Understanding Social Support Burden Among Family Caregivers

Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network, and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving. Using qualitative thematic analysis, we found that caregivers providing hospice care experience social support burden resulting from perceived relational barriers between friends and family, the inclination to remain in control, recognition of the loss of the patient as a source of social support and guidance in decision making, family dynamics, and decreased availability of emotional support. Social support researchers should consider how the quality of communication and relationships within social networks impacts the provision and subsequent outcomes of social support in varying contexts. Findings from this study suggest that hospice social support resources should be tailored to the caregiver’s support needs and include assessment on the type of support to be offered.     

Evidence That Self-Incentives Increase Fruit Consumption: A Randomized Exploratory Trial Among High-Risk Romanian Adolescents

High mortality rates associated with cancer and cardiovascular disease in Romania have been partly attributed to low fruit consumption. The aim of the present research was to test whether self-incentives delivered via implementation intentions could increase fruit consumption among 238 high-risk Romanian adolescents. Participants were randomly allocated to either: (1) a control condition (asked to plan to increase their fruit intake but given no further instruction), (2) a standard implementation intention condition (asked to form an implementation intention using standard open-ended instructions), or (3) a self-incentivizing implementation intention condition (asked to reward themselves at the end of the week if they had successfully consumed an extra portion of fruit each day). There were significant increases in fruit consumption in the self-incentivizing implementation intention condition, but not in the control condition or—contrary to predictions—in the standard implementation intention condition. The findings support the use of implementation intentions to deliver self-incentives and increase fruit consumption, and suggest that providing children with a structured prompt might enhance the effectiveness of implementation intention-based interventions compared with standard implementation intention instructions.     

The Theory of Social Systems as a Framework for Understanding Family Businesses

There is a long tradition of systemic approaches in family business research, but recent developments have been widely ignored. This article gives a brief overview of these approaches and models and then introduces the modern theory of social systems. This theory no longer considers individuals as parts of the system but assumes that the basic elements of a social system are acts of communication. In each system (family, business, ownership), a specific communication pattern evolves and each system operates within a specific functional logic. Families process relationship communication, businesses process decision communication, and ownership operates on the basis of legally secured communication. Each of these three structurally coupled systems provides a specific context. The functional logics are context markers and assign meaning to the communicative acts. To understand how a family business functions, it is important to understand the concrete functional logics and the structural coupling of the three systems.     

Social Determinants and Health Service Use Among Racial and Ethnic Minorities: Findings From a Community Sample

Multiple models conceptualizing the relationship between social determinants and health exist, but little research has examined the relationship between social determinants and health service use. Using previously collected survey data from racial and linguistic minorities from high-crime communities in a Midwestern urban area, this study uses the Commission on Social Determinants of Health framework to test the structural and intermediary determinants of health service use. The results indicate that perceived discrimination and neighborhood cohesion increase the likelihood of a person using health services. Implications for social work practice, advocacy, and research to address intermediary social determinants are discussed.     

A Conceptual Framework for Understanding the Relationship Between Poverty and Antisocial Behavior: Focusing on Psychosocial Mediating Mechanisms

This paper presents a framework that integrates and extends the literature on psychosocial mechanisms mediating poverty and the development of antisocial behavior. It provides a model to explain why some poor children outgrow early antisocial behavior, while others from the same environment adopt increasingly severe antisocial behaviors. The ability to differentiate these effects of poverty on antisocial or prosocial behavior provides theoretical guidelines for preventive intervention.     

A Preliminary Study of Social Issues in AIDS Prevention Among Adolescents

Educational efforts to prevent the spread of AIDS require a combination of accurate information and the application of that information to personal behavior. In this preliminary study, a scale was developed to evaluate the social and interpersonal skills of adolescents in AIDS-related and non-AIDS-related interactions. The instrument was administered to 101 Australian students in grades 10 and 11 of an urban high school. Findings indicate ratings of AIDS-related activities of the adolescents were not significantly different from their other social activities, suggesting levels of comfort and assertiveness among adolescents in AIDS-related activities can be modified. Students felt most anxious about problems with sexually transmitted diseases or drug use, suggesting difficulty in dealing with the possible public disclosure of these stigmatized conditions. Data suggest both individual and group scores among adolescents may improve on the five dimensions of the scale following interventions to promote social and interpersonal skills designed to apply knowledge obtained from AIDS education.     

