Poverty and the economic effects of TB in rural China

OBJECTIVE: To investigate the economic effects of illness on individual tuberculosis (TB) cases in rural China and to use a case-control study to show a strong TB-poverty link. SETTING: In 2002-2004 we studied 160 new smear-positive pulmonary tuberculosis (PTB) cases and 320 age- and sex-matched controls living in neighbouring houses in four rural counties of Henan Province. DESIGN: Cases and controls were interviewed 1-3 months after patients were diagnosed. We used matched multivariate logistic regression to compare cases with controls for poverty status using household income, household assets and relative wealth within the village. We conducted follow-up interviews of patients 10-12 months later to assess economic effects by collecting data on treatment costs, income losses, coping strategies and treatment completion. RESULTS: Poverty is strongly associated with TB incidence even after controlling for smoking and other risk factors. Excluding income losses, direct out-of-pocket treatment costs (medical and non-medical) accounted for 55.5 % of average annual household income, and most TB cases fell into heavy debt. The DOTS cure rate was 91 %. When DOTS was incomplete or not done, mortality was high. CONCLUSIONS: Poverty is both a cause and a devastating outcome of TB. Ongoing poverty reduction schemes in China must also include reducing TB.

The psychosocial impact of caregiving on young people who have a parent with an illness or disability: Comparisons between young caregivers and noncaregivers

Objective: To investigate the psychosocial impact of young caregiving by empirically validating prominent qualitative themes.. This was achieved through developing an inventory called the Young Caregiver of Parents Inventory (YCOPI) designed to assess these themes and by comparing young caregivers and noncaregivers. Method: Two hundred forty-five participants between 10 and 25 years completed questionnaires: 100 young caregivers and 145 noncaregivers. In addition to the YCOPI, the following variables were measured: demographics, caregiving context, social support, appraisal, coping strategies, and adjustment (health, life satisfaction, distress, positive affect). Results: Eight reliable factors emerged from the YCOPI that described the diverse impacts of caregiving and reflected the key themes reported in prior research. The factors were related to most caregiving context variables and theoretically relevant stress and coping variables. Compared with noncaregivers, young caregivers reported higher levels of young caregiving impact, less reliance on problem-solving coping, and higher somatization and lower life satisfaction. Conclusions: Findings delineate key impacts of young caregiving and highlight the importance of ensuring that measures used in research on young caregivers are sensitive to issues pertinent to this population.

Factors influencing Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction

The purpose of this study was to identify, through in-depth interview, factors that influenced 27 Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction (AMI). The median delay time from the onset of symptoms to arrival at the hospital was 15.6 hours for men and 53.7 hours for women. Three major categories emerged from the data: (a) becoming aware of the threat, (b) maintaining a sense of normality, and (c) struggling to mobilize resources. A variety of decisions were made by patients from the onset of chest Pain to seeking help. These decisions were heavily influenced by healthcare factors (access to emergency medical service (EMS) and treatment), personal factors (cognitive interpretations of symptoms), sociocultural factors (family situation, cultural beliefs, and practices), and coping strategies. (c) 2006 Wiley Periodicals, Inc.

Predictors of emotional well-being following a 'false positive' breast cancer screening result

Using a short-term longitudinal design, and consistent with a stress and coping perspective, this study examined the main and stress-buffering effects of social support and coping on emotional well-being following a 'false positive' breast cancer screening result. Immediately prior to obtaining results of follow-up assessment, 178 women completed measures of emotional well-being, stress appraisal, coping strategies and social support. Six weeks later, 85 women found to be cancer free completed a measure of well-being. Hierarchical regression analyses were used to examine the effects of social support and coping on well-being after controlling for initial well-being and stress appraisal. Consistent with predictions, avoidant coping was associated with higher levels of emotional well-being and social support was found to have a stress buffering effect on well-being. Active-cognitive coping strategies had a stress-buffering effect on well-being. Findings suggest that social support and coping do influence emotional well-being following recall for follow-up assessment of a 'false positive' breast cancer screening result.

