Interrelationships between the structural and functional aspects of social relationships, comorbidity and health related quality of life in breast cancer survivors

It is widely acknowledged in theoretical and empirical literature that social relationships, comprising of structural measures (social networks) and functional measures (perceived social support) have an undeniable effect on health outcomes. However, the actual mechanism of this effect has yet to be clearly understood or explicated. In addition, comorbidity is found to adversely affect social relationships and health related quality of life (a valued outcome measure in cancer patients and survivors). ^ This cross sectional study uses selected baseline data (N=3088) from the Women's Healthy Eating and Living (WHEL) study. Lisrel 8.72 was used for the latent variable structural equation modeling. Due to the ordinal nature of the data, Weighted Least Squares (WLS) method of estimation using Asymptotic Distribution Free covariance matrices was chosen for this analysis. The primary exogenous predictor variables are Social Networks and Comorbidity; Perceived Social Support is the endogenous predictor variable. Three dimensions of HRQoL, physical, mental and satisfaction with current quality of life were the outcome variables. ^ This study hypothesizes and tests the mechanism and pathways between comorbidity, social relationships and HRQoL using latent variable structural equation modeling. After testing the measurement models of social networks and perceived social support, a structural model hypothesizing associations between the latent exogenous and endogenous variables was tested. The results of the study after listwise deletion (N=2131) mostly confirmed the hypothesized relationships (TLI, CFI >0.95, RMSEA = 0.05, p=0.15). Comorbidity was adversely associated with all three HRQoL outcomes. Strong ties were negatively associated with perceived social support; social network had a strong positive association with perceived social support, which served as a mediator between social networks and HRQoL. Mental health quality of life was the most adversely affected by the predictor variables. ^ This study is a preliminary look at the integration of structural and functional measures of social relationships, comorbidity and three HRQoL indicators using LVSEM. Developing stronger social networks and forming supportive relationships is beneficial for health outcomes such as HRQoL of cancer survivors. Thus, the medical community treating cancer survivors as well as the survivor's social networks need to be informed and cognizant of these possible relationships. ^

HIV disclosure decisions and social support among African-American women in Houston, Texas

African Americans make up 12.3% of the population but account for over half of the new HIV cases and 39% of the AIDS cases in 2003 (Centers for Disease Control and Prevention [CDC], 2003). African American women in particular accounted for 64% of these cases of HIV and 60% of the AIDS cases (Leigh & Huff, 2003). This study contributed to the knowledge about the disclosure process of women living with HIV/AIDS by documenting the relationship between social support and the disclosure process in the African American HIV/AIDS population.^ The study aims were to: (1) discuss the participants' self concept of support; (2) describe the common characteristics of the disclosure process; and (3) evaluate the common characteristics of support sought in a potential disclosure source. The ethnographic qualitative methodology was utilized to elicit participant narratives of HIV disclosure and social support. The researcher utilized a key informant interview methodology building on existing social and organizational relationships (Krueger, 1994) to gain access to the population. ^ Semi-structured interviews are a widely used and accepted qualitative research method for use with hard to reach populations and sensitive topics. Ten participants completed a 45 to 60 minute, one on one semi-structured interview covering social support and disclosure variables. Inclusion and exclusion criteria included: (1) self identified as a person living with HIV/AIDS; (2) African American); (3) female; (4) age 18-64 years old, (5) residence in Houston or surrounding counties.^ Themes generated from the interviews were (1) nondisclosure, (2) experiences with disclosure, (3) timing, (4) disclosure sources, and (5) coping. The themes suggest African American women living with HIV/AIDS come from different lifestyles but share similar experiences. Women utilize different strategies such as deciphering whom to trust and determining how much information to divulge in order to protect themselves or others.^ Although the sample group was small for this study, the results inform us about the various experiences each woman goes through as it relates to social support and disclosure and that each woman has to customize her response to the type of support she is receiving and her personal attitude about her disease.^

The relationship between surgical residents' perception of leadership and patient safety culture

