Religious and Spiritual Practices: Association with Dispositional Optimism in an Underprivileged Population in Lascano, Uruguay.

Optimism seems to foster the ability to manage adverse situations better-a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we studied the association between religious/spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America; this makes it particularly interesting for exploring the role of religious/spiritual practices in this context. We found that these practices were positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who did not. This association seems to be especially robust in the case of the poor and less educated: those with religious/spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that these practices may play in dispositional optimism in disadvantaged populations deserves more attention.

Systemness Taps the Power of Interdependence in Healthcare.

SUMMARY: While the term systemness has been used in the healthcare sector for decades, its definition varies from organization to organization. Still, the goals are consistent: to improve patient experience, lower costs, reduce risk, and provide insights into a wide range of care and management issues. Most health systems face similar challenges, such as margin enhancement, quality improvement, increased access, and fending off disruptive competition. Systemness is a way to address these challenges while improving the overall interdependence of the organization. Although embraced by and advantageous to healthcare organizations, systemness efforts often fail. The obstacles are surmountable when organizations thoroughly analyze the achievable scale of systemness, community resources, and current mindset regarding the good of the whole. Leaders must play a vital role in promoting systemness by providing education and a routine review of day-to-day organizational activities. Sometimes, systemness requires a change in leadership or an updating of leadership skills.Organizations must recognize and assess their culture as it relates to principles of independence versus interdependence, and refocus clinical standardization through best-practice protocols and policies as COVID-19 affects the already-fractured healthcare sector. Fortunately, current and developing artificial intelligence, wearables, at-home testing, and improved technologies promise to provide a needed break for a contracting physician field and fatigued front line, and they present an opportunity for those organizations poised to meet the systemness challenge.

A Review and Survey of Neurosurgeon-Hospital Relationships: Evolution and Options.

As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership. Their responses form the basis for the subsequent discussion. Neurosurgeons can be independent, join a confederation such as an Independent Physician Association or another type of "clinically integrated" network, or be employed by a hospital, medical school, or physician group. With varying levels of integration comes the strength of size, management expertise, negotiating leverage, economies of scale, and possibly financial advantages, but with impact on autonomy and independence. Constructive alignment can lead to a win-win situation for both the individual physician and the organization, but options vary widely due to heterogeneous local conditions. This paper reviews possible relationships, moving along a spectrum from no financial integration to full integration. Concepts such as physician leasing, professional service agreements, "clinical integration," and employment are presented. This paper offers a practical reference that might be useful to a new graduate, independent neurosurgeon considering integration, or employed physicians considering alternatives.

Integrity in leadership, governance critical to establish and sustain a culture of safety.

Integrity carries special meaning in healthcare environments. Hospital and health system executives are called to make high-impact decisions every day-none more critical than those involving the delivery of accessible, error-free and evidence-based care.

Religious Background and Gambling Among Young Adults in the United States.

Despite the rapid growth of the gambling industry over the last 40 years, there have been few large-scale, nationally representative longitudinal studies of gambling among young adults. We use data from the National Longitudinal Study of Adolescent to Adult Health to investigate whether and how the gambling behavior of young adults is associated with their religious beliefs and practices during adolescence. We find that young adults who grew up as conservative Protestants, mainline Protestants, Mormons, and Jehovah's Witnesses; those were raised in a community with a higher percentage of conservative Protestants; and those who attended religious services weekly are less likely to have ever gambled. Among gamblers, young adults who attended religious services up to three times per month as adolescents are more likely to experience gambling problems than those who never attend. Notably, accounting for a young adult's propensity for risk-taking behavior does not explain the associations between religion and gambling.

Kin connection: kin involvement while growing up and marriage in adulthood.

Although previous research demonstrates the importance of the availability of marriageable men, earnings, and employment stability for racial differences in marriage, it also suggests that other factors likely contribute to this variation. This study investigates a new factor that might help to explain racial variation in marriage, the kinship group. To explore this possible connection, we examine the influence of parental kin involvement experienced during childhood and adolescence on marriage in adulthood using all three waves of the National Survey of Families and Households. While few of the measures of kin ties have significant effects on marriage, some measures were significantly related and the patterns of associations sometimes varied by race.

When faith divides family: religious discord and adolescent reports of parent-child relations.

What happens to family relations when an adolescent and her parent do not share the same religious convictions or practices? Whereas previous work on religion and intergenerational relations looks at relationships between parents and their adult children, we shift the focus to younger families, assessing how parent-child religious discord affects adolescents' evaluation of their relationship with their parents. Exploring data from the National Longitudinal Study of Adolescent Health, we find several interesting patterns of association between religious discord and parent-child relations. Overall, religious discord predicts lower quality intergenerational relations. When parents value religion more than their teens do, adolescents tend to report poorer relations with parents. Relationship quality is not lower, however, when it is the adolescent who values religion more highly. We also find that religious discord is more aggravating in families where parent and child share religious affiliation and in families where the parent is an evangelical Protestant.

Early Marriage in the United States.

Despite drastic changes in the American family, a significant minority of Americans marry early. Using data from the National Longitudinal Study of Adolescent Health (N = 14,165), this study evaluates the prevalence and antecedents of early marriage in the United States. The results indicate 25% of women and 16% of men marry before age 23, and early marriage varies widely across a number of characteristics. Individuals who marry earlier are more likely to be from disadvantaged families, from conservative Protestant or Mormon families, to value their religious faith more highly, to have a high-school diploma but a lower educational trajectory, and to cohabit before marriage. Scholars and policymakers interested in marriage should pay adequate attention to understanding and supporting these individuals' marriages.

The Role of Parental Religiosity in High School Completion.

Scientists have produced a modest literature documenting the associations between individual religious behaviors and educational outcomes. Most scholars hypothesize that religion provides a context of social capital in which students reap educational benefit (or detriment) from the adults in the religious community. Despite the intergenerational influence inherent in the various social capital explanations, few studies have directly examined the role of parental religiosity in the educational outcomes of adolescents. In this study, I begin to address this gap by investigating whether and how parental religiosity is associated with a student's chances of graduating from high school. I seek to answer three questions related to parental religiosity and students' high school graduation. First, does parental religiosity affect a student's chances of graduating from high school? Second, if parental religiosity is associated with high school graduation, does it operate primarily through the student's own religiosity or is there an independent effect? Third, if parental religiosity is independently associated with a student's high school graduation, what are the mechanisms by which it is associated? Using data from the first and third waves of the National Longitudinal Study of Adolescent Health (Add Health), I find that students whose parents attend religious services more often have greater odds of completing high school, and students who attend religious services with parents are almost 40% more likely to finish high school, net of a number of other religious and sociodemographic factors.