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[Writings of the medical observers on the state of the health of Tunisia under the French Protectorate (1881-1956)].

From the military occupation of Tunisia by France in 1881 to that country's independence in 1956, several successive medical observers left behind a wealth of information on the state of health of hte populations composing the Tunisian mosaic. Even thought pre-colonial Tunisia has often been described as a land saddled with disasters and plagues, medical "topographers," most of whom were military doctors accompanying the French expeditionary corps, focused on the fact that few epidemics ever occurred in Tunisia at the time of the Regency. According to some of them, the health situation was better than in Algeria who had been a colony for half a century. The research conducted by the Institut Pasteur in Tunis and medical dissertations by hospital interns in the Regency's capital provide a second source of information comprising invaluable information about endemic infectious diseases. In the inter-war period, the social hygiene movement concentrated upon fighting tuberculosis and protecting infant and maternal health, shifting medical focus to social or "ordinary" diseases and their treatment. Prior to Tunisian independence, a third wave of studies conducted by the new university's socio-medical research group reinforced the connection between lifestyle and health.

Biomedical Research↗

Mental health and social adjustment in young refugee children 3 1/2 years after their arrival in Sweden.

OBJECTIVE: To investigate the relative importance of various risk and protective factors for mental health and social adjustment in young refugee children. METHOD: Of 50 Iranian refugee preschool children who were first evaluated 12 months after arriving in Sweden, 39 were reevaluated in a follow-up study 2 1/2 years later. The effect of exposure to organized violence, age, gender, individual vulnerability, parental functioning, and peer relationships on the children's well-being and adjustment was investigated using multiple and logistic regression analyses. RESULTS: Exposure to war and political violence and individual vulnerability before traumatic stress exposure were important risk factors for long-lasting post-traumatic stress symptomatology in children. Mothers' emotional well-being predicted emotional well-being in children, whereas children's social adjustment and self-worth were mainly predicted by the quality of their peer relationships. CONCLUSIONS: The results underline the fact that refugee children's adaptation is the result of a complex process involving several interacting risk and protective factors. For many refugee children, current life circumstances in receiving host countries, such as peer relationships and exposure to bullying, are of equal or greater importance than previous exposure to organized violence.

Child↗

Social support factors as moderators of community violence exposure among inner-city African American young adolescents.

Using both surveys and the experience sampling method (ESM), community violence exposure, social support factors, and depressive and anxiety symptoms were assessed longitudinally among inner-city African American adolescents. Moderator models were tested to determine protective factors for youth exposed to community violence. Several social support factors emerged as protective-stabilizing forces for witnesses of violence both cross-sectionally and longitudinally, including maternal closeness, time spent with family, social support, and daily support (ESM). Contrary to hypotheses, several social support factors demonstrated a promotive-reactive effect such that, in conditions of high victimization, they failed to protect youth from developing symptoms. Effects did not differ by outcome or sex, though sex differences in findings emerged. Protective-stabilizing effects occurred more for witnessing violence, whereas promotive-reactive patterns occurred more for victimization. Results affirm social support factors as protective from the adverse effects of violence exposure, but they also suggest that some factors typically conceived as contributing to resilience might at times fail to protect youth in conditions of extreme risk.

Adolescent↗

[Comparison of Spanish gypsy and foreign immigrant maltreated children admitted to protection centers].

OBJECTIVES: To determine whether there are differences between Spanish gypsy and foreign immigrant children admitted to protection centers in the characteristics of the maltreatment, social and familial factors linked to maltreatment, and health status. METHODS: The social and health reports of 83 Spanish gypsy and 105 foreign immigrant children admitted to protection centers of the Aragonese Institute for Social Services (Instituto Aragones de Servicios Sociales [IASS]) because of maltreatment from January 1994 to December 2003 were reviewed. Maltreatment, its types, and warning signs were defined and assessed according to the guidelines drawn up by the IASS. The social and familial risk factors associated with maltreatment were determined according to national studies. Health status was assessed following protocols used by the IASS. A descriptive and comparative statistical study was performed. RESULTS: The Spanish gypsy children were mostly in the age group of 0-5 years, while foreign immigrants were mostly in the age group of 12-17 years. Spanish gypsy children showed a greater frequency of physical and emotional neglect and/or abandonment (p < 0.001) and were more likely to have families with problems of crime (odds ratio [OR] = 16.5; 95% confidence interval [95%CI], 6.7-40.7), drug/alcohol abuse (OR = 8.8; 95%CI, 3.7-21) and families with more than one social and health risk factor (OR = 9.3; 95%CI, 3.8-22.8). Spanish gypsy children showed a greater frequency of neurological disorders, disabling diseases, absent or incomplete immunizations, and dermatologic diseases. Foreign immigrant children showed a greater frequency of physical and psychological and/or sexual abuse (p < 0.001) and were more likely to live in a single parent family (OR = 7.9; 95%CI, 2.2-27.7). CONCLUSIONS: Identifying the differences between these two groups of maltreated children could be useful for professionals working in the community social services in charge of developing intervention strategies for the prevention and early detection of maltreatment, as well as for professionals in charge of the health of these children during their stay in a protection center.