Introduction. Patient safety culture is the integration of interrelated practices that once developed is supported by both the culture and leadership of the organization (Sagan, 1993). The purpose of this study is to describe and examine the relationship between surgical residents’ perception of their leadership and the resulting organizational safety culture within their clinical setting. This assessment is important to understanding the extent that leadership style affects the perception of the safety culture.^ Methods. A secondary dataset was used which included data from 68 surgical residents from two survey instruments, Organizational Description Questionnaire (ODQ) and Patient Safety Climate In Healthcare Organizations (PSCHO) Survey. Multiple regressions followed by hierarchical regressions with the introduction of the Post Graduate Year (PGY) variable examined the association between the leadership styles, Transactional and Transformational and the organizational safety culture variables, Overall Emphasis on Safety, Senior management engagement, Organizational resources for safety. Independent t-tests were conducted to assess whether males and females differ among the organizational safety culture variables and either leadership style.^ Results. The surgical residents perceived their organizational leadership to have greater emphasis placed on transformational leadership culture style relative to transactional leadership culture style. The only significant association found was between Transformational leadership and Organizational resources for safety. PGY had no significant effect on the leadership or the safety culture perceived. No significant difference was found between females and males in regards to the safety culture or the leadership style.^ Discussion. These results have implications as they support the premise for the study which is surgical residents perceive their existing leadership and organizational culture to be more transformational in nature than transactional. Significance was found between the leadership perceived and one of the safety culture variables, Organizational resources for safety. The foundation for this association lies in the fact that surgical residents are the personnel which are a part of the organizational resources. Although PGY differentiation did not seem to play a difference in the leadership perceived this could be attributed to the small sample size. No gender difference were found which supports the assumption that within such a highly specialized group such as surgical residents there is no gender differences since the highly specialized field draws a certain type of person with distinct characteristics. In future research these survey tools can be used to gauge the survey audiences’ perception and safety interventions can be developed based on the results. ^

A qualitative and quantitative assessment of cancer patients' perceptions of barriers to treatment

This study examined barriers that cancer patients experience in obtaining treatment. The principal aim of the study was to conduct a comprehensive quantitative and qualitative assessment of barriers to cancer treatment for Texas cancer patients. The three specific aims of the study were to: (1) conduct a review and critique of published and unpublished research on barriers to cancer treatment; (2) conduct focus groups for the qualitative assessment of cancer patients' perceived barriers to cancer treatment; and (3) survey a representative sample of cancer patients regarding perceived barriers to treatment. The study was guided by the Aday and Andersen access framework of predisposing, enabling, and need determinants of care-seeking.^ To address the first specific aim, a total of 732 abstracts were examined, from which 154 articles were selected for review. Of these 154 articles, 57 that related directly to research on barriers to cancer treatment were chosen for subsequent analysis. Criteria were applied to each article to evaluate the strength of the study design, sampling and measurement procedures. The major barriers that were consistently documented to influence whether or not cancer patients sought or continued required treatment included problems with communication between the patient and provider, lack of information on side effects, the cost of treatment and associated difficulties in obtaining and maintaining insurance coverage, and the absence of formal and informal networks of social support. Access barriers were generally greater for older, minority women, and patients of lower socioeconomic status.^ To address the second specific aim, a total of eight focus groups (n = 44) were conducted across the State of Texas with cancer patients identified by the Texas Community Oncology Network, American Cancer Society, and community health centers. One important finding was that cost is the greatest hurdle that patients face. Another finding was that with the health care/insurance crisis, an increasing number of physicians are working with their patients to develop individually-tailored payment plans. For people in rural areas, travel to treatment sites is a major barrier due to the travel costs as well as work time forfeited by patients and their family members. A third major finding was the patients' family and church play important roles in providing social and emotional support for cancer patients.^ To address the third aim, a total of 910 cancer patients were surveyed during October and November, 1993. Approximately 65% of the cancer patients responded to the survey. The findings showed that the major barriers to treatment included costs of medications and diagnostic tests, transportation, lack of social support, problems understanding the written information regarding their disease as well as losing coverage or having higher premiums or copayments once they were diagnosed (particularly among blacks).^ Significant differences in reported barriers were found between racial groups. The minority respondents (i.e., blacks and Hispanics) tended to experience more barriers to treatment compared to the white respondents. More specifically, Hispanics were more likely to report transportation as a barrier to treatment than both white and blacks. Future research is needed to better understand the problems that minority cancer patients experience in receiving treatment. (Abstract shortened by UMI.) ^

