A constellation of factors associated with premature births among African American women

A cohort, cross-sectional, historical study design was used to study factors related to spontaneous premature birth outcomes among African American women. The cohort consisted of 4,294 mothers drawn from the 1988 National Maternal and Infant Health Survey conducted by the National Center for Health Statistics. The objectives of the study were: (1) to examine the distribution of gestational ages of African American infants for selected variables reported for their families and (2) to describe risk factors associated with birth at 20–31 weeks of gestational age and at 32–36 weeks of gestational age. Risk factors examined include maternal age, maternal marital status, maternal living arrangements, maternal education, maternal work status, household income, gestational bleeding, month prenatal began, adequacy of prenatal care, parity, previous viable preterm birth, and behavioral factors of attitude toward pregnancy, smoking, drug, and alcohol use during pregnancy. Frequency distributions, cross tabulations, stratified analysis, and logistic regression analysis were used. ^ Risk factors associated with a 50 percent or more increase in preterm birth were cocaine use, low maternal education, teenaged mother, prenatal care deficits or overuse, and bleeding during the second half of pregnancy. The other risk factors of not living with the baby's father, smoking cigarettes and having a mistimed pregnancy carried statistically significance but lower strength of association. ^ Health care services, educational systems, and community organizations can develop and evaluate comprehensive health education and information campaigns that address preventable risk factors during pregnancy. Although preterm birth cannot always be prevented, preconception care can help identify and modify maternal risk and promote optimum health before conception. Quality care should include continued risk assessment, health promotion, and interventions. ^

Maternal factors, fetal parameters and the risk of shoulder dystocia

Introduction. Shoulder dystocia is a serious complication of vaginal birth, with an incidence ranging from 0.15% to 2.1% of all births. There are approximately 4 million births per year in the United States and shoulder dystocia will be experienced by approximately 20,000 women each year. Although studies have been reported on shoulder dystocia, few studies have addressed both maternal and fetal risk factors. The purpose of this study was to identify maternal and fetal risk factors for shoulder dystocia while proposing factors that could be used to predict impending shoulder dystocia. ^ Material and methods. Articles were reviewed from Medline Pubmed using the search phrase "Risk factors of shoulder dystocia" and Medline Ovid using the search words "Dystocia", "Shoulder" and "Risk factors". Rigorous selection criteria were used to identify articles to be included in the study. Data collected from identified articles were transferred to STATA 10 software for trend analysis of the incidence of shoulder dystocia and the year of publication and a pair wise correlation was also determined between these two variables. ^ Results. Among a total of 343 studies identified, only 20 met our inclusion criteria and were retained for this review. The incidence of shoulder dystocia ranged from 0.07% to 2% and there was no particular trend or correlation between the incidence of shoulder dystocia and year of publication between 1985 and 2007. Pre-gestational and gestational diabetes, postdatism, obesity, birth weight > 4000g and fundal height at last visit > 40cm were identified as major risk factors in our series of studies. ^ Conclusion. Future strategies to predict shoulder dystocia should focus on pre-gestational and gestational diabetes mellitus, postdatism, obesity, birth weight > 4000g and fundal height at last visit > 40cm. ^

Disparities in asthma prevalence: The influence of sociodemographic and workplace factors