Adolescent↗

[Child abuse: socioeconomic factors and health status].

OBJECTIVE: The objective of this study was to identify the relationship between characteristics of the family's ecological environment and child abuse. PATIENTS AND METHODS: Forty-five cases of child abuse and 90 matched controls (1 case per every 2 controls by age, sex and neighborhood were compared. Data collection was carried out by personal interview at the home of the child care-giver. RESULTS: There were statistically significant differences (p < 0.001) in the age and cultural level of the women interviewed, number of children and one-parent families, self-perceived health, depressive symptomatology and anxiety, economic strain and perceived social support. In multivariant analysis, single-headed households, education, number of children, economic strain and social support remained independent predictors of child abuse. Among single-headed households, social support had a strong protective effect. Among households headed by both parents, economic strain was positively associated with abuse. CONCLUSIONS: Child abuse has deep sociocultural and economic roots. Intervention strategies should be directed to the social integration of the families at risk.

Case-Control Studies↗

The personal protective behaviors of college student drinkers: evidence of indigenous protective norms.

Given the prevalence of alcohol consumption and the relative infrequency of harm among college students, the authors sought to determine how most college students protect themselves from alcohol-related harm. An analysis of the aggregate National College Health Assessment data identified a cluster of personal protective behaviors that correlated with reduced risk when drinking. Further analysis revealed that nearly three-quarters of student drinkers regularly employ at least 1 protective behavior, and well over half of the students who use protective behaviors routinely employ 2 or more. In addition, the data reveal that student drinkers employ situational abstinence, with nearly 7 out of 10 students reporting that they sometimes or usually refrain from drinking alcohol when they socialize. The use of these protective behaviors is a strong predictor of safety and harm for college-student drinkers.

Adult↗

Social anxiety, negative affectivity, and substance use among high school students.

The literature regarding the relationship between adolescent social anxiety and substance use is sparse, and available studies have produced discrepant results. Similarly, negative affectivity is a mood-dispositional dimension that is infrequently considered in studies of substance use. The authors used dispositional structural equation modeling to examine the concurrent relationships of social anxiety and negative affectivity with adolescent substance involvement among 724 students in 1 southern California high school. The final model indicated that increased substance use was associated with having lower grade-point average, being male, being White, having higher levels of negative affectivity, and having lower levels of social anxiety. The findings confirm that negative affectivity is positively related to adolescent substance use, whereas social anxiety appears to be protective against substance involvement.

Adolescent↗

Acquisition of the algorithms of social life: a domain-based approach.

Proposing that the algorithms of social life are acquired as a domain-based process, the author offers distinctions between social domains preparing the individual for proximity-maintenance within a protective relationship (attachment domain), use and recognition of social dominance (hierarchical power domain), identification and maintenance of the lines dividing "us" and "them" (coalitional group domain), negotiation of matched benefits with functional equals (reciprocity domain), and selection and protection of access to sexual partners (mating domain). Flexibility in the implementation of domains occurs at 3 different levels: versatility at a bioecological level, variations in the cognitive representation of individual experience, and cultural and individual variations in the explicit management of social life. Empirical evidence for domain specificity was strongest for the attachment domain; supportive evidence was also found for the distinctiveness of the 4 other domains. Implications are considered at theoretical and applied levels.

Adolescent↗

Effects of positive feedback on the social interactions of boys with attention deficit hyperactivity disorder: a test of the self-protective hypothesis.

