Vol 6-1 Original Research Article

Racial Disparities in Occupational Distribution Among Black and White Adults with Similar Educational Levels: Analysis of Middle-Aged and Older Individuals in the Health and Retirement Study

Shervin Assari1,2,3,4*, Hossein Zare5,6, Amanda Sonnega7

1Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

2Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

3Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

4Marginalization-Related-Diminished Returns (MDRs) Center, Los Angeles, CA, USA.

5Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.

6School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, 20774, USA.

7Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.

Background: Occupational classes play a significant role in influencing both individual and population health, serving as a vital conduit through which higher education can lead to better health outcomes. However, the pathway from education to corresponding occupational classes does not apply uniformly across different racial and ethnic groups, hindered by factors such as social stratification, labor market discrimination, and job segregation.

Aims: This study seeks to investigate the relationship between educational attainment and occupational classes among Black, Latino, and White middle-aged and older adults, with a focus on their transition into retirement.

Methods: Using cross-sectional data from the Health and Retirement Study (HRS), this research examines the impact of race/ethnicity, educational attainment, occupational classes, and timing of retirement among middle-aged and older adults. The analysis includes a sample of 7,096 individuals identified as White, Black, or Latino. Through logistic regression, we assess the additive and multiplicative effects of race/ethnicity and education on six defined occupational classes: 1. Managerial and specialty operations, 2. Professional Specialty, 3. Sales, 4. Clerical/administrative support, 5. Services, and 6. Manual labor.

Results: Participants were Black (n = 1,143) or White (n =5,953). This included Latino (N =459) or non-Latino (n = 6,634). Our analysis reveals a skewed distribution of Black and Latino adults in manual and service occupations, in stark contrast to White adults who were more commonly found in clerical/administrative and managerial positions. Educational attainment did not equate to similar occupational outcomes across racial groups. Key findings include: Firstly, Black individuals with a college degree or higher were less likely to occupy clerical and administrative positions compared to their White counterparts. Secondly, holding a General Educational Development (GED) credential or some college education was generally linked to reduced likelihood of being in managerial roles; however, this inverse relationship was less evident among Black middle-aged and older adults than White ones. Thirdly, having a GED reduced the chances of working in sales roles, while having a college degree increased such chances. An interaction between race and some college education revealed that the impact of some college education on sales roles was more significant for Black adults than for White ones. We did not observe any interaction between ethnicity (Latino) and educational attainment on occupational classes. Given the stability of occupational classes, these findings could also apply to the last occupation held prior to retirement.

Conclusion: This study highlights significant racial disparities in occupational classes among individuals with comparable levels of education, underscoring the profound implications for health and wellbeing disparities. Future research should explore strategies to alleviate labor market discrimination and job segregation as ways to close these occupational gaps. Additionally, the influence of social stratification, job segregation, and historical legacies, such as the repercussions of the Jim Crow era, on these disparities merits further investigation. Addressing these issues is crucial for enhancing the health and wellbeing of all populations.

DOI: 10.29245/2767-5122/2024/1.1141 View / Download Pdf
Vol 5-2 Original Research Article

Highly Educated Black Americans Report Higher than Expected Perceived Job Demands

Tiffany Hogan 1, Amy Mancia1, Kanah Ndiaye1, Brenda Rodriguez1, Babak Najand 2, Hossein Zare 3,4, Shervin Assari 1 5,6*

1Department of Urban Public Health, Charles R. Drew University of Medicine, Los Angeles, California, United States

2Marginalization-related Diminished Returns Center, Los Angeles, California, United States

3Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.

4School of Business, University of Maryland Global Campus (UMGC), Adelphi, 20783, USA.

5Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States

6Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States

Background: Educational attainment has well established and widely recognized the effects on employment conditions and job demands. However, the way in which educational attainment correlates with perceived job demands may be inconsistent across racial groups as suggested by Minorities’ Diminished Returns (MDRs). The aim was to test the moderating effect of race on the association between educational attainment and perceived job demands, particularly for Black and White individuals.