Asthma is a serious and continuing health problem that affects millions of Americans. Our study was conducted in response to this serious health problem and for purposes of addressing the issue of potential health disparities as outlined in Healthy People 2010. Data from sub-populations of subjects who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999-2004 were used to complete the following specific aims: (1) to update nationally-based estimates of the prevalence of current and lifetime (ever) asthma among adults in the United States (U.S.) and describe by gender the relationships between potential risk factors (e.g., sociodemographics and lifestyle) and asthma; (2) to describe demographic characteristics among working adults in the U.S. and update estimates of the prevalence of asthma in this sub-population, stratified by occupation and industry; and 3) to determine the utility of adapting a population-based Job Exposure Matrix (JEM) for classifying workplace exposures to asthmagens. ^ Our findings suggest the prevalence of asthma among U.S. adults is continuing to rise, with women having a higher prevalence of asthma than men. Living below the poverty threshold, obesity, and prior history of smoking remain important determinants of asthma. Our study also adds to the increasing evidence that health care workers (HCWs) and those employed in education remain at high risk and that appropriate evaluation and control measures need to be implemented. Over 78% of HCWs and 71% of teachers in our study were females suggesting that further exploration of gender-specific risk factors of asthma in working populations is needed. ^ Our study also addressed the feasibility of adapting a population-based asthma-specific JEM to NHANES (1999-2004). We were not able to apply the asthma-specific JEM due to the broad occupational categories within NHANES. This represents a missed opportunity to examine the association between workplace exposures and asthma in U.S. working adults. However, we have identified steps that may be implemented in future population-based studies that would allow the asthma-specific JEM (and other population-based job exposure matrices) to be used in future studies of the U.S. working population.^

Patient satisfaction in government health facilities in the state of Qatar

This study provides data which can contribute to improving services and delivering quality health care in government health facilities in the state of Qatar. To measure the satisfaction with current care of selected patients who receive care in Hamad General Hospital and the Khalifa Town Health Center in the city of Doha, a cross-sectional survey and a self-administered questionnaire were used.^ Analysis was performed on data from 444 patients on eight dimensions of patient satisfaction with medical care. These include: general satisfaction, availability of services, convenience of services, facilities, humaneness of doctors, quality of care, continuity of care, and aspects of the last visit. Patient satisfaction parameters were compared for males vs. females, for citizens vs. non-citizens, and for patients seen in the hospital vs. those seen in the health center.^ Results indicate that patients seen in the hospital were more satisfied with care than patients seen in the health center, that non-citizens were more satisfied than citizens, and that males were slightly more satisfied than females with medical services. ^

LIFE SATISFACTION: A COMPARISON OF RETIRED AND EMPLOYED WOMEN

This research addressed the question of life satisfaction for retired and employed women with long-term employment in a typically female occupational setting. Questions of how women's retirement is related to life satisfaction have been largely neglected because of cultural assumptions about the relative unimportance of the work role in women's lives. It is generally believed that the major source of satisfaction for women is in traditional family roles. Therefore, it follows that retirement from work is not experienced as a loss for women.^ The actual consequences of women's retirement have not been examined systematically. Descriptive data about their lives are inadequate. It is not known what patterns and resources result from a lifetime of work for women.^ The objectives of the study were to test assumptions from role and continuity theory regarding life satisfaction for retired women and women employed late in life and to describe the retirement and work experiences of the women.^ Life satisfaction was measured by the Neugarten, Havighurst and Tobin Life Satisfaction Index. Perceptions of appropriate roles for females and males were assessed through an attitudinal sex-role instrument. A composite index, derived from perceptions of health, social participation, and income at two time periods, measured level of continuity. These indices and demographic information, attitudinal items about work and retirement, and social network data comprised the mailed, self-administered survey and the personal interviews.^ The study population included 91 retired and 53 employed women, 55 years or older with a minimum of 20 years continuous employment, who were enrolled in the pension program of a large retail store.^ The retired women's perceptions of their health and social participation were more positive than the employed women's. Traditional retired women demonstrated higher life satisfaction than nontraditional retired women. Both retired and employed women who perceived continuity in life patterns scored statistically higher on life satisfaction than women who perceived discontinuity. Financial planning was the area of greatest retirement concern for retired and employed women.^