Tested the hypothesis that inflated self-assessments offered by children with attention deficit hyperactivity disorder (ADHD) serve a self-protective function. This was accomplished by examining the effects of positive feedback on self-perceptions and social interactions of boys with ADHD and comparison boys. Boys with ADHD and comparison boys, 8 to 11 years old, were paired in 60 dyads and interacted in two unstructured cooperative tasks. Following the first interaction, 1 boy in half of the dyads received positive feedback, supposedly from his partner, concerning his performance. Results indicated that following the first interaction, but prior to feedback, boys with ADHD had an overly positive view of how much their partner liked them. However, following the second interaction, boys with ADHD who received positive feedback actually showed a significant decrease in their self-perceptions, whereas comparison boys who received feedback showed an increase. These results are seen as supportive of the self-protective hypothesis that children with ADHD offer inflated self-perceptions to counter feelings of inadequacy. When presented with positive feedback, they are able to relax this defensive posture and offer more realistic self-assessments.

Attention Deficit Disorder with Hyperactivity↗

Visitor evaluations of management actions at a highly impacted Appalachian Trail camping area.

Protected area management involves balancing environmental and social objectives. This is particularly difficult at high-use/high-impact recreation sites, because resource protection objectives may require substantial site management or visitor regulation. This study examined visitors' reactions to both of these types of actions at Annapolis Rocks, Maryland, a popular Appalachian Trail camping area. We surveyed visitors before and after implementation of camping policies that included shifting camping to designated newly constructed campsites and prohibiting campfires. Survey results reveal that visitors were more satisfied with all social and environmental indicators after the changes were enacted. An Importance-Performance analysis also determined that management actions improved conditions for factors of greatest concern to campers prior to the changes. Posttreatment visitors were least satisfied with factors related to reduced freedom and to some characteristics of the constructed campsites. Although there was evidence of visitor displacement, the camping changes met management goals by protecting the camping area's natural resources and improving social conditions.

Camping↗

Self-protection from malaria vectors in Pakistan: an evaluation of popular existing methods and appropriate new techniques in Afghan refugee communities.

Experimental huts were used to measure the impact of several techniques for self-protection from malaria vectors in Pakistan. An electric fan, pyrethrum coils, untreated curtains, pyrethroid-vaporizing mats and permethrin-impregnated curtains reduced the total catches of blood-fed Anopheles stephensi by 27%, 36%, 47%, 56% and 65%, respectively. The most marked effect of all the interventions was in reducing the numbers of mosquitoes entering the huts, although all the techniques, except for the untreated curtain, also reduced the proportion of mosquitoes inside the hut which fed. Although the trends seen were similar for both anopheline (all An. stephensi) and culicine mosquitoes, they were more pronounced in the culicines. Social surveys were conducted on current self-protection practices. The social and economic constraints associated with each of the various techniques are discussed. All the strategies were shown to offer a degree of protection and their use should be encouraged. Impregnated curtains seem especially promising. Pyrethroid-impregnated bednets have been widely promoted in eastern Afghanistan since 1991 and have the advantage of providing protection when people sleep outside during the summer. However, surveys show that some owners stop using their nets in late autumn, despite the continued risk of malaria. People should be encouraged to use their bednets as impregnated curtains rather than putting them into storage.

Afghanistan↗

Methodology for studying discrimination based on sexual orientation and social sex-role stereotypes.

This article presents the methodology used in collecting data for the study of the relationship of sexual orientation and social sex-role to the protection of civil liberties. The methodology is designed to determine how departures in sexual orientation and social sex-role are the basis for the abridgment of civil liberties. Departure in sexual orientation is defined as physical sexual activity involving individuals of the same sex. Departure in social sex-role stereotypes is defined as departing from or conforming to the feminine stereotype for men, the feminine stereotype for women, the masculine sterotype for men, and the masculine stereotype for women.

Adult↗

Social support and psychosocial dysfunction after stroke: buffering effects in a community sample.

