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PubMed1984

The prevention and management of alcohol problems in the family setting: a review of work carried out in English-speaking countries.

There are at least six theoretical perspectives that underlie studies of alcohol misuse and the family. Adherence to one or to a limited range of viewpoints constricts the outlook of professional workers. The prevention and treatment of alcohol problems in the family setting is a neglected field, yet it offers scope for intervention with high risk groups, and at an incipient stage of alcohol misuse before help is normally sought. Despite the growing use of marital and family therapy for couples and families containing a problem drinking member, evaluative studies of such therapies generally lack methodological rigour and leave important issues unresolved. Nonspecialist professional agencies who encounter family problems often fail to identify or deal with alcohol misuse when it is present. Trained voluntary workers may be effective in the treatment of alcohol problems within the family context. There are disadvantages from viewing alcohol misuse within the family as a topic separate from other health and social problems. Finally, the issues that are reviewed have relevance for non-English speaking countries.

Adult↗
PubMed2006

Children at risk of neglect: challenges faced by child protection practitioners in Guatemala City.

OBJECTIVES: The objectives were to (1) delineate the definition, common forms, and perceived risk factors contributing to child neglect in Guatemala from the perspective of different stakeholders and (2) identify the challenges faced by child protection practitioners in identifying children at risk of neglect within the context of Guatemala. METHODS: A range of qualitative methods were used: semi-structured interviews (SSI) with key stakeholders involved in child neglect (n=9); semi-structured interviews with professionals working in the child protection services (n=14); focus group discussions (FGDs) with professionals, voluntary workers and children (n=60), and the group consensus method with key informants (KI, n=10). Data analysis was conducted using the framework approach. RESULTS: Participants described child neglect as a complex social phenomenon combining parental omission of care and an indifferent or negative attitude towards the child compounded by governmental neglect. The main factors which were perceived as contributing to neglect were poverty, societal and cultural norms, and importantly, gender roles and relations. These contextual factors complicate the identification of neglect and raise a number of difficult dilemmas for child protection workers that are exacerbated by limited Guatemalan legislation on neglect and restricted alternative care options. CONCLUSION: Stakeholder perspectives were found to be useful for providing contextual information and highlighting associated challenges related to assessing child neglect in Guatemala.

Child Abuse↗
PubMed2000

[Deficits in socioeconomic and psychosocial support of HIV-positive women].

Despite increasing numbers of heterosexually transmitted HIV-infected women and high numbers of female i.v.-drug users within HIV-infected population the subject of HIV-infection in women has been of low interest during the past years in Germany. This prospective study investigated the economic, social and psychological situation with regard to the special situation of this group. While there was no difference in clinical parameters we found a worse economic situation of HIV-positivity in women. Concerning the psychosocial situation there were few differences, but HIV-infected women sought help by voluntary workers more often. Specific education and socioeconomic support of HIV-infected women are conditions for the success of antiretroviral therapy of HIV-infection which has recently become more demanding and complex.

Adolescent↗
PubMed2000

Cost-effectiveness of an innovative four-year post-discharge programme for elderly patients--prospective follow-up of hospital and nursing home use in project elderly and randomized controls.

The cost-effectiveness of a post-discharge programme on the use of hospital care and the continuity of care was assessed in an elderly cohort (n = 204) discharged from the city hospital. The participation rate was 97.6%, and the patients were aged 75 years or over and lived alone. The randomized controls (n = 204) received standard aftercare. During the follow-up the costs of university hospital care decreased by 52% in the intervention group and by 24% in the control group per patient year, compared with the costs in the year preceding the project. This happened despite the higher morbidity in the intervention group in terms of fractures and the use of university hospital care in the year preceding the project. There was also a tendency in the intervention group for the previous non-users of university hospital care to remain non-users during the follow-up. The costs of city hospital care increased by 16% and 5%, and of all hospital care by 1.3% and 0.2%, respectively. There were no differences in admissions to permanent care in the nursing homes. The intervention group did not make their first contact with the hospitals or permanent care in nursing homes earlier than the control group during the follow-up. The co-operation between hospital and domiciliary care and voluntary workers was well-suited to the innovative care of the elderly people.