ASSOCIATIONS AND INTERRELATIONSHIPS OF SOCIOECONOMIC STATUS, BEHAVIORAL FACTORS AND BIOLOGICAL FACTORS WITH BIRTH WEIGHT

Although the influences of socioeconomic, behavioral and biological factors on birth weight have been extensively studied, most studies have been limited to clinical populations. This study examines such relationships in a national probability sample, the National Health and Nutrition Examination Survey of 1971-1974. The study sample consisted of 2161 white children and 812 black children, aged 1 to 5 years. Analyses were performed on a subsample consisting of 753 white and 138 black children whose mothers were also selected into the survey. Detailed analyses examined interrelationships among socio-economic, behavioral and biological factors by means of multiple regression and partial correlation procedures in the white population. These analyses were not carried out among blacks because of an observed clustering bias introduced in the black subsample that hampered generalization to the US population.^ The results among the whites indicated that the biological factors of maternal height, maternal weight, maternal size (weight/height('2)), maternal age and sex of child were independently related to birth weight and were also interrelated with socioeconomic factors such as family income, education of the mother and education of the head of the household. The joint effect was significantly associated with birth weight.^ Mothers' dietary practices represented the behavioral factors. Selected nutrients from the mothers' 24-hour dietary recall were used to develop indices of dietary quality. Dietary quality was significantly interrelated with socioeconomic status, biological factors and birth weight.^ The findings of this study suggest that smaller, younger mothers of lower socioeconomic status and female children were significantly associated with lower birth weight. The findings also suggest that dietary quality is a mediating factor among socioeconomic status and biological factors in that mothers with more financial and educational resources have better dietary practices. Such mothers may also practice other health behaviors that would prevent having a low birthweight baby. This dissertation contributes primarily to the further conceptualization and empirical testing of the interrelationships among socioeconomic, behavioral and biological factors with respect to birth weight. ^

AN ECONOMIC ANALYSIS OF THE DEMAND FOR CARE IN A FREE-STANDING EMERGENCY CENTER

Free-standing emergency centers (FECs) represent a new approach to the delivery of health care which are competing for patients with more conventional forms of ambulatory care in many parts of the U.S. Currently, little is known about these centers and their patient populations. The purpose of this study, therefore, was to describe the patients who visited two commonly-owned FECs, and determine the reasons for their visits. An economic model of the demand for FEC care was developed to test its ability to predict the economic and sociodemographic factors of use. Demand analysis of other forms of ambulatory services, such as a regular source of care (RSOC), was also conducted to examine the issues of substitution and complementarity.^ A systematic random sample was chosen from all private patients who used the clinics between July 1 and December 31, 1981. Data were obtained by means of a telephone interview and from clinic records. Five hundred fifty-one patients participated in the study.^ The typical FEC patient was a 26 year old white male with a minimum of a high school education, and a family income exceeding $25,000 a year. He had lived in the area for at least twenty years, and was a professional or a clerical worker. The patients made an average of 1.26 visits to the FECs in 1981. The majority of the visits involved a medical complaint; injuries and preventive care were the next most common reasons for visits.^ The analytic results revealed that time played a relatively important role in the demand for FEC care. As waiting time at the patients' regular source of care increased, the demand for FEC care increased, indicating that the clinic serves as a substitute for the patients' usual means of care. Age and education were inversely related to the demand for FEC care, while those with a RSOC frequented the clinics less than those lacking such a source.^ The patients used the familiar forms of ambulatory care, such as a private physician or an emergency room in a more typical fashion. These visits were directly related to the age and education of the patients, existence of a regular source of care, and disability days, which is a measure of health status. ^

Association between length of stay in the U.S. and diabetes risk factors among Chinese Americans in Houston, Texas in 2004-2005