Methods: This study was a cross-sectional analysis of MIDUS Refresher 1, including 1,232 Black and White adults over the age of 25 in the United States. Education attainment was the independent variable and perceived job demands was the dependent variable covariates. Linear regression was used for multivariate models.

Results- We observed positive association between education and perceived job demands, however, statistical interaction between race and education suggested stronger positive associations for Black than White individuals.

Conclusion: Being a highly educated Black professional in the United States equals high demand such increase stress is a risk factor of being a middle class black American. Innovated and bold market policies are required to solve this unfair dilemma.

DOI: 10.29245/2767-5122/2024/2.1138 View / Download Pdf
Vol 5-2 Review Article

Potential Therapeutic Effects of Passive Limb Movement in Patients with Spinal Cord Injuries

Song-Young Park1,2*, Andres Benitez-Albiter1*, Cody P. Anderson1, Sungyeon Kim3, Young-hwan An3, Sang-Seo Park4*, Jung-Hyun Kim5

1School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska

2Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska

3Department of Training Support Center, Korea Paralympic Committee, Republic of Korea

4Department of Physiology, KyungHee University, Republic of Korea

5Department of Sports Medicine, Kyung-Hee University, Yongin, Korea

Spinal cord injuries (SCI) lead to significant changes in autonomic function, hemodynamics, and body composition. These structural and functional alterations are closely associated with the development of cardiovascular pathologies and other metabolic diseases. Recent clinical studies suggest that passive limb movement (PLM) has beneficial effects on cardiovascular function and skeletal muscle health, which has drawn a growing interest for the use of PLM as a therapeutic option for patients with SCI. However, there is a lack of mechanistic studies that examine the underlying mechanisms of how PLM may ameliorate cardiovascular and skeletal muscle function in patients with SCIs. In this review, we will discuss potential mechanisms of SCI-induced perturbations in autonomic function, hemodynamics, and body composition. Furthermore, we will highlight the therapeutic effects of PLM on autonomic function, vascular structure and function, and skeletal muscle in patients with SCIs. Additionally, we will also introduce the effects of other passive therapeutic interventions such as vibration and massage therapy with potential benefits and concerns for cardiovascular and skeletal muscle adaptations in SCI. Therefore, optimizing the application of PLM in patients with SCIs may be useful to salvage SCI-induced attenuations in vascular function and body composition.

DOI: 10.29245/2767-5122/2024/2.1139 View / Download Pdf
Vol 5-2 Original Research Article

Psychoanalytic and Sociobiological Factors in Attitudes toward Persons with Disabilities: Discussion Focused on Rehabilitation Counseling Profession

Kenneth Thomas1*, Jeong Han Kim2

1University of Wisconsin - Madison

2University of Texas – Rio Grande Valley

This study's goal was to examine, expand upon, and update a chapter that was first printed in a relatively small number of copies of the book titled Essays and Research on Disability1.  Thomas was the sole author of the original chapter, which discussed how attitudes about disability develop from a psychoanalytic and sociobiological perspective.  Kin, reciprocal, and induced altruism were the first three altruism principles in sociobiology that were covered in this study. Then, Karen Horney's neo-Freudian viewpoint (i.e., less emphasis on sex and focused more on the social environment and culture regarding personality development) and traditional Freudian theories (such as castration anxiety, loss of love, and loss of the object) were tied to sociobiology, and this relationship was further addressed in terms of the evolution of attitude toward handicap. Then, recommendations were offered across a broad range of rehabilitation counseling services and educational practices that might be improved by using these insights, both clinically and politically.  Finally, the present study extends this discussion by addressing similar concerns in the areas of counseling service priorities, multicultural rehabilitation counseling, and identity politics.