Survey of living conditions of Arctic indigenous peoples

Major findings of the Survey of Living Conditions in the Arctic (SLiCA) are: (1) A combination of traditional activities and cash employment is the prevailing lifestyle of Arctic indigenous peoples; (2) family ties, social support of each other, and traditional activities have a lot to do with why indigenous people choose to remain in Arctic communities; (3) well-being is closely related to job opportunities, locally available fish and game, and a sense of local control. Well-being and depression (and related problems like suicide) are flip sides of the same coin. Improving well-being may reduce social problems; and, (4) health conditions vary widely in the Arctic: three-in-four Greenlandic Inuit self-rate their health as at least very good compared with one-in-two Canadian and Alaska Inuit and one-in-five Chukotka indigenous people. Findings are based on 7,200 interviews in a probability sample of Inupiat settlement regions of Alaska, the four Inuit settlement regions of Canada, all of Greenland, and the Anadyrskij, Anadyr, Shmidtovs, Beringovskij, Chukotskij, Iujl'tinskij, Bilibinskij, Chaunskij, Providenskij, Uel'Kal' districts of Chukotka. Indigenous people and researchers from Greenland, Russia, Canada, the United States, Denmark, Norway, Sweden, and Finland collaborated on all phases of the study.

Perception of employers and employees regarding the attitude of businesses toward the environment: a qualitative analysis

Commitment and involvement from the different members of an organization are two key elements for an organization to achieve its environmental excellence. Firstly, businesses are aware of the close relationship between their activities and the environment, for they are not only polluting agents but also agents with the capacity to reduce adverse environmental impacts. Secondly, the fact that employees can play a relevant role in terms of the socially responsible measures to be taken by organizations has started to become an irrefutably important issue. This piece of research is intended to help gain knowledge concerning the attitude of the two main actors in productive activity toward the environmental, that is, employers and employees; as well, this research intends to identify factors determining behaviour towards the environmental. For this, we have gathered the ideas and assessments contained in the discourse of a group of small and medium-sized businesses, large company owners and officers, employees, and work related risk prevention representatives. Qualitative work consisted of in-depth interviews and the creation of discussion groups.

A methodology for the implementation and continuous improvement of social responsibility (RS) and financial responsibility

This work sets out an innovative methodology that aims to facilitate the implementation and continuous improvement of Social Responsibility. It is a methodology that takes account of strategic-economic, social and environmental questions and allows measuring the impact of each of these aspects on the stakeholders and on each of the value areas. It can be extrapolated to all kinds of organisations regardless of their size and sector and admits scaleable models. A marked feature that sets it aside from other methodologies is that it eliminates subjectivity from the qualitative aspects and introduces an algorithm to quantify them.