Studies have suggested that acculturation is related to diabetes prevalence and risk factors among immigrant groups in the United States (U.S.), however scant data are available to investigate this relationship among Asian Americans and Asian American subgroups. The objective of this cross-sectional study was to examine the association between length of stay in the U.S. and type 2 diabetes prevalence and its risk factors among Chinese Americans in Houston, Texas. Data were obtained from the 2004-2005 Asian-American Health Needs Assessment in Houston, Texas (N=409 Chinese Americans) for secondary analysis in this study. Diabetes prevalence and risk factors (overweight/obesity and access to medical care) were based on self-report. Descriptive statistics summarized demographic characteristics, diabetes prevalence, and reasons for not seeing a doctor. Logistic regression, using an incremental modeling approach, was used to measure the association between length of stay and diabetes prevalence and related risk factors, while adjusting for the potential confounding factors of age, gender, education level, and income level. Although the prevalence of type 2 diabetes was highest among those living in the U.S. for more than 20 years, there was no significant association between length of stay in the U.S. and diabetes prevalence among these Chinese Americans after adjustment for confounding factors. No association was found between length of stay in the U.S. and overweight/obese status among this population either, after adjusting for confounding factors, too. On the other hand, a longer length of stay was significantly associated with increased health insurance coverage in both unadjusted and adjusted models. The findings of this study suggest that length of stay in the U.S. alone may not be an indicator for diabetes risk among Chinese Americans. Future research should consider alternative models to measure acculturation (e.g., models that reflect acculturation as a multi-dimensional, not uni-dimensional process), which may more accurately depict its effect on diabetes prevalence and related risk factors.^

Professional Liability of the Construction Professional as an Expert Witness in the Spanish Legal Framework

Inside COBRA 2011 RICS International Research Conference, the present paper is linked to analyze the liability of the construction professional in his practice as a expert witness in the Spanish legal framework. In a large number of legal procedures related to the building it is necessary the intervention of the expert witness to report on the subject of litigation, and to give an opinion about possible causes and solutions. This field is increasingly importantly for the practice of construction professional that requires an important specialization. The expert provides his knowledge to the judge in the matter he is dealing with (construction, planning, assessment, legal, ...), providing arguments or reasons as the base for his case and acting as part of the evidence. Although the importance of expert intervention in the judicial process, the responsibilities arising from their activity is a slightly studied field. Therefore, the study has as purpose to think about the regulation of professional activities raising different aims. The first is to define the action of the construction professional-expert witness and the need for expert evidence, establishing the legal implications of this professional activity. The different types of responsibilities (the civil, criminal and administrative) have been established as well as the economic, penal or disciplinary damages that can be derived from the expert report

PROFILE AND THE QUALITY OF LIFE OF LOGGERS

RESUMO – Objetivou-se com este estudo caracterizar o perfil e avaliar o nível de satisfação que reflete na qualidade de vida no trabalho (QVT) de trabalhadores da colheita de madeira de duas contratadas (C1 e C2), por duas grandes empresas do setor florestal, sendo uma do segmento de papel e celulose (PC) e, a outra, do segmento de carvão vegetal (CV). A avaliação ocorreu a partir da percepção dos trabalhadores das contratadas em questão, utilizando um modelo pré-concebido que contempla 11 blocos ou dimensões referentes a variáveis intervenientes e definidores da QVT, englobando 48 trabalhadores em três categorias funcionais: operador de motosserra (7 trabalhadores da C1 PC e 10 da C2 CV), ajudante de motosserrista (7 trabalhadores da C1 PC e 8 da C2 CV) e operador de carregador florestal (11 trabalhadores da C1 PC e 5 da C2 CV). Os dados referentes às variáveis intervenientes na QVT foram obtidos a partir de escala fechada do tipo Likert, com os escores variando de 1 a 7, em que 1 correspondeu ao nível "bastante insatisfeito" e 7, ao nível "bastante satisfeito". O perfil dos trabalhadores é de pessoa jovem, baixo nível de escolaridade e pouco tempo de serviço na empresa. Quanto ao nível de satisfação no trabalho, constatou-se que os trabalhadores da C1 PC se encontravam "satisfeitos" e os da C2 CV, "mediamente satisfeitos" com o trabalho e as condições proporcionadas pelas respectivas empresas, apesar de estatisticamente não ter sido detectada diferença entre os valores médios encontrados nas duas situações, pelo teste de Mediana (P>0,01). Os fatores que mais contribuíram para esses resultados favoráveis foram os benefícios extras oferecidos pelas prestadoras de serviços, as condições de segurança no trabalho e o contentamento com o emprego formal. ABSTRACT – The objective of this study was to characterize profile and satisfaction level, which reflects the quality of life (QOL) of forest workers of two contracts for harvest activities, one in the pulp and paper industry (PI) and another in charcoal industry (CI). The evaluation of the satisfaction indexes was carried out according to the workers perception by using a model including 11 parameters to reflect these workers QOL. The group study of 48 workers encompassed three functional categories: chainsaw operators (7 from C1 and 10 from C2), chainsaw operator's assistant (7 from C1 and 8 from C2), and log loader operators (11 from C1 and 5 from C2). Data regarding the factors involved in QOL were collected from a closed, Likert-type scale with scores ranging from 1-7, in which level 1 corresponded to "very dissatisfied" and level 7 to "very satisfied". The general profile of the group shows that most of them are young, with low level of education and employed in the companies for a short time. Overall, the employees of contractors of the paper and pulp industry are "satisfied" and those working for the charcoal company are only "moderately satisfied" with the work and policies offered by the respective companies, although no significant statistical difference was detected between the two groups, for the median test (P> 0.01). The main reasons behind these results are the general beneficts offered by the companies, the safety measurements and the overall satisfaction for been employed.