Aged↗
PubMedDate not supplied

Outreach interventions for the homeless mentally ill.

There has been a steady rise in the number of homeless mentally ill in Britain. This article reviews the scale of the problem and identifies the need for change within mental health services in order to address this challenge. It is argued that mainstream psychiatric services need to become more diverse and open in their approach to this potentially isolated group of users. The authors suggest that this could be achieved by embracing assertive outreach interventions. Innovative projects using a range of care providers, including voluntary workers, past users of the service and professional mental health workers, are discussed as an alternative framework to traditional services. In conclusion, the article highlights some of the professional and social implications for psychiatric nurses and mental health practice.

Community Mental Health Services↗
PubMed1984

Four years of British audiology.

The last four years have, as envisaged by Dr Watson, seen a rapid growth in 'Audiology in the Community'. The high prevalence of hearing loss in the community, especially in the elderly, has been indicated by the pilot epidemiological study of the Institute of Hearing Research. This and other studies suggest that in the over-seventies as many as three out of five have a hearing loss sufficient to impair ordinary communication. However, the numbers having and using hearing aids falls far short of this. The range of hearing aids available through the National Health Service has increased substantially, and support services have improved with more and better qualified technical, scientific and therapeutical staff, and with the growth of rehabilitation schemes involving both professional and voluntary workers. Much still remains to be done in educating the community and the profession of the need for earlier referral and treatment of hearing loss. Assistance for the profoundly deaf will, it is hoped, come through the research studies on electrical stimulation of the cochlea. In the meantime Vistel , television captioning and similar exercises in exploiting advances in technology enhance the quality of life of those with profound loss. Help for those suffering from tinnitus has improved greatly in the last four years, partly through recognition that the difficulties are real, and partly through the increasing use of hearing aids and maskers to overcome the debilitating consequences of this condition. Preventative measures progress steadily, as do efforts towards the earlier detection of hearing loss in infants and children.

Aged↗
PubMed2001

[Telephone hot line service to Kirkenes SOS in Norway].

BACKGROUND: For many years, voluntary organisations in Norway have operated telephone help line services inspired by the Samaritans and their work in Great Britain. MATERIAL AND METHODS: Characteristics of the calls in 1997 to a service run by Church of Norway volunteers and dedicated to the prevention of suicide were reviewed. Characteristics of the callers and of the problems indicated are presented. The analysis is based on registrations of each call by the voluntary worker. RESULTS: A total of 125,000 calls were registered throughout the country. 30% were silent calls. Men used the service almost as frequently as women. Loneliness, psychiatric problems, physical illness and relational problems were often discussed. 2-11% of the callers, mostly younger people, mentioned suicidal thoughts.

Adult↗
PubMed1976

[Filariasis in patients returned from the tropics. Studies on 64 cases].

A discussion is presented on the epidemiological and clinical aspects of filariasis in persons returning from tropical countries. In our population filariasis is mainly imported from central and western Africa, especially Cameroon. Missionaries and voluntary workers spending periods of years in the tropics are particularly exposed. About 50% of the patients are normal on clinical examination and 40% do not even evidence symptoms due to the low parasite density. Therefore, demonstration of the parasite, which is the diagnostic aim, is often very difficult and requires special techniques. Whenever parasite demonstration is impossible, itching, eosinophilia and a positive immunofluorescence reaction are important diagnostic signs, but they may occasionally develop years after the subject's return. Treatment is by diethylcarbamazine and suramine; their administration and side effects are described and 2 cases involving severe reactions due to inadequate treatment are cited.

Adult↗
PubMed1989

[Hospice].

