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[Child and adolescent psychiatry and child and adolescent welfare: general interprofessional relations--results of a study].

Child and adolescent Psychiatry on the one hand and Social Welfare Services and Child Protection on the other share common fields. The theoretical orientation of the Social Sciences differs from that of Psychiatric Medicine, producing a potential of conflict in areas of mutual operation. This report is based on an analysis of the transferrals from Child and adolescent psychiatric in-patient treatment to foster care. The results show that the children concerned mainly present with conduct disorder plus emotional problems and that the process of transferral is impaired by a number of factors which can be clearly named.

Adolescent↗

Executive Order No. 123 reorganizing the Ministry of Social Services and Development, now referred to as Ministry of Social Welfare and Development, 30 January 1987.

This Order reorganizes the Ministry of Social Services and Development. Among the bureaus of the Ministry are the following: "b) Bureau of Family and Community Welfare--assistance to socially disadvantaged families and communities including family planning, planning outreach programs to develop their capability in defining needs and formulating solutions as well as setting up viable community structures which bring about desired social changes..."d) Bureau of Women's Welfare--promoting women's welfare, with specific attention to the prevention or eradication of exploitations of women in any form, such as but not limited to prostitution and illegal recruitment; as well as the promotion of skills for employment and self naturalization; e) Bureau of Child and Youth Welfare--care and protection of abandoned, neglected, abused or exploited children and youth, delinquents, offenders, the disturbed, street children, victims of prostitution and others, for their social adjustment and economic self-sufficiency." The Order authorizes the Ministry to establish regional offices providing, among other things, day care centres, street children centres, centres for youth with special needs, homes for the aged, and homes for unwed mothers. Attached to the Ministry is a Population Commission, which "shall continue as the population planning and coordinating agency."

Adolescent↗

[Only 1 out of 1 000 patients with alcohol dependence problems are reported according to the Driver's Licence Act. Physicians estimate to increase the number of reports some 70 times with a two-year ignition interlock program].

This poll, aimed at general practitioners and dependence specialists, shows that only one out of 1,000 patients diagnosed alcohol-dependent are reported to the county administrative board in accordance with the Swedish Driver's Licence Act. The anticipated negative effect on continued doctor-patient contact stands out as the predominant obstacle to filing a report. Among general practitioners an uncertainty about diagnosing alcohol dependence and alcohol abuse also was an important obstacle. Given the opportunity to participate in a two-year alcolock programme as an alternative to driver's licence revocation, doctors estimate that they would report some 70 times the number of patients. This estimation is obviously subject to considerable uncertainty, but does reflect an important attitude and an expectation that such a report constitutes a positive move from both an individual and a social perspective.

Accidents, Traffic↗

Women's employment, social support, and mortality.

This study uses a longitudinal design to examine the extent to which social support at work is protective against death and the degree to which it explains mortality differences between employed women and those not in paid employment. Women's total role responsibilities and community involvement, as an alternative source of social support and social integration, are also considered in the analysis. The outcome examined is mortality risk over a 15 year period. The 1140 women included in this study were randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical and vital records for 15 years post interview period are linked with the survey data. The results of this analysis suggest that social support at work is protective against mortality among employed women and contributes to mortality risk differences between employed and nonemployed women. While the relative hazard of death for nonemployed women who have some community involvement is greater than for employed women, the difference is not statistically significant. Community involvement may provide an alternative, albeit weaker, avenue for gaining some of the same advantages available in paid employment. Future research directions are discussed.

Adolescent↗

Interactive and higher-order effects of social influences on drug use.

