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PubMed2006

Revealing the cues within community places: stories of identity, history, and possibility.

Place-based approaches to community change have become increasingly popular strategies for addressing significant social problems. With their intentional focus on 'place,' most efforts have sought to gain greater understanding into how neighborhood contexts affect people. However, while both aggregate characteristics and social dynamics of neighborhoods have been subject to scrutiny in the literature, less attention has been paid to understanding how the environmental characteristics of neighborhoods and communities as places have meaning for residents. The present study used an innovative methodology called Photovoice to obtain a greater understanding of the meanings residents ascribe to the salient characteristics of their neighborhoods and communities. As part of a place-based initiative, 29 adult and youth residents in seven distressed urban neighborhoods photographed and dialogued about the meaningful physical attributes of their community. According to participants, place characteristics provided cues about their personal histories as members of the community; communicated messages about the value and character of the community and its residents; defined social norms and behavior within the community; and provided markers that could remind residents of who they are and inspire a sense of possibility for who they could become. Implications for practice are discussed.

Community Participation↗
PubMed2006

Survival and morbidity of HIV patients on hemodialysis and peritoneal dialysis: one center's experience and review of the literature.

BACKGROUND: Controversy continues concerning the morbidity and mortality of HIV-infected ESRD patients on the two dialysis options. This article presents our experience with complications and survival rate among our HIV-infected ESRD patients on peritoneal dialysis and hemodialysis. We reviewed the literature on this subject. METHODS: The charts of seven and eight HIV-infected ESRD patients on peritoneal dialysis and hemodialysis respectively, between January 1989 and November 2004, were reviewed retrospectively for specific clinical and demographic data. Their survival was calculated using the Kaplan-Meier method. RESULTS: Total follow-up of HIV-infected PD and HD patients was 248.3 and 207 patient months, respectively. There was no significant difference in hospitalization rate between HIV-infected PD and HD patients (1.01 and 1.39 admission/year, respectively, P = NS). Survival of HIV-infected patients on PD at one, two and three years was 100, 83, and 50%, and for HD patients was 75, 33, and 33%, respectively. HIV-infected patients on HD had more prevalent advanced HIV disease. Two out of seven PD patients were on PD for more than five years and one of the HD patients was on that form of dialysis for more than nine years. Median survival of patients with advanced (Stage IV) AIDS (both HD and PD) was 15.1 months (range 1.6-17.3) while this value for non-advanced (Stage II, III) patients was 61.2 months (range 6.8-116.6). CONCLUSION: Type of renal replacement therapy does not have a significant effect on the morbidity and mortality of HIV-infected ESRD patients. Survival is worse in patients with advanced HIV disease. Both dialysis options provide similar results in HIV patients; hence, the choice of dialysis modality should be based on patient's preference and social conditions.

Adult↗
PubMed1984

Prevention of age-associated loss of autonomy: epidemiological approaches.

The concept of autonomy is proposed as a global objective of health and social services and epidemiological contributions to devising procedures for maintaining autonomy of old people are reviewed. It is suggested that the conventional model of "normal" vs "pathological" aging, identification of the "elderly" as a separate adult age group and preoccupation with clinical as opposed to public health models of intervention and with service provision rather than with clients' needs are less than optimal. More attention should also be given to the identification of extrinsic factors in aging and to recognising ways in which the effects of aging are aggravated by social conditions and unrelieved by ineffectual and inappropriate services. Epidemiology has more to contribute to meeting the challenges of aging than is generally recognised.

Aging↗
PubMed1983

Life events in Xhosas in Cape Town.

A life events scale for research into Xhosa speaking people of Cape Town was developed. It was standardised on 131 residents of Cape Town's three major Black suburbs. Measures of perceived impact and rate of occurrence were elicited. The Spearman Rank correlation between prevalence and impact scores was not significant (r = 0.04). Items were ranked according to composite impact scores. Cultural and social factors were considered to play a part in explaining differences between the present findings and those of other studies. Limitations on the applicability of the scale and methodological issues were discussed. The problems in direct comparison between different cultural groups were emphasized, with particular stress on constraints on life events research in an African setting.

Adaptation, Psychological↗
PubMed1991

Northern Ireland: political violence and self-reported physical symptoms in a community sample.

In order to investigate the possible relationship between physical health and political violence in Northern Ireland a random sample of residents of four electoral areas (two with relatively high violence and two with relatively low violence) was interviewed at home. Each person was asked to rate their health in terms of common physical symptoms, to indicate their use of family doctor and hospital services, and to rate the level of political violence in their neighbourhood. Analysis of covariance (with a measure of psychological well-being, a measure of trait neuroticism plus age and socioeconomic status as covariates) revealed that women reported more physical symptoms than did men, people in the 'high' violence areas reported more symptoms than did those in the 'low' violence areas, while those who rated their own neighbourhood most highly in terms of perceived violence also reported the greatest number of physical symptoms. However, a series of chi 2 tests revealed no association between political violence or perceived political violence and uptake of services.

Cross-Sectional Studies↗
PubMed1992

Environmental scanning for Social Services.

This article describes the development of a process of systematic regional environmental scanning as part of strategic planning in the Ministry of Social Services (MSS) in British Columbia, over the 1987-1990 period. Social Services, a large regionalized social service organization, adopted a formal strategic planning process in early 1988. Ministry services are delivered in ten regions with widely varying characteristics. To ensure that this diversity is reflected in the planning process, it is essential that regional environmental information receive consideration. A simple format was developed and regional directors asked to consult with their staff and to scan their regions for issues that may impact the ministry over the medium term. The information obtained was presented by regional directors at a Senior Management Committee meeting and included in the ministry's annual Business Plan, a document which informs staff, contractors, stakeholders, and the community at large of the ministry's values, objectives, and operational goals. The inclusion of regional analyses adds useful information to the Plan. A second output of the planning process is the ministry budget. The systematic regional scans were found to be extremely useful to regional staff, other directors, and to the ministry executives while setting priorities.