Terminal care for cancer patients must be oriented to the dignity of human being. For this purpose our hospice has five principles, that is, to control physical pain, to relieve spiritual problems, to settle socio-economical matters, to give religious support and lighten family loads. To put into practice these five principles, various kinds of staff take their places as caregivers: physicians, nurses, helpers, chaplains, psychiatrists and voluntary workers. Moreover, the Hospice has many facilities such as a community hall, a kitchen for family members, guestrooms for family members and friends, a chapel for services and patient's rooms with one bed which make it possible for the patients to communicate intimately with family members or friends. During these 7 years, from April '81 to March '88, 398 terminally ill cancer patients have been treated at the Seirei Hospice. Through these experience, we have observed that most of terminally ill cancer patients do wish to live as long as possible in good condition without physical pain. So, we should conclusively emphasize that medical treatment including radiotherapy and cancer chemotherapy, attempting to reduce the physical distresses, ought to be continued until the time when the treatment might come to waste the patient's energy and only increase their agony.

Adolescent↗
PubMedDate not supplied

[Cultural management of citizens of retirement age in the South Magdeburg city district and initial results of implementing the 21 December 1987 ministerial decision for federal promotion of clubs and meetings of public solidarity].

It is spoken about cultural taking care of old-age pensioners of the town district Magdeburg-Süd in good co-operation between the Magdeburg Council and factories, firms, social organizations, and deputies as well as voluntary workers. The realization of the Cabinet Council resolution is first estimated and further tasks are shown.

Aged↗
PubMed1985

The role of voluntary village aides in the control of malaria by presumptive treatment of fever. 1. Selection, training and practice.

As part of a multi-disciplinary malaria research programme in a rural area of Madang Province, the Papua New Guinea Institute of Medical Research (PNG IMR) in 1982 established a village-based intervention programme of presumptive treatment of fever in 35 villages (population about 5,200). Seventy-four villages aides, selected by people from their own village, attended two-week training courses conducted by PNG IMR staff, and were trained to dispense three-day courses of amodiaquine (for children) or chloroquine (for adults) to anyone presenting with fever (presumptive malaria). The majority of village aides, who were voluntary workers, were married men and women between the ages of 20 and 35 years, who had had up to six years' schooling. In 1983, 5,075 fever cases were treated by village aides, which represents a quarter of the number of fever episodes estimated to occur each year in this area. Utilization of village-aide services was variable, the most important determining factors being the personality and standing of the village aide, and the distance (walking time) to the village aide's house from the patient's house. The village aides' role was expanded to include taking blood slides, dispensing other medicines (aspirin and dressings), treatment of diarrhoea by oral rehydration, and registration of vital demographic events in the village. Regular supervision, currently undertaken on a two-weekly basis by PNG IMR staff, regular refresher courses, and, probably, some sort of compensation (not necessarily monetary) are important for the long-term continuation of the programme, which may serve as a model for other areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Purposes, tasks and duties of the ENT departments of the provincial hospital].

The authors present the scheme of work, aims and duties of otolaryngology department of the county hospital. Basic activities and aims are as follows: diagnostic and therapeutic procedure, specialistic supervision over other otolaryngology departments and out-patients clinics in the county, teaching otolaryngology department assistants and voluntary workers, postgraduate courses supervised by The Postgraduate Medical Centre, public and educational service. All those activities guarantees the proper work of the department, especially in case of the new country area division.

Delivery of Health Care↗
PubMed2005

Increasing trend of HIV seropositivity among commercial sex workers attending the Voluntary and Confidential Counseling and Testing Centre in Manipur, India.

A total of 1903 commercial sex workers (CSWs) attending the Voluntary and Confidential Counseling and Testing Centre at the Department of Microbiology, Regional Institute of Medical Sciences, Manipur, were screened for HIV infection over a period of five years from March 1998 to February 2003. All cases were in the age group 13-55 years. Most cases were in the age group 20-30 years (50.86%). Out of 1903 CSWs, 304 were found to be HIV-seropositive, confirmed by three tests (ELISA/RAPID/SIMPLE) of different biological antigen principles according to India's National AIDS Control Organisation guidelines. The annual rising trend in incidence of HIV seropositivity among CSWs from March 1998 (10.93%) to February 2003 (29.68%) was observed in the test site attenders, in contrast to the declining trend among injecting drug users in the state from March 1998 (76%) to February 2003 (59.82%). In all, 622 sexually transmitted infection (STI) cases were diagnosed, of which 242 (38.90%) had syphilis, which was the commonest STI, and 172 (27.65%) had ulcerative lesions. Increasing HIV seropositivity among CSWs observed in this study reflects the changing pattern of HIV transmission in Manipur.