RECIPROCIDADE ENTRE INDIVÍDUO E ORGANIZAÇÃO E SEUS IMPACTOS SOBRE A SATISFAÇÃO E O COMPROMETIMENTO

Reciprocidade indivíduo-organização e afetividade são dois fenômenos presentes na vida organizacional e que se tornaram tópicos de pesquisa no campo de estudos do comportamento organizacional. Esse estudo teve como objetivo reforçar as evidências empíricas acerca das relações entre cognições de troca indivíduo-organização e afetividade no contexto de trabalho. Para tanto, foram submetidas à teste empírico cinco hipóteses inspiradas em um estudo inédito desenvolvido por Siqueira (2002b). Contou-se com a utilização de um questionário composto por cinco escalas validadas, referentes as variáveis do estudo, que avaliaram percepção de suporte organizacional (PSO), percepção de reciprocidade organizacional (PRO), comprometimento organizacional normativo (CON), satisfação no trabalho (STR) e comprometimento organizacional afetivo (COA). Participaram 275 profissionais, sendo 183 pertencentes ao setor administrativo e 92 ao setor administrativo-acadêmico de uma Instituição de Ensino Superior, situada na região do Grande ABCD Paulista e com inserção no estado de São Paulo. OS participantes do estudo tinham idade média de 32 anos, sendo a maioria (58,2%) do sexo feminino, com escolaridade em nível superior (39,6%) e tempo médio de trabalho na organização de quatro anos. Os dados coletados foram organizados em um banco de dados eletrônico para tratamento estatístico, quando se utilizou o aplicativo SPSS (Statistical Package for the Social Scienses). Foram realizadas análises descritivas das variáveis e análises de correlação e de regressão múltipla para os testes das cinco hipóteses. Todas as hipóteses foram confirmadas. Conclui-se então, que o presente estudo reforça as proposições de Siqueira (2002b) acerca da pertinência de se considerar os três conceitos analisados (PSO, PRO E CON) como integrantes do esquema mental de reciprocidade. Ainda, os resultados do estudo reafirmam as evidências acerca da capacidade preditiva do EMR sobre satisfação no trabalho e comprometimento organizacional afetivo. Por fim, a análise dos dados aponta percepção de suporte organizacional como sendo o componente cognitivo do EMR com maior poder de influência sobre satisfação no trabalho e comprometimento organizacional afetivo. Portanto, cognições acerca das relações de troca social com organizações antecedem satisfação e comprometimento afetivo que, por sua vez, são importantes fatores a favor da organização, contribuindo para sua efetividade.

RECIPROCIDADE ENTRE INDIVÍDUO E ORGANIZAÇÃO E SEUS IMPACTOS SOBRE A SATISFAÇÃO E O COMPROMETIMENTO

Reciprocidade indivíduo-organização e afetividade são dois fenômenos presentes na vida organizacional e que se tornaram tópicos de pesquisa no campo de estudos do comportamento organizacional. Esse estudo teve como objetivo reforçar as evidências empíricas acerca das relações entre cognições de troca indivíduo-organização e afetividade no contexto de trabalho. Para tanto, foram submetidas à teste empírico cinco hipóteses inspiradas em um estudo inédito desenvolvido por Siqueira (2002b). Contou-se com a utilização de um questionário composto por cinco escalas validadas, referentes as variáveis do estudo, que avaliaram percepção de suporte organizacional (PSO), percepção de reciprocidade organizacional (PRO), comprometimento organizacional normativo (CON), satisfação no trabalho (STR) e comprometimento organizacional afetivo (COA). Participaram 275 profissionais, sendo 183 pertencentes ao setor administrativo e 92 ao setor administrativo-acadêmico de uma Instituição de Ensino Superior, situada na região do Grande ABCD Paulista e com inserção no estado de São Paulo. OS participantes do estudo tinham idade média de 32 anos, sendo a maioria (58,2%) do sexo feminino, com escolaridade em nível superior (39,6%) e tempo médio de trabalho na organização de quatro anos. Os dados coletados foram organizados em um banco de dados eletrônico para tratamento estatístico, quando se utilizou o aplicativo SPSS (Statistical Package for the Social Scienses). Foram realizadas análises descritivas das variáveis e análises de correlação e de regressão múltipla para os testes das cinco hipóteses. Todas as hipóteses foram confirmadas. Conclui-se então, que o presente estudo reforça as proposições de Siqueira (2002b) acerca da pertinência de se considerar os três conceitos analisados (PSO, PRO E CON) como integrantes do esquema mental de reciprocidade. Ainda, os resultados do estudo reafirmam as evidências acerca da capacidade preditiva do EMR sobre satisfação no trabalho e comprometimento organizacional afetivo. Por fim, a análise dos dados aponta percepção de suporte organizacional como sendo o componente cognitivo do EMR com maior poder de influência sobre satisfação no trabalho e comprometimento organizacional afetivo. Portanto, cognições acerca das relações de troca social com organizações antecedem satisfação e comprometimento afetivo que, por sua vez, são importantes fatores a favor da organização, contribuindo para sua efetividade.

