The study of regional inequality has attracted numerous attentions of geographers and economists. The interdisciplinary research has been reflected in a spatial-temporal hierarchical structure, that is, the multi-scalar nature of economic convergence and the temporal dynamics of geographical inequality. With the support of big databases, the integration of these two growing fields provides opportunities for a spatially integrated social science. Therefore, this dissertation aims to explore this long-debated issue from two novel perspectives. On the one hand, the newly available county-level dataset will be employed to reexamine the three major issues of economic inequality and then a comparative analysis at the county level, city level and provincial level will be conducted to study the scale nature of economic inequality. On the other hand, the spatial data exploratory analysis as well as the geospatial analysis provides a new methodological framework to study the spatial effects of economic development. / With the support of the Barameter on China’s Development database, this dissertation covers 2254 county-level units, 338 prefecture-level units and 27 provincial units during the period of 1997 to 2010. Three major research issues have been reexamined at three different spatial scales using the geospatial analysis. Firstly, besides the temporal trend of economic inequality at multiple scales, the decomposable Theil index is applied to measure the intra/inter provincial/prefectural inequality as well as the urban-rural disparity. It is found that economic inequality is more prominent within provinces and between prefectures. Moreover, different from previous studies, the inequality within urban or rural areas is much more intense than the urban-rural disparity. Secondly, global and local spatial patterns of economic inequality are explored with the exploratory spatial data analysis technique. With the recent advances in geovisualization, a spatially explicit view of development mobility provides new insights on the role of spatial spillover effects. It is found that spatial clustering of economic development is investigated differently at these three spatial scales during the whole time period. Spatial integrated moves where the county-level unit’s development improves or worsens more than its neighbors are more frequently encountered than the reversed situation. Thirdly, spatial filtering method as well as multilevel modelling is employed to examine the causal mechanisms underlying economic inequality, which are nested among different spatial scales in China. The spatio-temporal and hierarchical analysis reveals that the county-level development is influenced significantly by its decentralization, fixed investment as well as urbanization rate. Simultaneously, the multi-mechanisms underlying regional development are spatially heterogeneous shaped largely by geography and policy. / The above findings thus contribute to the recent literature on economic inequality and suggest meaningful theoretical and policy implications. The county-level scale provides a novel perspective for understanding the trajectory of economic development in China. As suggested by the new economic geography literature, the prominent significance of space is reaffirmed at different spatial scales and reiterates pervasive existence of spillover effects operating at local scales. Furthermore, institutional reforms, such as empowering counties, should be enlarged to strengthen cooperative relationships among local governments thus realizing cross-border economic cooperation. Meanwhile, with the advances of geocomputing and geovisualization, new interdisciplinary approaches are needed to study this longstanding issue, so as to visualize the spatially integrated dynamics of regional development. / 自从改革开放以来，中国经济保持着每年约10%的增长速度。