AVALIAÇÃO DA ANSIEDADE E DO ENFRENTAMENTO DE EXECUTIVOS EM SITUAÇÃO DE DESEMPREGO

O presente estudo teve por objetivos, investigar a presença de ansiedade em executivos após a quebra de vínculo empregatício; identificar as principais estratégias de enfrentamento utilizadas por esses sujeitos; e relacionar a influência do nível de ansiedade no enfrentamento da situação de desemprego. Participaram 35 sujeitos, de 35 a 56 anos, sendo 27 homens e oito mulheres, desempregados há mais de um (1) mês e em processo de recolocação em uma consultoria em São Paulo. Utilizou-se o Inventário de Ansiedade Traço-Estado e a Escala de Modos de Enfrentamento de Problemas EMEP. Os dados foram submetidos ao Statistical Package for the Social Science (SPSS), versão 13.0 para Windows. Os resultados indicaram que o grau de ansiedade encontrava-se dentro da média esperada e houve correlação positiva significativa entre Ansiedade-Traço e Estado o que é esperado, pois quanto maior o traço ansioso maior será o estado, para essa população. Quanto ao enfrentamento e grau de ansiedade, houve correlação negativa entre ansiedadeestado e o uso de estratégias de enfrentamento focalizadas no problema, ou seja, quanto mais ansiedade, menos os sujeitos orientam-se para resolver problemas; sendo o contrário verdadeiro, pois existiu correlação positiva entre ansiedade-estado e estratégias focalizadas nas emoções desagradáveis, indicando que quanto maior o estado ansioso mais os sujeitos se utilizam estratégias que inibem ações habilidosas e adaptativas. Enfrentamentos baseados em práticas religiosas e pensamentos fantasiosos também estiveram correlacionados com estratégias focalizadas na emoção (sentimentos negativos) podendo sugerir caráter adaptativo menos eficaz. As correlações entre as estratégias de enfrentamento baseadas na emoção e idade mostraram-se negativas, principalmente para sujeitos mais velhos. Não foi encontrada correlação entre desemprego e ansiedade, porém quanto maior tempo de desemprego, menor a utilização de práticas religiosas ou pensamento fantasioso. A análise de confiabilidade do instrumento para esse estudo, através do Alpha de Cronbach foi 0,79; a análise de variância (Anova) entre os fatores de enfrentamento e sexo indicou uma diferença significativa para os fatores de enfrentamento focalizados na emoção e religiosidade/ pensamento fantasioso (p < 0,05). Concluiu-se que a variável ansiedade é presente quando relacionada ao enfrentamento focalizado na emoção e busca de práticas religiosas ou pensamento fantasioso entre sujeitos em situação de desemprego; fato que sugere dificuldades de equilíbrio adaptativo. Sugerem-se outros estudos com amostras maiores e que possam verificar com mais precisão a relação entre tempo de desemprego, sexo, faixa etária e dados do agrupamento familiar entre desempregados de cargos de gerência ou altos executivos