Adolescent↗
PubMed2003

Washington State social workers' attitudes toward voluntary euthanasia and assisted suicide.

This study examines attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) among 862 professional social workers from Washington State, USA. Although AS has been portrayed as more acceptable than VE, social workers make only a minor distinction in their support for the legalization of such acts (VE 72.4%; AS 77.6%). Only 26.6% agreed with the US Supreme Court's ruling that assisted suicide is not a constitutional right. More than 75% believe that social workers should be involved in the decision-making process with clients who are considering VE/AS. About 20% of social workers report being consulted about VE/AS issues either by clients or in their personal lives. Social workers employed in medical settings are more than twice as likely to be consulted about VE/AS than those employed in non-medical settings. Religious commitment explains some opposition to VE/AS for Protestants and Catholics, but not for other faiths. A small number of social workers (19) admitted to assisting the death of a patient by VE and 5 admitted to AS.

Adult↗
PubMed2004

When a social worker becomes a voluntary commissioner and calls on the Code of Ethics.

When practicing in a new arena, where does a social worker turn for guidance? This article discusses the author's experiences as chair of a governor-appointed Special Commission to Study Sexual Orientation Discrimination. The Code of Ethics of the National Association of Social Workers proved a useful guide in framing the social work role and in helping to resolve thorny issues that emerged.

Advisory Committees↗
PubMedDate not supplied

Health workers' participation in voluntary counselling and testing in three districts of Mashonaland East Province, Zimbabwe.

OBJECTIVES: To determine the proportion of health workers who had undergone VCT for HIV in three districts of Mashonaland East Province and to further explore reasons for non-participation in those who had not been tested. SETTINGS: The study was conducted in the rural Districts of Murewa, Mutoko and Mudzi in Mashonaland East province. DESIGN: The study was a descriptive cross sectional survey. SUBJECTS: All categories of health workers in Murewa, Mutoko and Mudzi. MAIN OUTCOME MEASURES: Participation in VCT, and reason for non-participation. RESULTS: Out of 200 questionnaires sent out 183 (91.5%) were completed and returned. The majority of the respondents were nurses 142 (77.6%), female 113 (61.7%), married 135 (73.8%). The median age was 33 (Q1; 28: Q3; 38) and they had attained a high school education 137 (74.9%). Of the respondents 160 (87.4%) had not gone for VCT; 141 (77%) did not want to have an HIV test. The reasons for not being willing to have an HIV test included not being ready to go for VCT 154 (84.2%); could not cope with the results, 143 (78.1%), do not have the courage to go 133 (72.7%); no need for testing as there is no cure for HIV/AIDS 106 (57.9%). One hundred and twenty six (69%) indicated that they needed counselling for them to be able to go for VCT. CONCLUSION: HIV/AIDS programmes have been directed at the community at large neglecting the health worker. This study, therefore, recommends programmes specifically tailor-made for health workers. These programmes should have a strong counselling component and should focus on self-efficacy so that health workers can finally be ready, be able to cope with HIV results and have the courage to participate in VCT.

Adult↗
PubMed1989

Voluntary village health workers in Papua New Guinea.

The aid post orderly system remains the cornerstone of primary health services in Papua New Guinea (PNG). Inadequate supervision limits its impact. Recent promotion of voluntary village health aides (VVHA) is leading some provincial Divisions of Health to start large-scale projects, which are even more likely to break down through poor supervision. VVHAs are in general inappropriate to provide widespread curative care in PNG. Health personnel should rather reinforce and support existing services. However, voluntary village aide schemes may be appropriate in localized disadvantaged areas. Health planners should consider carefully their goals in setting up such schemes; how they are going to develop projects; and, if villagers want VVHA schemes, the staff required for training and supervision. Monitoring and evaluation should be incorporated into the initial design and provide feedback to participants. Intensive supervision may be appropriate for a defined period, with subsequent closure of the project, or its absorption into the existing health care framework.

Community Health Workers↗