在快速增长的同时，愈来愈显著的区域差异问题也成为困扰中央和地方政府的一大难题。许多学者已对区域差异问题展开了广泛且深入的研究，主要围绕区域差异的时间趋势、空间格局以及驱动因素等三大主要问题，但至今由于研究方法、研究尺度或者研究区域的不同，学者们很难达成对区域差异问题的统一见解，从而影响有效区域政策的制定。 / 区域差异研究发展到至今，大致经历了从宏观尺度向微观尺度的转变，研究的视角也开始更注重时间空间的动态结合，但仍存在以下不足：首先，以往研究主要围绕省级单元进行，或者仅以个别经济发展较快的省份作为研究对象，宏观尺度的研究掩盖了微观尺度上的区域发展过程，而个别省份的研究又影响了区域研究的整体性；其次，以往研究主要依赖于传统的统计方法，虽然一些最新的研究开始应用多层次模型等，但根据克鲁格曼提出的新经济地理，空间的作用不可忽略。空间模型的应用仍是以后更深入了解区域差异的重要方法。 / 本文针对现今区域差异研究的不足，在具有可比性时空动态分析的理论框架和多尺度多机制的分析框架下，从研究尺度和研究方法上进行创新，旨在为更深入理解区域差异问题提供一种新的视角。基于从1997年到2010年的全国县级发展数据库，本文首先探讨并比较县级、地级市及省级层面上区域差异的时间趋势，其次采用地理可视化技术和空间马尔科夫链，探讨了区域差异的空间格局及其动态特征，最后运用空间过滤方法及多层次多变量模型，探讨了不同尺度上驱动因素的相互作用。完成的主要研究工作如下： / 首先，在分析了几种不同衡量区域差异的指标后，本文采用了泰尔系数衡量并比较全国省、市、县等不同尺度上的区域差异趋势，并利用泰尔系数的分解性特征，进一步研究区域差异在不同地理尺度上、城乡单元之间的关联性和特征，并着重研究了区域差异趋势的空间异质性。本文发现了区域差异在较小的空间尺度上更为显著，省级、地级市之间的区域差异大体呈现倒U型，但县域空间差异却呈现逐渐增强的趋势。通过多尺度泰尔系数的分解，区域经济差异在省内部和地级市之间更为明显。不同于以往的研究，城市或者乡村内部的差异远超过城乡差距，并成为导致县域差异的主因。另外，由于空间异质性，区域差异在东部、西部、中部、东北呈现不同的时间趋势及特征。 / 其次，在采用地理信息系统和探索性空间数据分析方法鉴定区域发展的全局和局部空间集聚特征后，为了进一步理解这种空间特征的动态性，本文采用空间马尔科夫链探讨区域发展的空间溢出特征，并结合地理可视化技术，更直观显示区域发展的空间关系及其变化。本文发现了区域发展主要呈现出空间集聚的特征，且空间集聚的强度在细尺度上更为明显。2004年开始，空间集聚开始呈现出逐渐北移的新特征。从时空角度看，一个区域的经济发展受它地理邻居单元的影响，呈现出共同进退的特征；一般而言，一个区域的发展速度均快过邻居的发展。 / 再次，采用空间过滤方法，并结合多层次模型，设计出符合理论框架的定量模型。并采用多尺度多变量模型分析财政分权、全球化、固定投资、人力资本以及政策对区域发展的影响，以及驱动因素在不同空间尺度间的相互影响。研究发现空间溢出对于县域发展作用不显著，但受到财政分权、外商投资以及固定资产的重要影响。地理和政策对于区域发展的影响呈现出空间异质性。 / 总之，本文从县级尺度出发，采用最新的一些地理空间方法重新探讨了区域差异的三大经典问题。本文证实了新经济地理学的观点，空间尺度和空间溢出对于重新理解区域发展问题至关重要。同时，本文提出了一些实用性较强的区域发展政策，旨在实现更为均衡的区域发展模式。 / He, Sanwei. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 150-166). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Chronic pain is a common and costly health condition for children. Previous studies have documented racial and gender disparities in pain care for adults, with women and racial minorities receiving poorer pain assessment and treatment. Providers contribute to these disparities when their pain-related decision-making systematically varies across patient demographic groups. Little is known about racial and gender disparities in children with chronic pain, or the extent to which providers contribute to these disparities. In a sample of 129 medical students (henceforth referred to as ‘providers’), Virtual Human (VH) methodology and a pain-related version of the Implicit Association Test (IAT) were used to assess the effects of patient race/gender and provider implicit racial/gender attitudes on providers’ pain assessment and treatment decisions for children with chronic pain. Findings indicated that, in the context of abdominal pain, providers rated Black patients as more distressed (mean difference [MD]=2.33, p<.01, SE=.71, 95% CI=.92, 3.73) and as experiencing more pain-related interference in daily activities (MD=3.14, p<.01, SE=.76, 95% CI=1.63, 4.64) compared to White patients. Providers were also more likely to recommended opioids for Black patients’ pain compared to White patients (MD=2.41, p<.01, SE=.58, 95% CI=1.05, 3.76). Female patients were also perceived to be more distressed by their pain (MD=2.14, p<.01, SE=.79, 95% CI=.58, 3.70), however they there were no differences in treatment recommendations based on patient gender (all ps>.05). The sample reported implicit attitudes that men and Black Americans were more pain-tolerant than their demographic counterparts; however, pain assessment and treatment decisions were not related to these implicit attitudes. This study represents a critical step in research on pain-related disparities in pediatric pain. Future studies are needed to further elucidate specific paths through which the pain experience and consequent treatment differ across racial and gender groups.<br>

