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Objective To explore socioeconomic status (SES) differences in patterns of doctor-patient communication within head and neck cancer clinics and why such differences exist. Methods Thirty-six head and neck cancer review appointments with five Physicians were observed and audio-taped, along with follow-up interviews involving 32 patients. Data were analysed using Thematic Analysis, and compared by patient SES (education, occupation and Indices of Multiple Deprivation). Results Three main themes were identified: (a) Physicians used more humour and small talk in their consultations with high SES patients; (b) Low SES patients were more passive in their participation, engaged in less agenda setting and information-seeking, and framed their clinical experience differently; (c) Low SES patients had different preferences for involvement, defining involvement differently to high SES patients and were seen to take a more stoical approach. Conclusion Low SES patients take a more passive role in medical consultations, engage in less relational talk and are less likely to raise concerns, but were satisfied with this. Physicians may adapt their communication behaviour in response to low SES patients' expectations and preferences. Practice implications A question prompt list may help low SES patients to raise concerns during their consultations. This may reduce inequalities in communication and health.

Background The degree to which patients participate in their care can have a positive impact on health outcomes. This review aimed to map the current literature on patient participation behaviours in interactions with physicians and the extent to which differences in these behaviours can be explained by socio-economic status (SES). Search strategy Four electronic databases were searched from 1980 onwards using key words related to socio-economic status and patient participation behaviours. Study selection Titles, abstracts and full texts were screened by two reviewers, with the second reviewer screening 20% of all entries. Data extraction Data on year of publication, country, patient population, setting, patient participation behaviour studied, and SES measure used were extracted. Main results Forty-nine studies were included in the review. Most studies were conducted in the United States, and the most commonly studied patient participation behaviour was involvement in decision making. Most studies measured SES using education as an indicator, with very few studies using occupation as a measure. Many studies did not report on participants' medical condition or study setting. Patient participation in their health-care appointment increased with increasing SES in 24 studies, although in 27 studies no significant association was found. Discussion and conclusions Current literature was found to be mainly US-centric. Many studies did not specify participants' medical condition or in what setting the study was undertaken. More studies are needed on less commonly studied patient participation behaviours. It would be helpful for further studies to also include a wider range of SES indicators.

Objective Central to current debates over immigration is the impact of transnational ties on immigrant political incorporation in the United States. Some researchers believe these ties hinder incorporation, while others have found a positive relationship between these variables, and yet other scholars have found that transnational connections exert no significant impact on immigrant behavior in the United States. We test these competing hypotheses in an attempt to resolve this scholarly debate. Methods We rely on data from the 2006 Latino National Survey and use logistic regression to test the impact of transnational ties on immigrant political incorporation (via naturalization). Results Transnational ties positively impact immigrants’ orientations toward citizenship and eventual naturalization. Conclusions Immigrant political incorporation is not a unidirectional process where immigrant engagement in the United States increases with disengagement in the ancestral homeland. Rather, Latino immigrants with ties to their ancestral homelands are more likely to desire and seek out U.S. citizenship.

Objective. This study adds to our knowledge of the naturalization process by considering the impact of political orientations in shaping the pursuit of U.S. citizenship among contemporary Latino and Latina immigrants. Methods. We draw on data from the 1999 Harvard/Kaiser/Washington Post “Latino Political Survey” and use ordered logistic regression analyses to test the effects of political orientations on immigrant naturalization. Results. Political orientations exert a powerful influence on naturalization beyond the traditional sociodemographic determinants. Furthermore, the impact of political orientations on naturalization varies by gender. Conclusions. Naturalization can be induced by stressing the importance of voting and being interested in politics. In addition, Latinas are more likely to pursue naturalization than Latinos and the factors driving their decisions systematically differ from those of their male counterparts.