DOI: 10.29245/2767-5122/2023/2.1135 View / Download Pdf
Vol 5-1 Original Research Article

Base for Physiotherapeutic Treatment Recommendations for Long COVID-19 Patients After Questioning Experienced Physiotherapists Using a Delphi Method

Chloé Schorderet1,2,3*, Roger Hilfiker4, Lara Allet1,2,5

1School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland

2The Sense Innovation & Research Center, Lausanne and Sion, Switzerland

3Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands

4School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Leukerbad, Switzerland

5Department of Community Medicine, University Hospitals and University of Geneva, Geneva, Switzerland

Background: Long COVID-19 is frequently observed in people who have contracted SARS-COV-2. It is characterized by a set of symptoms that can persist for months after infection and represents a challenge for all health care professionals. Among them, physiotherapists play an essential role thanks to their extensive knowledge in the rehabilitation field. To provide quality treatment, they need recommendations on which to rely. The aim of this study is to gather opinions from therapists working in Europe on the management of long COVID-19 patients in physiotherapy.

Method: A Delphi method was conducted in three rounds. In the first round, participants were asked about the deficits observed in long COVID-19 patients and about tests, monitoring and treatment to be implemented during the treatment of these patients. During the second and third rounds, they were informed about the results already obtained and had to confirm their answers with 6-point Likert scales.

Results: The most frequently observed impairments were pain, reduction in general physical fitness and respiratory problems. For assessment and treatment, the responses are specific to each impairment category. The 6-minute test seems to be particularly relevant for the assessment of several deficits and active approaches seem to have an essential place in the treatment.

Conclusion: Our study highlighted the diversity of impairments observed by physiotherapists in long COVID-19 patients and allowed to create a consensus on the assessments and treatments to be preferred for each type of impairment. In general, active treatment should be preferred for most of the impairments for which long COVID-19 patients consult a physiotherapist.

DOI: 10.29245/2767-5122/2021/1.1134 View / Download Pdf
Vol 5-1 Original Article

Association Between Multifidus Intramyocellular Lipids and Pain-Related Disorders, Lumbar Spine Dysfunction, Gait Disturbance in Patients with Chronic Low Back Pain: A Cross-Sectional Study Using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire

Izaya OGON1*, Hiroyuki TAKASHIMA2, Tomonori MORITA1, Mitsunori YOSHIMOTO1, Yasushi FUJITA3, Tsuneo TAKEBAYASHI4 and Atsushi TERAMOTO1

1Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan

2Faculty of Health Sciences, Hokkaido University, Sapporo, Japan

3Department of Orthopaedic Surgery, Nishioka Daiichi Hospital, Sapporo, Japan

4Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan

Background and aims: Fat degeneration in the multifidus muscle (Mm) was more common than in other trunk muscles. We hypothesised that the lipid contents of the Mm and patient-reported quality of life (QOL) are related. However, there are no papers examining the association between fatty degeneration of the Mm and patient-reported QOL using magnetic resonance spectroscopy (MRS). This cross-sectional study aimed to investigate the association between patient-reported QOL, evaluated with the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and the intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) contents of the Mm and psoas major (PM) by MRS in patients with chronic low back pain (CLBP).

Materials and Methods:

Forty-eight patients (mean age, 64.2 ± 13.2 years; age range, 41–79 years) with nonspecific CLBP underwent MRS for the quantification of IMCL and EMCL of the right Mm and PM in a volume of interest at L4/L5. All subjects underwent MRS and completed the JOABPEQ in the same day. We performed multiple linear regression analysis of the IMCL and EMCL contents of the Mm and PM with the five domains of the JOABPEQ adjusted for age, sex, and body mass index.

Results: The IMCL content of the Mm was correlated with pain-related disorders (standardised partial regression coefficient (β)=−0.59, p<0.01), lumbar spine dysfunction (β=−0.64, p<0.01), and social life dysfunction (β=−0.31, p<0.01) which showed moderate negative correlation, but not with psychological disorders. The EMCL content of the Mm was not correlated with the five domains of the JOABPEQ. The IMCL and EMCL contents of the PM was not correlated with the five domains of the JOABPEQ.