The study of moderators and higher-order effects of social influences on drug use has many implications for theories of health behavior. In the present study, we investigated the longitudinal predictive effects of some of the prominent moderator variables that represent forms of susceptibility toward social influence in teenage drug use. We also studied the possibility that social influence may predict drug use in nonlinear (quadratic) forms, consistent with theories proposing that threshold or decelerating effects may occur in social influences on normatively sanctioned behaviors. Results showed that several of the interactive and quadratic predictive effects were significant. The findings supported the views that certain moderator variables act as buffers, which either protect the individual from social pressures to use drugs, or make the individual more susceptible to such pressures. In addition, two of the obtained quadratic effects of social influence lent support to the application of social impact theory to drug use. Overall, our findings suggest that interactive and nonlinear approaches to social influences on drug use provide a unique and viable theoretical perspective from which to construe this problem health behavior.

Adolescent↗

[10 years' research in the social sciences on AIDS in Burkina Faso. Elements for prevention].

The first cases of AIDS in Burkina Faso were reported in 1986. During the past ten years, there have been several types of research conducted in Burkina Faso in the field of social sciences, including KABP, focus groups, and ethnographic studies. This article reviews approximately 100 publications and presents the results most relevant to prevention. Although general knowledge of the disease, its transmission and means of protection has improved, part of the population remains poorly informed; erroneous ideas remain prevalent and certain concepts, for example asymptomatic infection, are ignored. Young women in rural areas have the poorest knowledge. Understanding the information is conditioned by underlying perceptions of blood and physiology, the "components of the person", pre-existent and sexually transmitted diseases, and modes of transmission. Research on sexuality has elucidated the age at which individuals become sexually active, and paramatrimonial practices. The prevalence of STD is high. STD are mostly treated by traditional practitioners or by automedication. Family planning is insufficiently developed. AIDS prevention should be integrated into wider considerations of reproductive health. The popular perception that "Others" are responsible for bringing AIDS into the country has often been reinforced by health messages. Consequently, people do not sufficiently consider themselves vulnerable to HIV infection. The populations that are most vulnerable, for various reasons that have been analysed, include young girls and women, married women, prostitutes, truck drivers, and young men from rural areas. The message "Fidelity or condom" has been widely used. However, it has hindered the generalisation of the use of condoms, because asking for a condom consequently implies distrust of the partner. The interpretation of fidelity is diverse, and many people who choose this means of prevention believe erroneously that they are protected. Studies of the social impact of AIDS reveal fragmentation of society, reactions causing social exclusion and discriminative practices, and no social visibility of HIV infected persons. After ten years of preventive actions, the prevalence of HIV is still increasing, evidence of the failure of the preventive strategies. It is no longer sufficient to see prevention as the transfer of knowledge from professionals to the population. Preventive strategies such as voluntary testing and the participation of HIV+ persons in informative actions need to be developed. Prevention should be understood on new bases. The concept of "vulnerability" might help the definition of in-depth actions and also focus interventions. The idea of developing social cohesion to confront the epidemic may help avoid some of the adverse consequences of previous actions. Do these concepts conform to current AIDS prevention attitudes? To answer this question, social scientists should study the ideologies, knowledge, beliefs, and practices of institutions and professionals working in the field of AIDS prevention.

Acquired Immunodeficiency Syndrome↗

The functions of societies and the evolution of group living: spider societies as a test case.

Many models have been advanced to suggest how different expressions of sociality have evolved and are maintained. However these models ignore the function of groups for the particular species in question. Here we present a new perspective on sociality where the function of the group takes a central role. We argue that sociality may have primarily a reproductive, protective, or foraging function, depending on whether it enhances the reproductive, protective or foraging aspect of the animal's life (sociality may serve a mixture of these functions). Different functions can potentially cause the development of the same social behaviour. By identifying which function influences a particular social behaviour we can determine how that social behaviour will change with changing conditions, and which models are most pertinent. To test our approach we examined spider sociality, which has often been seen as the poor cousin to insect sociality. By using our approach we found that the group characteristics of eusocial insects is largely governed by the reproductive function of their groups, while the group characteristics of social spiders is largely governed by the foraging function of the group. This means that models relevant to insects may not be relevant to spiders. It also explains why eusocial insects have developed a strict caste system while spider societies are more egalitarian. We also used our approach to explain the differences between different types of spider groups. For example, differences in the characteristics of colonial and kleptoparasitic groups can be explained by differences in foraging methods, while differences between colonial and cooperative spiders can be explained by the role of the reproductive function in the formation of cooperative spider groups. Although the interactions within cooperative spider colonies are largely those of a foraging society, demographic traits and colony dynamics are strongly influenced by the reproductive function. We argue that functional explanations help to understand the social structure of spider groups and therefore the evolutionary potential for speciation in social spiders.