Schools should be safe and supportive spaces for all students, yet Black students tend to face biased treatment in the education system, which often results in harsh disciplinary measures. This research examined the role of animalistic dehumanization (i.e., perceiving others as animal-like and uncultured and denying uniquely human characteristics), in predicting choice of harsher disciplinary measures for Black students as opposed to White students. It was hypothesized that individuals who dehumanize Black students to a greater degree would be more likely to believe that Black students need to be disciplined through harsher measures. Additionally, it was hypothesized that the link between dehumanization and choice of disciplinary measure would be mediated by empathy, attribution of mind, and/or perceived threat. Both Study 1 (in which dehumanization was assessed) and 2 (in which dehumanization was experimentally manipulated) failed to provide evidence supporting the role of dehumanization in differential choices of school disciplinary measures for Black vs. White students. However, both studies provided evidence suggesting that dehumanization of and negative attitudes toward Black Americans are still prevalent and related in American society, and that animal learning perceptions and paradigms influence participant perceptions of threat from students and disciplinary decisions. These findings indicate a need for continued investigation of racial stereotypes about students when assessing racial disparities in school discipline.

The lack of sociological research on adult/child stratification in children’s books and the impacts books make in the lives of children and adults, especially in regards to socialization, are important reasons to investigate this medium. Through a conflict and feminist perspective, as well as utilizing a cultural diamond framework, this research examines the representations of power disparities between adults and children, and the structures of childrearing within the cultural object of 64 bestselling children’s picture books from 1993 to 2008. I employed content analysis to evaluate appearances of gender, age, race, parental behaviors, and childrearing structures. My findings demonstrate that gender and age disparities prevail, non-white main characters remain invisible, males as main adult characters exhibit higher rates of parental behaviors, and concerted cultivation child rearing structure is present in illustrations. Future research should focus on other aspects of the cultural diamond to gain deeper knowledge of cultural meanings.

Breast cancer affects over three million women in the United States, but this disease burden is not shared equally across all races. Black women, in particular, are diagnosed with more advanced cancer at a younger age and experience a disproportionately high mortality rate compared to white women. Factors that contribute to such disparity include socioeconomic status, tumor biology, age, insurance status, comorbidities, obesity, patients’ reproductive history and barriers to quality care. These factors alone, however, do not account for all the racial differences in mortality and outcomes experienced by black women. There is a growing body of literature that indicates black women are not receiving the same treatment and care as white women. Black women are less likely to receive surgery, radiation therapy, hormone therapy and targeted therapy than white women. Black women are also more likely to experience delays in the initiation of treatment, early discontinuation of treatment and overall guideline non-concordant care. The current literature has presented widespread racial disparities in the treatment of black women with breast cancer. Future research needs to focus on tangible interventions such as physician bias training and patient navigators to mitigate the inequity of care in the treatment of breast cancer.

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health nurses at a local health department. Survey participants remained anonymous. Data were collected on demographics. A paired t test was conducted to compare the statistical significance of the results. A quantitative software tool was used to analyze the data. Study results showed a confidence interval of 95% at p = 0.15, indicating that cultural competence informational modules made a significant difference between the pretest and the posttest of the Cultural Competence Self-Assessment Checklist. Thus, cultural competence informational modules make a difference in public health nurses' awareness, knowledge, and skills, which can enhance their ability to provide culturally competent care to racial and ethnic minorities. The implications of this project for social change include supporting health care professionals' ability to promote and implement cultural competence practices for all populations to decrease health disparities

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Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit ownership status will be associated with higher prevalence of physical restraint use. Results: Findings show that nursing homes with high proportions of blacks have a lower likelihood of high physical restraint use. Nursing homes with a higher proportion of Medicaid-reliant residents have a higher likelihood of restraint use, as does for-profit nursing homes. Discussion: The findings indicate that there are no racial/ethnic disparities present in the use of physical restraints in nursing homes. There is indication of socio-economic disparities, since nursing homes with higher Medicaid-reliant residents are associated with greater restraint. There are policy implications associated with these findings, including raising Medicaid per diem or implementing a quality performance payment incentive. Further research will be needed to determine ways to reduce racial/ethnic disparities in nursing homes. This research, adds to the nursing home literature focused on socio-economic disparities.

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No description available.