This study examined the effect of social support as a mediator between stressful life events experienced by stroke survivors and outcome measured by psychosocial dysfunction. Eighty-five stroke survivors were interviewed at home two to 24 months after discharge from active rehabilitation. The sample was selected for a high number of stressful life events in the recent past, placing subjects at risk for psychosocial dysfunction. Eight components of social support were measured to determine the magnitude of their influence on adjustment. A new instrument, the Social Support Inventory for Stroke Survivors, was designed for this purpose. The General Health Questionnaire, used to measure psychosocial symptomatology, showed that 27% of the sample suffered psychosocial dysfunction. Multiple regression analysis explained 14.5% of total variance as due to social support and functional status. Risk analysis, using the odds ratio, indicated that an especially strong protective effect was produced by community social support.

Adaptation, Psychological↗

Social relationships, sleep quality, and interleukin-6 in aging women.

This study examined the interplay of social engagement, sleep quality, and plasma levels of interleukin-6 (IL-6) in a sample of aging women (n = 74, aged 61-90, M age = 73.4). Social engagement was assessed by questionnaire, sleep was assessed by using the NightCap in-home sleep monitoring system and the Pittsburgh Sleep Quality Index, and blood samples were obtained for analysis of plasma levels of IL-6. Regarding subjective assessment, poorer sleep (higher scores on the Pittsburgh Sleep Quality Index) was associated with lower positive social relations scores. Multivariate regression analyses showed that lower levels of plasma IL-6 were predicted by greater sleep efficiency (P < 0.001), measured objectively and by more positive social relations (P < 0.05). A significant interaction showed that women with the highest IL-6 levels were those with both poor sleep efficiency and poor social relations (P < 0.05). However, those with low sleep efficiency but compensating good relationships as well as women with poor relationships but compensating high sleep efficiency had IL-6 levels comparable to those with the protective influences of both good social ties and good sleep.

Aged↗

Gender, social support, and posttraumatic stress in postwar Kosovo.

The effects of social support and traumatic experiences on mental health in conflict situations may be different by gender. The Kosovo Emergency Department Study was conducted in July and August 2001 to assess mental health 2 years after the end of the war in Kosovo. Of 306 emergency department patients (87.7% response rate), all were ethnic Albanian, 97.4% had experienced traumatic events, and 89.5% had posttraumatic stress symptoms. Women and persons who experienced more traumatic events had higher posttraumatic stress scores. Persons with social support had lower posttraumatic stress scores. In a final model, social support had a greater protective effect for women, whereas traumatic events had a greater detrimental effect on men. Two years after the war in Kosovo, there remained a high prevalence of posttraumatic stress symptoms, particularly among women with low social support. Interventions targeting social support may be important public health efforts in the postwar context.

Adult↗

[Children with conducts disorder and using psychoeducational services: a social, psychological and family portrait].

Contemporary studies suggest that most of the children who manifest conducts disorder also present personal as well as family problems. This is particularly true for children whose disorder is precocious. The identification of personal characteristics as well as social and family risk and protection factors associated with children with such problems are of great use for intervention planning and service organization for them and their families in Québec. In consequence, the objectives of this study are to identify the social, family and psychological factors that characterize children presenting conducts disorder. To do so, 62 children in treatment between the ages of 7 and 12 and with a diagnosis of conducts disorder are compared with 36 children of the same age without such diagnosis. Results show that children with conduct problems come from less stable and cohesive families as well as a lower socio-economic level. Moreover, their network of social support is less developed. The study reveals that the parents of children with conducts disorder use punishment more often. Finally, the research demonstrates that the children of this group have a much higher probability of presenting an exteriorized disorder (66 %) than the children of the other group (8 %). All these distinctive characteristics allows to correctly classify 93,8 % of the children of this study in the 2 groups. The results indicate the need to improve the parents'educational practices, increase the child's social network as well as reduce the conducts of opposition and inattention of the child. Finally, the complexity of the problems raised with the child and families commands a concerted professional intervention.

English Abstract↗

[Social and hygienic aspects of occupational health risk and resources of protection in time].

The article suggests the parameters and criteria to evaluate the grade of occupational risk for health in hazardous work conditions. The parameters include prior hygienic ones, posterior medical and biologic ones. The principles of optimal protection by the time are based on the dose approach taking into account the occupational disease development. The authors describe the method evaluating efficiency of protection by the time with a consideration of the dose range of acting factor. Large protective resources of time are shown and recommendations are given for adequate use of the various forms of protection by time taking into account the workers' age and length of service as well as the work organization.

Adult↗