QUALIDADE DE VIDA E ESTRATÉGIAS DE ENFRENTAMENTO DE MULHERES COM E SEM LINFEDEMA APÓS CÂNCER DE MAMA

O linfedema no membro superior é uma complicação inerente ao tratamento de câncer de mama. Caracterizado pelo aumento do volume do membro, leva às limitações físicas e funcionais, e impacto negativo no âmbito psicológico e social. O objetivo deste estudo foi investigar a qualidade de vida e seus domínios, as estratégias de enfrentamento frente ao câncer de mama, e a correlação entre essas variáveis. Este estudo foi realizado em um centro de saúde dedicado às mulheres, por quatro meses. Os instrumentos de avaliação foram: questionário de caracterização geral e específico do câncer de mama, perimetria dos membros superiores; questionários de qualidade de vida da Organização Européia de Pesquisa e Tratamento do Câncer, EORTC QLQ-30 e BR-23; e Inventário de Estratégias de Coping. Foram entrevistadas 82 mulheres, idade média de 57,4 anos (DV12,3), submetidas a tratamento cirúrgico de mama unilateral e esvaziamento axilar, sem metástase. O linfedema apresentou-se em 39,03% (32) e parece não interferir muito na qualidade de vida das mulheres pós-câncer de mama, sendo a função social a mais prejudicada. Sintomas relacionados à quimioterapia e a mama incomodam as mulheres de ambos grupos, porém os sintomas relacionados aos braços foram estatisticamente maiores nas portadoras de linfedema. As estratégias mais utilizadas pelas entrevistadas para enfrentar o câncer foram a reavaliação, resolução de problemas, fuga, suporte social e autocontrole, somente o autocontrole foi estatisticamente maior nas mulheres com linfedema. As estratégias de resolução de problemas, autocontrole e baixo suporte social podem ter colaborado para o desencadeamento do linfedema. Conclui-se que o uso de estratégias ativas e positivas para enfrentar o câncer de mama parece resultar na boa adaptação psicossocial

Collaborative alliances and organisational innovation : a study of the innovation process

Despite the voluminous studies written about organisational innovation over the last 30-40 years our understanding of this phenomenon continues to be inconsistent and inconclusive (Wolfe, 1994). An assessment of the theoretical and methodological issues influencing the explanatory utility of many studies has led scholars (e.g. Slappendel, 1996) to re-evaluate the assumptions used to ground studies. Building on these criticisms the current study contributes to the development of an interactive perspective of organisational innovation. This work contributes empirically and theoretically to an improved understanding of the innovation process and the interaction between the realm of action and the mediating effects of pre-existing contingencies i.e. social control, economic exchange and the communicability of knowledge (Scarbrough, 1996). Building on recent advances in institutional theory (see Barley, 1986; 1990; Barley and Tolbert, 1997) and critical theory (Morrow, 1994, Sayer, 1992) the study aims to demonstrate, via longitudinal intensive research, the process through which ideas are translated into reality. This is significant because, despite a growing recognition of the implicit link between the strategic conduct of actors and the institutional realm in organisational analysis, there are few examples that theorise and empirically test these connections. By assessing an under researched example of technology transfer; the government's Teaching Company Scheme (TCS) this project provides a critique of the innovation process that contributes to theory and our appreciation of change in the UK government's premier technology transfer scheme (QR, 1996). Critical moments during the translation of ideas illustrate how elements that are linked to social control, economic exchange and communicability mediate the innovation process. Using analytical categories i.e. contradiction, slippage and dysfunctionality these are assessed in relation to the actions (coping strategies) of programme members over a two-year period. Drawing on Giddens' (1995) notion of the duality of structure this study explores the nature of the relationship between the task environment and institutional environment demonstrating how and why knowledge is both an enabler and barrier to organisational innovation.

Individual and group differences in driving behaviour

Road traffic accident involvement rates show that younger males are over represented in accidents. A number of studies have shown individual differences in accident involvement. Questionnaire-based methods to investigate individual and group differences in driver stress and risk perceptions reported in chapter 2 and 3 revealed that neuroticism was associated with; heightened perception of personal risk, driver stress, and inefficient coping strategies. Younger drivers and female drivers reported higher levels of stress. Young male drivers assessed their personal risk and driving abilities less realistically than did other age and sex groups. Driving simulator-based methods reported in chapter 4 revealed that young drivers and male drivers; drive faster, overtake more often, and commit more `high risk' overtakes than do other age and sex groups. Middle-aged and elderly drivers were poorer at maintaining a fixed distance from a lead `vehicle'. Older drivers adopt a slower, more cautious driving style, but appear to be worse at controlling distance from a `lead' vehicle. Results are consistent with individual and group differences in accident involvement rates. Findings are discussed with reference to the implementation of driver education programs to reduce stress, the adoption of more realistic perceptions of risk among younger drivers, and the training of compensation strategies to counteract age-related changes in older drivers.

Perception of risk, feelings of vulnerability and effects on driving behaviour in women drivers across the lifespan.