Patterns of Illness Behavior Among Rural Elderly: Preliminary Results of a Health Diary Study

This paper summarizes the responses of rural elderly people to a variety of symptoms experienced during a three-week period. Responses to symptoms included causal attributions, consultation patterns, and intervention strategies. Data recorded in diaries during a three-week period highlight the importance of lay care in the illnesses of older people. Most symptoms were managed by older respondents themselves. When symptoms were discussed with someone else, the consultant was most likely a family member or friend rather than a health care professional. Only one third of the respondents contacted any formal provider about any of their symptoms. The majority of respondents combined medical and nonmedical explanations in interpreting their symptoms. The most frequent response to a symptom was doing nothing. The next two most commonly reported interventions were over-the-counter medications and activity limitation. Analyses revealed few differences among residential categories in patterns of illness behavior. Rural-urban differences often disappeared when controlling for demographic and socioeconomic background which covary with residence.     

Heterosexual Anal Intercourse: An Understudied, High-Risk Sexual Behavior

Differences between heterosexuals who have or have not engaged in anal intercourse were analyzed. Though anal intercourse is widely recognized as an activity that greatly increases the risks for HIV transmission, it has received little attention in heterosexual populations. A questionnaire was mailed to a random sample of university students, a population in which many people engage in vaginal intercourse with several partners each year. The three largest minorities were randomly oversampled in order that all four major ethnic/racial groups could be statistically evaluated for possible differences. Almost 23% of nonvirgin students had engaged in anal intercourse. Regression analysis indicated that people who had participated in anal intercourse were more likely than people without anal experience to have been younger at first vaginal intercourse, to be older when the data were collected, to have engaged in vaginal intercourse in the last three months before data collection, to be more erotophilic, to use less effective contraceptive methods, and to have used no condom at last coitus. Overall, people who engage in anal intercourse take more sexual risks when engaging in vaginal intercourse than do people without anal experience. No major ethnic/racial differences were detected. Sexologists have not explored anal sex in much detail, hence we have been weak in educating those 20 to 25% of young adults who are not reluctant or (inhibited about) exploring anal intercourse. As young adults use condoms less for anal than vaginal intercourse, they have not learned enough about the risk of anal sex.     

Social Skills Training for Drug Prevention in High-Risk Female Adolescents

Background.The effectiveness of social skills training/social network restructuring in the primary and secondary prevention of drug use was examined in a multiethnic cohort of 296 female adolescents ages 14 to 19 years who were pregnant or parenting and/or at risk for drug use.Methods.Subjects were randomly assigned to one of two conditions: (a) PALS Skills Training or (b) a control intervention involving no skills training. PALS Skills Training is a combination of cognitive and behavioral techniques to improve social skills and to restructure the teens' social network. All students also participated in a 16-week normative education “Facts of Life” course.Results.The prevalence of alcohol and any drug use increased significantly over the three assessment periods in the PALS Skills group but not in the No Skills group. Teens in the PALS Skills group who reported no drug use at baseline were 2.9 times as likely to be using marijuana than teens in the No Skills group at 3 months postintervention. PALS Skills Training was no more effective in the secondary prevention of drug use than the control intervention.Conclusions.Social skills training was found to be ineffective as a means of primary prevention among non-drug-using high-risk adolescents and may even be counterproductive as a means of primary prevention of marijuana use in this population. When combined with normative information on drug use prevalence, acceptability, and hazards, social skills training is no more effective as a means of secondary prevention than normative education alone.     

Understanding and Diagnosing Antimicrobial Resistance on Social Media: A Yearlong Overview of Data and Analytics

To better understand user conversations revolving around antibiotics and antimicrobial resistance (AMR) on Twitter, we used an online data collection and analysis toolkit with full firehose access to collect corpuses of tweets with “antibiotic” and “antimicrobial resistance” keyword tracks. The date range included tweets from November 28, 2015, to November 25, 2016, for both datasets. This yearlong date range provides insight into how users have discussed antibiotics and AMR and identifies any spikes in activity during a particular time frame. Overall, we found that discussions about antibiotics and AMR predominantly occur in the United States and the United Kingdom, with roughly equal gender participation. These conversations are influenced by news sources, health professionals, and governmental health organizations. Users will often defer to retweet and recirculate content posted from these official sources and link to external articles instead of posting their own musings on the subjects. Our findings are important benchmarks in understanding the prevalence and reach of potential misinformation about antibiotics and AMR on Twitter.     