Conclusions: IMCL content of the Mm was significantly correlated with the pain-related disorders, lumbar spine dysfunction, gait disturbance, and social life dysfunction domain scores of the JOABPEQ. Future studies using magnetic resonance spectroscopy of the Mm in patients with CLBP may help optimize exercise strategies using IMCL as an index to enhance patient-reported quality of life.

DOI: 10.29245/2767-5122/2023/1.1133 View / Download Pdf
Vol 5-1 Case Report

A Single Session of Spinal Decompression with Oscillation and Videofluoroscopy

Richard E. Busch III D. C1*, Prahlad G Menon2, Sergey Leo Sorin, M.D., DABFM3

1Indiana University, Parker University, Dallas, TX

2Bioengineering, University of Pittsburgh, Pittsburgh, PA

3International Institute of Holistic Medicine, 2840 E. Chestnut Expy, Springfield, MO

Background: Computerized spinal decompression using the intervertebral differential dynamics (IDD) therapy protocol has achieved 86–92% positive results in reducing back pain. There are many causes of back pain, and one of the most common is a degenerative disc. The etiology of a degenerative disc is not completely understood, but it can be related to acute injuries, repetitive stress, nutrition, genetic factors, and oxidative stress1. Standard of care may include physical therapy or manipulation to introduce movement to the spinal vertebrae. IDD Therapy® uses a calculated, sinusoidal, logarithmic primary waveform to separate the spinal vertebrae. More recent studies have shown that the addition of a secondary waveform gives a significant increase in efficacy. We observed these effects on the spine during an IDD Therapy® session.

Methods: Images of the intervertebral space were taken by videofluoroscopy during the IDD Therapy® session.

Results: The expected separation of L5-S1 was achieved. We also noted the separation profile of the vertebrae was uniquely uniform despite the graduated pressures, particularly when the secondary oscillation waveform was introduced. L5-S1 separation was 1 mm in size, and the anterior–posterior correlation was significant (p<0.05).

Conclusion: Active oscillatory signaling introduced during the high-tension period of treatment may lead to more compliant muscle re-education and thus enhanced uniform separation of the vertebrae. We believe that IDD Therapy® using Accu-Spina® may achieve 92% positive results because the secondary oscillatory signal induces mechanotransduction of mechanical stimuli into electrochemical activity at the cellular level. Further research will lead to greater confidence and further exploration of mechanotransduction in intradiscal cellular tissues.

DOI: 10.29245/2767-5122/2023/1.1132 View / Download Pdf
Vol 5-1 Review Article

Object Relations Theory: A Primer for Rehabilitation Psychologists

Kenneth R. Thomas. DEd1*, Kaiqi Zhou,2 David A. Rosenthal, PhD3

1Professor Emeritus, Rehabilitation Psychology, University of Wisconsin-Madison

2Ph.D Candidate, Rehabilitation Psychology, University of Wisconsin-Madison

3Professor, Rehabilitation Psychology, University of Wisconsin-Madison

Object Relations (OR) has been identified as one of the four major schools of psychoanalysis1. This article provides a comprehensive review of OR practice and theory in the context of rehabilitation psychology. Extensive data are presented on five of the most prominent pioneer object relations theorists, including Melanie Klein, W. R. D. Fairbairn, Michal Balint, Harry Guntrip, and D. W. Winnicott. All of these individuals have contributed significantly to object relations theory. Melanie Klein and W. R. D Fairbairn have been credited with founding the object relations perspective, Michael Balint has been touted as the leading object relations theorist, Harry Guntrip was analyzed by both Fairbairn and Winnicott, and D.W. Winnicott is probably the most creative and respected psychoanalytic theorist since Sigmund Freud. All five of these theorists brought a fresh, new perspective on psychoanalytic theory and practice, and their contributions may be used to better understand the personality development of persons with a disability and to inform the practice of rehabilitation psychology.

DOI: 10.29245/2767-5122/2023/1.1131 View / Download Pdf