Rede e apoio social entre idosos atendidos em um ambulatório de Geriatria

O objetivo geral deste estudo foi analisar a relação entre a rede e apoio social, satisfação com o apoio social recebido e as variáveis sociodemográficas, de saúde física e mental, dos idosos atendidos em um Ambulatório de Geriatria de um Hospital Geral Terciário do interior paulista. Trata-se de um estudo descritivo, transversal e exploratório, realizado com 98 idosos atendidos no referido ambulatório. Para a coleta de dados, utilizaram-se o Mini Exame do Estado Mental, um questionário de caracterização sociodemográfica e de saúde, a Escala de Depressão Geriátrica (EDG-15), o Índice de Katz, a Escala de Lawton e Brody, a Escala de medida da rede e apoio social do Medical Outcomes Study e a Escala de Satisfação com o Suporte Social. Os aspectos éticos foram respeitados conforme a Resolução 466/2012 do Conselho Nacional de Saúde. A média de idade dos idosos foi de 80,1 anos, 70,4% eram mulheres, 49,0% viúvos; a média de anos de estudo foi 2,3; 24,5% dos idosos residiam com o cônjuge e filhos ou somente com os filhos; a renda familiar média foi de R$1.773,70. Quanto à capacidade funcional, 80,6% eram independentes para as atividades básicas da vida diária e 88,8% eram parcialmente dependentes para as instrumentais. Os idosos possuíam, em média, 5,3 diagnósticos médicos e os sintomas depressivos estiveram presentes para 61,2% deles. Quanto à rede social, o escore total médio foi de 6,4 pessoas para contato na rede, sendo que 36,7% apresentavam médio contato e participação em atividades sociais. Em relação ao apoio social, o maior escore médio foi para a dimensão material (90,2) e o menor para a interação social positiva (81,8); já para a satisfação com o suporte social, 36,7% e 32,7% apresentaram alta e média satisfação, respectivamente. Foi encontrada correlação inversa entre os escores de todas as dimensões da escala de apoio social e os escores da EDG-15, indicando que quanto maior o apoio social em todas as dimensões, menor é a presença de sintomas depressivos e houve diferenças estatisticamente significativas para todas as dimensões, material (p=0,014), afetiva (p=0,026), interação (p=0,011), emocional (p=0,001) e informação (p=0,005); já a correlação entre os escores das dimensões da escala de apoio social e os escores na escala de Lawton e Brody, foi inversa e fraca para as dimensões material (r=-0,157) e informação (r=-0,027), sugerindo que quanto menor a independência para as AIVDs, maior o apoio social nas referidas dimensões, porém, não houve diferença estatisticamente significativa, material (p=0,121) e informação (p=0,789). A correlação entre os escores da EDG-15 e os escores da escala de satisfação com o apoio social, foi inversa e moderada (r=- 0,467), indicando que quanto maior a satisfação com o apoio social, menor a presença de sintomas depressivos, sendo estatisticamente significativa (p=0,000). Evidencia-se a importância de conhecer se os idosos estão inseridos em rede social e se percebem o apoio social para um melhor direcionamento da assistência prestada ao idoso e para o planejamento e formulação de políticas públicas, programas e projetos voltados a essa população

The Affective Dimensions of Social Controversy

Social controversy is a sustained, mediated debate between at least two oppositional parties which is more than just a difference of opinion; rather it is a persistent conflict over the political and cultural implications that dominant forms of communicative reasoning, practices, and norms have for a public. Simply put, during social controversies the norms guiding public life can be negotiated, reaffirmed, negated, and/or transformed. This can lead to progressive political, cultural, and/or social change in some instances, while establishing or reifying conservative and even oppressive norms, practices, and laws in others. Building upon Olson and Goodnight's (1994) theoretical and methodological framework of social controversy, this dissertation argues that scholars should analyze the role affect plays in this type of conflict as a means to address the regulation of public conduct as well as public discourse. The rhetorical and argumentative significance of the affective dimensions of social controversy have been conceptualized and analyzed via an examination of emotion-based claims and affective states that have become salient, discernable and/or apprehendable during specific public disagreements. Such a conceptualization demonstrates that critical insights regarding the norms that guide public conduct, the role risk and vulnerability play in the regulation of individuals' public behavior, and the relationship between affect and citizenship can be gained by focusing on a controversy's affective dimensions. To highlight the importance of the study of affect in social controversy as well as better understand the larger critical significance affect theory has for rhetorical and argumentation studies, this dissertation has analyzed the affective dimensions of three conflicts. They are: the Abu Ghraib prisoner abuse social controversy, the International Freedom Center social controversy, and the controversy over the 2004 French ban on conspicuous religious attire in public schools. The findings from this dissertation that have specific and general implications for future work in the field of controversy as well as rhetoric and argumentation, respectively.