Animals↗

Munchausen syndrome by proxy.

Munchausen syndrome by proxy (MBP) is the deliberate induction or reporting of physical symptoms in a child. It is a form of child abuse that can result in death, iatrogenic disease, or the masking of a genuine illness. MBP is suggested by symptoms that do not follow the usual course of illness, particularly if the symptoms only occur in the presence of the same person. MBP may occur when caretakers (usually mothers) perceive that being the parent of a sick child will solve personal conflicts and be socially rewarded, or if life experiences have demonstrated that the price of love is physical illness. When MBP is suspected, the health care team needs to take aggressive action to confirm or disprove it and to protect the child. A social worker confronted with possible MBP must manage a difficult situation that often involves painful team issues as well as confusion over the nature of reality.

Child↗

Child centered literacy orientation: a form of social capital?

OBJECTIVE: To describe the home literacy environment and to identify financial, human, and social capital variables associated with the presence or lack of Child Centered Literacy Orientation (CCLO) in families with young children who regularly attend pediatric primary care clinics. DESIGN: Cross-sectional case-control analysis of structured parent interviews conducted in two hospital-based and four community-based pediatric clinics in New England. SUBJECTS: Parents of 199 healthy 1- to 5-year-old children whose mean age was 30 +/- 15 (SD) months were interviewed. Parents were primarily mothers (94%) with a mean age of 28 +/- 7 (SD) years 60% of whom were single. Educational levels of study parents varied: 43% had not graduated from high school, 29% had a high school equivalency, and 28% had at least a year of college or vocational training. This was a multiethnic parent group. Sixty-five percent were bilingual or non-English speaking. Fifty-eight percent were born outside of the continental United States. Parents were primarily of low-income status with 85% receiving Women, Infant, and Children (WIC) food supplements, Aid to Families With Dependent Children, and/or Medicaid. RESULTS: Half of the parents interviewed reported that they rarely read books. Sixty percent of children had fewer than 10 books at home and two-thirds of these households contained fewer than 50 books total. When asked open-ended questions, 28% of parents said that sharing books with their child was one of their three favorite activities together, 14% said that looking at books was one of their child's three favorite things to do, and 19% reported sharing books at bedtime at least six times each week. Thirty-nine percent of families had at least one of these three literacy-related responses present and so were said to have a CCLO. A backwards stepwise multiple logistic regression on CCLO was performed with family financial, human, and social capital variables. Parents married or living together (odds ratio [OR] 2.56, 95% confidence interval [CI] = 1.21-5.42), higher adult-to-child ratios in the home (OR 1.92, 95% CI = 1.20-3.05), households speaking only English (OR 2.67, 95% CI = 1.24-5.76), parents reading books themselves at least a few times a week (OR 2.86, 95% CI = 1.38-5.91), and homes with more than 10 children's books (OR 3.3, 95% CI = 1.6-6.83), were all independently and significantly associated with the presence of CCLO. Older child age and higher parent education remain in the model but were not significant at the P <.05 level. Ethnicity and income status were dropped for lack of additional significance from this model, which described 24% of the variance in CCLO. CONCLUSION: Although two-parent families and higher adult-to-child ratios in the home appear to be social capital variables with protective effects, low-income, single-parent, and minority or immigrant families are at significant risk for lacking both children's books and a CCLO. We suggest that CCLO may itself be another form of social capital reflecting parental goals and expectations for their children. We speculate that interventions which provide children's books and information about reading with children to impoverished families with young children may facilitate more parent-child book sharing. Pediatricians and other primary care providers serving underserved populations may have a unique opportunity to encourage activities focusing on young children and promoting literacy.