Sustained driving in older age has implications for quality of life and mental health. Studies have shown that despite the recognised importance of driving in maintaining health and social engagement, many women give up driving prematurely or adopt self-imposed restrictive driving practices. Emotional responses to driving have been implicated in these decisions. This research examined the effect of risk perception and feelings of vulnerability on women’s driving behaviour across the lifespan. It also developed and tested a modified theory of planned behaviour intervention to positively affect driving habits. The first two studies (N=395) used quantitative analysis to model driving behaviours affected by risk perception and feelings of vulnerability, and established that feelings of vulnerability do indeed affect women’s driving behaviour, specifically resulting in increases in driving avoidance and the adoption of maladaptive driving styles. Further, that self-regulation, conceptualised as avoidance, is used by drivers across the lifespan. Qualitative analysis of focus group data (N=48) in the third study provided a deeper understanding of the variations in coping behaviours adopted by sub-groups of drivers and extended the definition of self-regulation to incorporate adaptive coping strategies. The next study (N=64) reported the construction and preliminary validation of the novel self-regulation index (SRI) to measure wider self-regulation behaviours using an objective measure of driving behaviour, a simulated driving task. The understanding gained from the formative research was used in the final study, an extended theory of planned behaviour intervention to promote wider self-regulation behaviour, measured using the previously validated self-regulation index. The intervention achieved moderate success with changes in affective attitude and normative beliefs as well as self-reported behaviour. The results offer promise for self-regulation, incorporating a spectrum of planning and coping behaviours, to be used as a mechanism to assist drivers in achieving their personal mobility goals whilst promoting safe driving.

A preliminary investigation of 4 to 11-year-old children's knowledge and understanding of stress

Objective. To examine children's knowledge, understanding and experience of stress from 4 to 11 years of age across four age groups (4–5, 6–7, 8–9, and 10–11 years old). Methods. A semi-structured interview format was used to elicit information from 50 children about their understanding and experience of stress. Results. Most children were able to define stress, with older children providing more complex responses. Many children had indirect and/or personal experience of stress. Younger children were more likely than older children to report that there was nothing people could do to stop stress; children reported using both adaptive and maladaptive coping strategies to deal with stress. Conclusion. Some young children have a basic understanding of stress and many have experience of stress; both understanding and experience develop with age. Practice Implications. The research has potential implications for provider-patient communication, particularly within preventative health education and clinically within the field of childhood post-traumatic stress disorder (PTSD).

Feelings of vulnerability and effects on driving behaviour:a qualitative study

Feelings of vulnerability in driving can be considered an emotional response to risk perception and the coping strategies adopted could have implications for continued mobility. In a series of focus groups with 48 licensed drivers aged 18-75 years, expressions of vulnerability in driver coping behaviours were examined. Despite feelings of vulnerability appearing low, qualitative thematic analysis revealed a complex array of coping strategies in everyday driving including planning, use of 'co-pilots', self-regulation, avoidance and confrontive coping, i.e. intentional aggression toward other road users. The findings inform future intervention studies to enable appropriate coping strategy selection and prolong independent mobility in older adults. © 2014 Elsevier Ltd. All rights reserved.

Extreme weather events and construction SMEs:vulnerability, impacts and responses

Purpose – The UK experienced a number of Extreme Weather Events (EWEs) during recent years and a significant number of businesses were affected as a result. With the intensity and frequency of weather extremes predicted in the future, enhancing the resilience of businesses, especially of Small and Medium-sized Enterprises (SMEs), who are considered as highly vulnerable, has become a necessity. However, little research has been undertaken on how construction SMEs respond to the risk of EWEs. In seeking to help address this dearth of research, this investigation sought to identify how construction SMEs were being affected by EWEs and the coping strategies being used. Design/methodology/approach – A mixed methods research design was adopted to elicit information from construction SMEs, involving a questionnaire survey and case study approach. Findings – Results indicate a lack of coping strategies among the construction SMEs studied. Where the coping strategies have been implemented, these were found to be extensions of their existing risk management strategies rather than radical measures specifically addressing EWEs. Research limitations/implications – The exploratory survey focused on the Greater London area and was limited to a relatively small sample size. This limitation is overcome by conducting detailed case studies utilising two SMEs whose projects were located in EWE prone localities. The mixed method research design adopted benefits the research by presenting more robust findings. Practical implications – A better way of integrating the potential of EWEs into the initial project planning stage is required by the SMEs. This could possibly be achieved through a better risk assessment model supported by better EWE prediction data. Originality/value – The paper provides an original contribution towards the overarching agenda of resilience of SMEs and policy making in the area of EWE risk management. It informs both policy makers and practitioners on issues of planning and preparedness against EWEs.