The lexical needs of ESP students in a professional field

This paper examines two kinds of questions relating to the lexical needs of professional ESP students: (1) what range of terms and words do they need help with? (2) what types of dictionary, bilingual and/or monolingual, can they make use of in solving lexical problems?

Justice, emotions and satisfaction in complaint behavior in services

This study proposes a marketing approach to service recovery (SR) models in order to help to explain what factors affect cumulative satisfaction, loyalty and word-of-mouth following complaint behavior. The model has its base on the definition of perceived justice and its influence on satisfaction with service recovery (SSR) and on emotions (positive and negative). Trust acts as a central construct in the model, receiving influence from the affective and cognitive aspect and mediating the relationship between SSR and cumulative satisfaction and between positive/negative emotions and loyalty. The sample for this study consists of 303 Spanish B2C-EC users who made a complaint after an electronic transaction. Results from the analysis show the influence of perceived justice ?mainly interactional justice and procedural justice? on SSR, and the relevance of positive emotions as a key factor in SSR processes, in contrast to the major role which negative emotions have traditionally played in these models. Furthermore, trust mediates the relation between SSR and cumulative satisfaction, and is the factor which has a higher influence on loyalty, whilst cumulative satisfaction becomes the more relevant factor affecting WOM.

Bem-estar subjetivo e bem-estar no trabalho em profissionais de educação física

Atualmente, bem-estar cada vez mais ganha espaço como parte importante e integrante da vida das pessoas. Pesquisas vêm buscando destacar fatores positivos que exerçam influencia em sua vida pessoal, e conseqüentemente em seu trabalho. O objetivo deste estudo foi verificar as relações entre bem-estar subjetivo (satisfação geral com a vida, afetos positivos e afetos negativos) e bem-estar no trabalho (satisfação no trabalho, envolvimento com o trabalho e comprometimento organizacional afetivo) em professores de educação física que atuavam em escolas e academias, descrevendo os níveis de bem-estar subjetivo e bem-estar no trabalho, análises de variância e correlação entre os construtos. A amostra foi composta por 124 professores de educação física, 34 atuavam em escolas particulares e 90 atuavam em academias, sendo 81 do sexo masculino e 43 do sexo feminino, solteiros e casados e faixa etária entre 21 e 59 anos, com escolaridade distribuída desde o ensino superior completo até o mestrado concluído. O instrumento de coleta foi um questionário auto-aplicavel composto por cinco escalas que mediram as variáveis do estudo e um questionário de dados complementares. Os resultados deste estudo revelaram que BES e BET guardam relações entre si. Os professores são considerados pessoas relativamente felizes com sua vida pessoal e revelaram uma relação mediana no que se refere a sua vida profissional. Os resultados das correlações relacionadas ao BES sinalizaram que o acúmulo de experiências negativas ao longo da vida poderia reduzir a vivencia de experiências positivas e de avaliações positivas sobre a vida em geral e vice-versa e ao BET, satisfação no trabalho, envolvimento com o trabalho e comprometimento organizacional afetivo são interdependentes. No que se refere às comparações, para BES os professores que atuavam em academias obtiveram médias significativamente maiores de afetos negativos do que os de escolas e por outro lado, a média de satisfação geral com a vida dos professores de escolas foi significativamente superior à dos que atuavam em academias demonstrando que estes vivenciaram mais experiências negativas do que os que trabalhavam em escolas e que os professores de escola eram mais satisfeitos com sua vida do que os de academias. Para BET, o quadro geral se mantém semelhante para professores de educação física que atuavam em escolas e academias. Futuros estudos deveriam aumentar o número de professores bem como, investigar outras áreas de atuação da educação física e compara-las com o presente estudo ampliando os estudos envolvendo bemestar e professores de educação física.(AU)