Analysis of Variance↗

Influence of temperature, social, and dietary stress on development and stability of protective microflora in chickens against S. typhimurium.

In the day-old chick, physiological stress in the form of high or low temperatures or feed and water deprivation either interfered with colonization or altered the protection provided by normal intestinal microflora against subsequent challenge with Salmonella typhimurium. The response was more obvious after individual exposure of chicks to salmonella than after exposure to infected seeders. Physiological and dietary stress at 2 weeks of age did not appreciably alter the S. typhimurium excretion pattern in treated chicks. The protective microflora appears to be quite stable under these stress conditions.

Animals↗

AIDS and social work: the ethics and civil liberties agenda.

Social workers are becoming increasingly involved in casework and social policy debate related to the acquired immune deficiency syndrome (AIDS) crisis. To enhance their delivery of services and contribution to policy formulation, social workers need to be familiar with a wide range of ethical and civil liberties issues that have been generated by the AIDS epidemic. This article provides an overview of six major ethical and civil liberties issues pertaining to social work practice related to AIDS: (1) mandatory screening and testing of clients for the human immunodeficiency virus (HIV), (2) client access to health insurance, (3) professionals' duty to treat HIV-infected clients, (4) privacy and confidentiality, (5) client involvement in AIDS research, and (6) relevant legal issues. Implications for social work practice are highlighted, particularly with respect to protecting clients' rights and formulating a social action agenda.

AIDS Serodiagnosis↗

Pathways toward educational achievement among African American and Puerto Rican adolescent mothers: reexamining the role of social support from families.

Although a majority of adolescent mothers are graduating from high school, the processes that enhance the educational attainment of adolescent mothers are not well understood. With a sample of 93 African American and Puerto Rican adolescent mothers, we assessed the effects of material support from family (i.e., child care assistance from grandmother and residence with grandmother) and emotional support from family over and above pre- and postpregnancy risk factors (i.e., maternal age at first birth, delayed grade placement before pregnancy, ethnicity, depressive symptoms, stressful life events, and repeat pregnancy) during the first year postpartum on educational attainment at 6 years postpartum. Significant contributors to the explained variance in educational attainment included: delayed grade placement before pregnancy, maternal age at first birth, depressive symptoms, emotional support from family, and residence with grandmother. Unexpectedly, higher perceived emotional support from family and living with grandmother predicted lower educational attainment. Post hoc analysis of qualitative data suggested reasons for these latter findings and point to the need to reconceptualize and broaden the elements of social support that constitute protective factors for adolescent mothers.

Black People↗

Strategies of social comparison among people with low self-esteem: self-protection and self-enhancement.

People with low self-esteem (LSE) seem to focus on self-protection; rather than trying to achieve gains for their self-esteem, they try to avoid losses. This research examined, in a social comparison context, the hypothesis that LSEs seek self-enhancement when they have an opportunity that is "safe," that is, carrying little risk of humiliation. Experiments 1 and 2 indicated that LSEs sought the most social comparisons after receiving success feedback, whereas high-self-esteem Ss (HSEs) sought the most comparisons after failure. Further results suggested that LSEs who succeeded were seizing a safe means of self-enhancement and that HSEs who failed were seeking to compensate for the failure. Also supporting this interpretation for LSEs was Experiment 3, in which LSEs who succeeded sought the most comparisons when such comparisons promised to be favorable. All three studies illustrate the value of a new measure of social comparison selection.

Adolescent↗

Hurling alone? How social capital failed to save the Irish from cardiovascular disease in the United States.