A conceptual framework for understanding resilience of construction SMEs to extreme weather events

Purpose Small and Medium-sized Enterprises (SMEs), which form a significant portion in many economies, are some of the most vulnerable to the impact of Extreme Weather Events (EWEs). This is of particular importance to the construction industry, as an overarching majority of construction companies are SMEs who account for the majority of employment and income generation within the industry. In the UK, previous research has identified construction SMEs as some of the worst affected by EWEs. Design/methodology/approach Given the recent occurrences of EWEs and predictions suggesting increases in both the intensity and frequency of EWEs in the future, improving the resilience of construction SMEs is vital for achieving a resilient construction industry. A conceptual framework is first developed which is then populated and expanded based on empirical evidence. Positioned within a pragmatic research philosophy, case study research strategy was adopted as the overall research strategy in undertaking this investigation. Findings Based on the findings of two in-depth case studies of construction SMEs, a framework was developed to represent EWE resilience of construction SMEs, where resilience was seen as a collective effect of vulnerability, coping strategies and coping capacities of SMEs, characteristics of the EWE and the wider economic climate. Originality/value The paper provides an original contribution towards the overarching agenda of the resilience of SMEs, and policy making in the area of EWE risk management by presenting a novel conceptual framework depicting the resilience of medium-sized construction companies.

Violence against women in Ethiopia

Investigating the experience of violence against women and exploring women's coping strategies is a crucial component of re-tailoring the provision of services for victims/survivors. This article explores violence against women in the context of culture, theory of fear of violence and literature on spaces perceived to be 'safe' or 'dangerous' by women victims/survivors of violence in Ethiopia. To collect the relevant data, we conducted 14 semi-structured interviews with Ethiopian women who are victims/survivors of violence and three interviews with gender experts in Ethiopia. Our group of women suffer in 'silence' and confide only in friends and relatives. They did not resort to institutional support due to lack of awareness and general societal disapproval of such measures. This contrasts with claims by experts that the needs of these women are addressed using an institutional approach. Culture, migration status and lack of negotiating power in places of work are key factors when considering violence. The majority of the respondents in this study occupy both public and private spaces such as bars and homes and have experienced violence in those spaces. The social relations and subsequent offences they endured do not make spaces such as these safe. Education of both sexes, creation of awareness, sustainable resource allocation to support victims/survivors, ratification of the Maputo protocol and effective law enforcement institutions are some of the practical strategies we propose to mitigate the incidence of violence in Ethiopia. © 2010 Taylor & Francis.

Spillover: the empirical utilisation of the concept. An empirical review of the social scientific corpus between 2004-2014

In recent decades, spillover has become a highly influential concept which has led to the initiation of new theoretical and methodological approaches that are designed to understand how people attempt to reconcile their work and private lives. The very notion of spillover presupposes that these spheres are connected, since the people who move between them bring certain ‘less visible’ content with them such as cognitive or affective mental constructs, skills, behaviors, etc. This paper attempts to create fresh insight into the different areas, themes and methodologies related to how spillover has been addressed over the last ten years. Four main categories are discussed based on the 76 academic articles that were selected: (1) general spillover research, (2) job flexibility and spillover, (3) individual coping strategies, and (4) the spillover effect on the different genders. The final section of the paper provides a tentative synthesis of the main conclusions and findings from the examined papers.