Life Experiences of People Affected by Crohn’s Disease and Their Support Networks Scoping Review

This scoping review identifies and describes relevant studies related to the evidence published on life experiences and perceived social support of people affected by Crohn’s disease. Twenty-three studies were definitely selected and analyzed for the topics explored. The overall findings show patients’ needs and perceptions. There is a lack of evidence about patients’ perceived needs as well as the understanding of social support that has contributed to improve their life experiences with that chronic illness. Lack of energy, loss of body control, body image damaged due to different treatments and surgeries, symptoms related to fear of disease, feeling burdened loss related to independence, and so on are some of the concerns with having to live with those affected by the Crohn. To underline those experiences through this scoping review provides valuable data for health care teams, especially for the nursing profession, considered by those affected as one of the main roles along the whole pathological process. This review provides the basis for developing broader research on the relatively underexplored topics and consequently improves specific programs that could address patients’ needs.

Management of social networks in the educational process

The research developed in this work consists in proposing a set of techniques for management of social networks and their integration into the educational process. The proposals made are based on assumptions that have been proven with simple examples in a real scenario of university teaching. The results show that social networks have more capacity to spread information than educational web platforms. Moreover, educational social networks are developed in a context of freedom of expression intrinsically linked to Internet freedom. In that context, users can write opinions or comments which are not liked by the staff of schools. However, this feature can be exploited to enrich the educational process and improve the quality of their achievement. The network has covered needs and created new ones. So, the figure of the Community Manager is proposed as agent in educational context for monitoring network and aims to channel the opinions and to provide a rapid response to an academic problem.

An Architecture by means of Anthropology. Beyond learning the tools of social science

Los arquitectos y urbanistas tienen una larga tradición en el aprendizaje de las herramientas de las ciencias sociales, especialmente las que les permiten analizar y describir mejor los entornos y las personas para las que trabajan. Esto ha llevado a los arquitectos a desarrollar mejores herramientas de observación y descripción del ámbito social y no sólo el material. Sin embargo, la mayoría de las veces este acercamiento interdisciplinar ha identificado las ciencias sociales, especialmente la antropología, con la etnografía. Este artículo parte de la crítica a esta identificación hecha por el antropólogo Tim Ingold y se centra en lo que él propone como el método central de la antropología, la observación participante. Para después revisar varias propuestas actuales de científicos sociales que tratan de desarrollar una disciplina no representacional y orientada al futuro, un objetivo más cercano al de la arquitectura. El artículo intenta imaginar cómo esta práctica transdisciplinar podría desarrollarse.

The importance of promoting multimodal teaching in the foreign language classroom for the acquisition of social competences: practical examples

This article analyses the way in which the subject English Language V of the degree English Studies (English Language and Literature) combines the development of the five skills (listening, speaking, reading, writing and interacting) with the use of multimodal activities and resources in the teaching-learning process so that students increase their motivation and acquire different social competences that will be useful for the labour market such as communication, cooperation, leadership or conflict management. This study highlights the use of multimodal materials (texts, videos, etc.) on social topics to introduce cultural aspects in a language subject and to deepen into the different social competences university students can acquire when they work with them. The study was guided by the following research questions: how can multimodal texts and resources contribute to the development of the five skills in a foreign language classroom? What are the main social competences that students acquire when the teaching-learning process is multimodal? The results of a survey prepared at the end of the academic year 2015-2016 point out the main competences that university students develop thanks to multimodal teaching. For its framework of analysis, the study draws on the main principles of visual grammar (Kress & van Leeuwen, 2006) where students learn how to analyse the main aspects in multimodal texts. The analysis of the different multimodal activities described in the article and the survey reveal that multimodality is useful for developing critical thinking, for bringing cultural aspects into the classroom and for working on social competences. This article will explain the successes and challenges of using multimodal texts with social content so that students can acquire social competences while learning content. Moreover, the implications of using multimodal resources in a language classroom to develop multiliteracies will be observed.