OBJECTIVES: We performed a historical review of cardiovascular risk profiles of Irish immigrants to the United States, 1850-1970, in regard to lifestyle, socio-economic circumstances, and social capital. METHODS: We analyzed US Census data from 1850-1970, area-based social and epidemiological data from Boston, data from Ireland's National Nutrition Surveillance Centre, and literature on Irish migration. RESULTS: The Irish were consistently at increased risk of cardiovascular diseases, a risk that related initially to material deprivation, across the life course of at least 2 generations. CONCLUSIONS: The principal difference between the Irish and other disadvantaged immigrant groups, such as the Italians, was dietary habits influenced by experiences during the Irish famine. Although there was a psychosocial component to the disadvantage and discrimination they experienced as an ethnic group, the Irish also exhibited strong community networks and support structures that might have been expected to counteract discrimination's negative effects. However, the Irish's high levels of social capital were not protective for cardiovascular disease.

Boston↗

Effect of Sardinian heritage on risk and age at onset of type 1 diabetes: a demographic case-control study of Sardinian migrants.

BACKGROUND: Children of Sardinian heritage are at high risk of type 1 diabetes, whereas no data are available in young adults. Age at onset of type 1 diabetes could be associated with different relative weight of genetic susceptibility and environmental determinants in the pathogenesis of the disease. We test this hypothesis in subjects with Sardinian heritage 0-29 years of age living in the city of Turin, a highly industrialized area in Northern Italy. METHODS: In all, 202 cases with onset of type 1 diabetes aged 0-29 years during 1984-1991 and 1010 controls randomly selected from residents of the city of Turin, frequency-matched by sex and year of birth to cases, were included in this study. Name and place of birth of parents were ascertained by postal inquiry and linkage with city population and census files. Social class was based on the highest educational level of parents abstracted from 1991 and 1981 census files. RESULTS: Differential effects on risk of type 1 diabetes of Sardinian heritage and social class in the age groups 0-14 and 15-29 years were found. In children with one and both Sardinian parents the odds ratios (OR) were 2.09 (95% CI : 0.85-5.15) and 3.20 (95% CI : 0.75-13.64); in young adults 0.81 (95% CI : 0.18-3.64) and 1.95 (95% CI : 0.51-7.40), respectively. In subjects with low social class the OR were 1.16 (95% CI : 0.68-1.97) in children and 0.66 (95% CI : 0.41-1.05) in young adults. CONCLUSIONS: This study shows higher risk of type 1 diabetes in subjects of Sardinian heritage; higher risk in children than in young adults and a protective effect of low social class in young adults. These findings are consistent with the hypothesis of heterogeneity of type 1 diabetes by age at onset, with prevailing genetic effect in childhood and environmental determinants in adulthood.

Adolescent↗

The critical need for specialized health and safety measures for child welfare workers.

Child welfare workers are facing a growing threat of physical violence as they carry out their responsibilities to protect children and support families. Over the past several years, at least eight workers have been killed nationwide and hundreds of others assaulted. From July 1, 1992, to June 30, 1993, there were 25 incidents in New Jersey. In response, the New Jersey Division of Youth and Family Services devised a nine-point plan for improved health and safety measures for social service workers. Social workers cannot effectively protect children or help families if they themselves are not safe.

Accidents, Occupational↗

Evaluation of a three-year school-based intervention to increase adolescent sun protection.

The efficacy of a school-based intervention was evaluated using a randomized controlled trial in Australia. In consecutive grades (8, 9, and 10), students in the intervention group received components of a program that addressed issues related to the need to protect yourself from the sun, behavioral strategies related to using sun-protective measures, personal and social images of having a tan, the use of sun-safe clothing, and how to change their schools through forms of structural change. Pre- and postintervention measures among junior high school students showed greatest improvement in the intervention group's knowledge scores and minimal changes in sun protection behavior from Grade 8 to Grade 9, which were not maintained through Grade 10. Results of the study highlight some limitations of school-based interventions for changing sun protection behaviors.

Adolescent↗