Bem-estar subjetivo e bem-estar no trabalho em profissionais de educação física

Atualmente, bem-estar cada vez mais ganha espaço como parte importante e integrante da vida das pessoas. Pesquisas vêm buscando destacar fatores positivos que exerçam influencia em sua vida pessoal, e conseqüentemente em seu trabalho. O objetivo deste estudo foi verificar as relações entre bem-estar subjetivo (satisfação geral com a vida, afetos positivos e afetos negativos) e bem-estar no trabalho (satisfação no trabalho, envolvimento com o trabalho e comprometimento organizacional afetivo) em professores de educação física que atuavam em escolas e academias, descrevendo os níveis de bem-estar subjetivo e bem-estar no trabalho, análises de variância e correlação entre os construtos. A amostra foi composta por 124 professores de educação física, 34 atuavam em escolas particulares e 90 atuavam em academias, sendo 81 do sexo masculino e 43 do sexo feminino, solteiros e casados e faixa etária entre 21 e 59 anos, com escolaridade distribuída desde o ensino superior completo até o mestrado concluído. O instrumento de coleta foi um questionário auto-aplicavel composto por cinco escalas que mediram as variáveis do estudo e um questionário de dados complementares. Os resultados deste estudo revelaram que BES e BET guardam relações entre si. Os professores são considerados pessoas relativamente felizes com sua vida pessoal e revelaram uma relação mediana no que se refere a sua vida profissional. Os resultados das correlações relacionadas ao BES sinalizaram que o acúmulo de experiências negativas ao longo da vida poderia reduzir a vivencia de experiências positivas e de avaliações positivas sobre a vida em geral e vice-versa e ao BET, satisfação no trabalho, envolvimento com o trabalho e comprometimento organizacional afetivo são interdependentes. No que se refere às comparações, para BES os professores que atuavam em academias obtiveram médias significativamente maiores de afetos negativos do que os de escolas e por outro lado, a média de satisfação geral com a vida dos professores de escolas foi significativamente superior à dos que atuavam em academias demonstrando que estes vivenciaram mais experiências negativas do que os que trabalhavam em escolas e que os professores de escola eram mais satisfeitos com sua vida do que os de academias. Para BET, o quadro geral se mantém semelhante para professores de educação física que atuavam em escolas e academias. Futuros estudos deveriam aumentar o número de professores bem como, investigar outras áreas de atuação da educação física e compara-las com o presente estudo ampliando os estudos envolvendo bemestar e professores de educação física.(AU)

Use of model plant hosts to identify Pseudomonas aeruginosa virulence factors

We used plants as an in vivo pathogenesis model for the identification of virulence factors of the human opportunistic pathogen Pseudomonas aeruginosa. Nine of nine TnphoA mutant derivatives of P. aeruginosa strain UCBPP-PA14 that were identified in a plant leaf assay for less pathogenic mutants also exhibited significantly reduced pathogenicity in a burned mouse pathogenicity model, suggesting that P. aeruginosa utilizes common strategies to infect both hosts. Seven of these nine mutants contain TnphoA insertions in previously unknown genes. These results demonstrate that an alternative nonvertebrate host of a human bacterial pathogen can be used in an in vivo high throughput screen to identify novel bacterial virulence factors involved in mammalian pathogenesis.