British Columbia↗
PubMed1993

The effects of the spontaneous ingestion of particular foods or beverages on the meal pattern and overall nutrient intake of humans.

The influence of the ingestion of particular beverages and foods on the overall nutrient intakes and meal patterns of humans was investigated by paying 323 adults to maintain 7-day diaries of everything they ingested, time of ingestion, and subjective and social conditions. Ingestion of noncaloric beverages, diet sodas, and coffee or tea, were associated with low overall intakes but were not found to influence the amount eaten over the course of the day or in individual meals. Fifteen different caloric containing drink or food types were found, in general, to add to the total calories ingested in meals or over the day without displacing calories ingested in other forms. The results indicate that individual foods or beverages are ingested independent of other constituents and that intake within meals or over the entire day is elastic and readily influenced by nonregulatory factors.

Adolescent↗
PubMed1989

Maltreatment of children in The Netherlands: an update after ten years.

Governmental consultation and advice on child abuse and neglect in the Netherlands started in 1972 as a two-year experiment with four offices for "confidential doctors" in four major cities of the country. After these two experimental years, a governmental institute for prevention of child abuse and neglect was organized. Over the ensuing decade the number of offices increased to ten, covering the whole country. The State Department of Welfare, Public Health, and Environment collected data from the confidential doctors and their coworkers every year. This study compares the data of the first year 1974 with those of 1983 in order to detect changing patterns over a 10-year period. The major changes are as follows: a threefold increase in cases, an extraordinary increase in cases of emotional maltreatment, an increase in detection of child fatalities but decrease in severity of physical abuse. Sexual abuse was hardly recognized in 1974 but gradually was recognized more frequently during the study decade and accounted for an alarming 7.2% of detected cases of maltreatment in 1983. No change was found in the social conditions of the family and the identity of the perpetrators--primarily fathers and/or mothers. A decrease was noted in the percentage of married parents. The increased percentage of single parents was primarily represented by mothers alone. An increase in the numbers of victims residing at home and a decrease in the need for children's homes as a temporary or permanent residence is attributed to aftercare. The discrepancy between the results of this voluntary notification system in the Netherlands and the results of a mandatory reporting system as used in the U.S.A. is still very high. The hope is that the government will decide to make reporting of maltreatment mandatory for everyone.

Adolescent↗
PubMed1995

Child abuse and neglect in Japan: coin-operated-locker babies.

The coin-operated-locker baby is a type of child abuse that may be unique to Japan. The term refers to newborns who are placed, while alive or dead, in coin-operated lockers. This practice has been decreased by specific measures. It is likely that social and economic variables in Japan account for differences in the frequency and types of child abuse cases when compared to American or European societies as social conditions in Japan change the reported incidence of child abuse may increase in the future. Recently, the government of Osaka organized a group specifically designed to deal with the detection and protection of abused and neglected children. In 1993, they published a manual on how to deal with child abuse, but the Japanese judicial administration still uses old laws for abuse cases. The development of new laws is occurring in parts of the country now. This paper introduces the present status of coping with child abuse and neglect in Japan.

Child↗
PubMed1990

Otitis media and hearing loss in children attending an ENT clinic in Luanda, Angola.

At the ENT clinic in Luanda, Angola, 110 consecutive cases of children with chronic otitis media (COM) were studied to find out some clinical characteristics regarding age of onset and duration of otorrhea as well as the general state of health of the children. Eighty-five percent of the children had had longstanding otorrhea. In 75% of all the cases ear discharge had started during early childhood. It was possible to institute a simple conservative treatment of COM. Fifty percent returned to the clinic for a follow-up. The majority of the children came from families who lived under fairly good social conditions. One-hundred and five children with sensorineural hearing loss consulted the clinic. Many of them had had their hearing loss for several years before coming to the clinic. The etiology was in 39 cases infectious disease, meningitis being the most common one. Seventy-two percent had severe to profound hearing loss. Children with slight to moderate hearing loss rarely appeared at the clinic. Some of the hearing-handicapped children could be sent to a special school for rehabilitation.

Adolescent↗
PubMed1994

Failures in outpatient tonsillectomy policy in children: a retrospective study in 311 children.

The literature suggests that outpatient tonsillectomy in children is a safe and cost-effective procedure. These conclusions have been based on the low rate of post-operative complications. Recent papers suggest contra-indications for ambulatory surgery in some patients. A retrospective study involving 311 children was performed in our Department. We defined two groups in which the out-patient policy had failed. The first group (43 children) comprised inpatient children scheduled because of an unhealthy preoperative state (12 patients), a sleep-apnea syndrome (5 children), a major associated procedure (3 patients), a social or family environment not reliable enough for postoperative supervision (19 patients) or because of parental refusal (4 patients). The second group (268 patients) was constituted of scheduled outpatients. In this group, the outpatient policy failed in 31 and children had to be kept overnight, because complications occurred. The main short-term complication was bleeding (13 patients). In 8, delayed complications were observed. Thus, according to the literature, children with concomitant heavy medical problems or with a poor social environment have to be managed as inpatients. For the others outpatient procedures were possible but parents should previously be informed of the possible overnight hospital supervision which is needed in 11.6% of cases. When comparing the youngest patients under 4 years of age with the others, although the preexisting medical and social conditions are important factors that may contraindicate ambulatory surgery, once the latter has been decided on, there is no significant difference between the two age groups regarding the number of children requiring overnight hospital supervision.

Adolescent↗