estimated to answer the research questions. Study findings indicated that of the maternal work characteristics, mothers’ multiple jobs held, occupation, and work schedule were significantly related to the youths’ transition outcomes. When mothers held multiple jobs for 1 to 25 weeks per year, and when mothers held jobs involving lower levels of occupational complexity, their youths were more likely to experience employment rather than post-secondary education. Adolescents whose mothers worked a standard work schedule were less likely to experience other types of transitions than post-secondary education. With regard to the effects of maternal employment on parenting practices, none of the maternal work variables were related to parental involvement, and only one variable, mothers working less than 40 hours per week, was negatively related to parental monitoring. In addition, when parents were more involved with their youths’ education, the youths were less likely to transition into employment and other types of transitions rather than post-secondary education. The parenting practices did not mediate the relation between the significant work variables (holding multiple jobs, work schedule, and occupation) and youths’ transition outcomes. Finally, none of the interactions between maternal work characteristics and poverty status, race/ethnicity, and gender met the criteria for determining significance; but in a series of sub-group analyses, some differences according to poverty status and gender were found. Despite the lack of mediation and moderation, the findings of this study have important implications for social policy and social work intervention. Based on the findings, suggestions are made in these areas to improve working mothers’ lives and their adolescents’ development and successful transition to adulthood. Finally, directions for future research are discussed.

The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

INTRODUCTION AND AIMS: Research highlights the need to better understand the impact of alcohol-related harm on families and communities. Scottish policy initiatives to reduce alcohol consumption and alcohol-related harm include the planned introduction of a minimum unit price for alcohol. We aimed to explore existing and proposed changes in alcohol policy, from the standpoint of heavy drinkers, through accounts of their involvement and repercussions for family and friends. DESIGN AND METHODS: Interviews were conducted with 20 heavy drinkers, recruited from hospital alcohol treatment centres in Scotland's two largest cities. Participants were part of a larger longitudinal mixed methods study. Interviews explored experiences of alcohol-related harm and the impact, or potential impact, of alcohol policy changes on drinking patterns, risk-taking, consumption and wellbeing. Data coded for 'family and friends' were thematically analysed using a constant comparison method. RESULTS: Family and friends were portrayed as important for aiding moderation and abstinence, but more often for sustaining continued heavy drinking. Heavy drinkers with complex needs and those living in deprived communities suggested that increased alcohol prices could exacerbate the detrimental effect on their health and social circumstances, and that of their family, should their consumption remain excessive. DISCUSSION AND CONCLUSIONS: Population level policy initiatives to reduce alcohol consumption, such as minimum unit pricing, will impact on the families and social networks of heavy drinkers in addition to the drinker. The most vulnerable may be affected disproportionately. Alcohol policy changes and evaluations need to consider consequences for drinkers, families and communities. [O'May F, Whittaker A, Black H, Gill J. The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

Teaching by chat

This paper discusses some didactical aspects of chat usage for instructional purposes. Areas covered range from the choice of course type and student group for using chats, to the preparation and moderation of chats, and discussing how to manage both troublemaking students and systems. In February 1998 I was the chair of a committee at my previous university that was authoring a recommendation list about the Internet to the president of the school. One of our recommendations was to eliminate the IRC server (Internet Relay Chat), since it was only causing traffic and was just being used for games. We stated that we could not envision a use for chatting either for research or for instructional purposes. Five years later here I am: teaching 4 of my 5 courses by way of chat. There has been an enormous growth in the use of chat-based instruction, but also quite a lot of problems encountered. Much of the available literature addresses technical problems, or discusses chats from an educational psychology perspective. This paper will address ten of the didactical issues in chat-based instruction, summarizing the experiences that I have made in many years of chat experience (DIPF/Orig.)