Symbolic Interactionism: A Framework for Understanding Risk-Taking Behaviors in Farm Communities

ABSTRACT

Risk behaviors are key drivers of occupationally related injuries and illnesses, considerably impacting the uptake and success of injury interventions, technologies, and practices. This is certainly true in the agricultural sector, where farmers often ignore recommended safety practices or have even been known to disable safety technologies. Although research studies have characterized specific individual safety or risk behaviors, few studies have thoroughly examined farmers’ risk and safety orientations or how these develop in response to environmental and societal exposures. This study utilizes data collected over the past decade with a variety of small to midsize farm personnel to explore the meanings that farmers ascribe to risk and safety and how these influence risk and safety behaviors. In all, over 90 interviews with farmers, farm-wives, and family members were reviewed. Researchers used a grounded theory approach to identify patterns of environmental and societal exposures, as well as their impact on farmers’ risk and safety orientations. Analysis revealed exposures and orientations to risk and safety, which could be largely explained through the lens of symbolic interactionism. This framework posits that people create a sense-of-self as a way of adjusting and adapting to their environment. For farmers in this study, belief in their ability to persevere allows them to succeed, despite the considerable stressors and challenges they face each day. However, this identity can, at times, be maladaptive when it is applied to safety decisions and hazard exposures. The authors discuss the implications of this research and how it may be used to productively inform future farm safety efforts.     

Screening for Intestinal Parasitic Infections Among Myanmar Migrant Workers in Thai Food Industry: A High-Risk Transmission

The impact of intestinal parasitic infections on public health has been neglected. Millions of Myanmar natives have migrated to work in Thailand. We performed a study of intestinal parasitic infections in Myanmar-migrants working in the Thai food industry. A total of 338 Myanmar migrant workers in a food plant at Samut Sakhon Province, Thailand, were recruited for this study. 284 (84%) returned requested stool samples. Samples were examined for intestinal parasites by means of simple smear, formalin-ether concentration, Locke-Egg-Serum medium, and Harada-Mori culture methods. We found parasites in 177 (62.3%) migrants (29 of 46 males; 148 of 238 females). The majority (89.3%) were infected with parasites transmitted by fecal-oral route, including Blastocystis hominis (41.5%), Trichuris trichiura (22.2%), Giardia lamblia (14.1%), and Ascaris lumbricoides (1.8%). Mixed infections were common (40.7%). The highest prevalence (73.3%) was found among migrants from Kohsong city, Myanmar. This high parasite infection rate in Myanmar migrant workers is an obvious public health hazard.     

Understanding the Critical Role of Social Work in Safety Net Medical Settings: Framework for Research and Practice in the Emergency Department

Social workers in Emergency Departments (ED) provide counseling, community resource linkage, and discharge planning. The ED is a critical intervention point for patients with multiple unmet medical, psychological, and social needs, and little or no other contact with service providers. In part because of its role as a medical safety net for underserved populations, use of the ED has steadily increased over time. There is limited research examining the utility of social services in the ED. This article provides a brief history of hospital social work and a literature review of ED social work research with the goal of advancing current research and practice agendas.     

Evidence of Increasing Coronary Heart Disease Mortality Among Black Men of Lower Social Class

PURPOSE: Few data are available to examine coronary heart disease (CHD) mortality trends by social class in the United States, in contrast to ample data and well-documented social class disparities in CHD in Europe. In addition, previous analyses of U.S. national data indicated that the rate of decline in CHD mortality slowed substantially for blacks in the 1980s. Using a recently published method for calculating mortality rates by social class, we examined trends in CHD mortality for black men and white men aged 35–54 in North Carolina from 1984 to 1993.

METHODS: Men were assigned to one of four social classes: primary white collar (I), secondary white collar (II), primary blue collar (III), or secondary blue collar (IV), based on usual occupation as recorded on the death certificate. Population denominators for each social class were constructed using data from census Public Use Microdata Sample files. Average annual percent change in mortality rates for each race–social class group was derived from linear regression of the log-transformed age-adjusted rates.

RESULTS: For black men, CHD mortality increased by 18% in social class II, by 2% in social class III, and by 6% in social class IV over the 10-year study period. In contrast, CHD mortality decreased by 33% for black men in social class I (the highest class). CHD mortality declined for all white men, with the greatest decline in social class I and the least decline in social class IV.

CONCLUSIONS: These results suggest that CHD prevention efforts have not benefited black men of lower social class, and that public health programs need to be targeted to these men.