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PubMed1999

The risk and protective functions of perceived family and peer microsystems among urban adolescents in poverty.

Utilized a pattern-based approach to discover the different constellations of perceived social transactions separately for family and peer systems and explored the risk and protective functions of these microsystem profiles for both depression and antisocial behavior among a sample of ethnically and racially diverse urban adolescents living in poverty. Measures of perceived social support, involvement and hassles with family and peers, as well as perceived social acceptance and peers' values were entered into two sets of iterative cluster analyses to identify distinct profiles of family and peer transactions. From each of the perceived family and peer transactional analyses, six replicated profiles emerged. Several of the profiles were consistent with expectations from prior literature such as Enmeshing families and Rejecting peer networks, while others were novel and intriguing such as Entangling peers. Family profiles were consistent in their risk and protective associations for both depression and antisocial behavior, while the peer profiles varied in their effects for each developmental outcome. For example, the Rejecting peer profile placed adolescents at increased risk for depression but protected them from antisocial behavior. Implications for future research and preventive intervention are discussed.

Adolescent↗
PubMed1991

[The physician Charlotte Olivier (1865-1945) and control of tuberculosis among the poor in Lausanne].

At the beginning of the 20th century, tuberculosis is regarded as a social disease. For lack of an anti-infectious therapy, an indirect prophylaxis seems mandatory: a network of institutions, sanitation of dwellings, protection of children. One assists at the development of a social and preventive medicine which cares for the sick in their social environment. This implies, however, intrusion into private life. Fighters against tuberculosis in this form are predominantly women: charitable ladies, visiting nurses, and doctors. Among the latter, Charlotte Olivier is prominent; in the decisive years of 1911-1925 she directs the Lausanne antituberculous dispensary.

History, 19th Century↗
PubMed2006

Protecting children from the dangers of urban poverty.

Exposure to the social ecology of poor urban neighborhoods significantly increases the incidence of traumatic stress disorders, placing children growing up in such neighborhoods at disproportionate risk. Although the risk factors for and effects of childhood complex traumatic stress disorders are well documented, there is little intervention research to guide the delivery of services to this population. This paper builds on current knowledge of childhood trauma and related treatments by introducing an intervention model using constructive family ritual functioning as a mechanism for increasing the protective function of the family. The intervention model postulates that use of family rituals as a coping resource will lead to decreased symptoms of chronic traumatic stress and rates of exposure to additional trauma.

Adaptation, Psychological↗
PubMed2004

[Health protection against electromagnetic fields].

In recent years there has been an increasing social concern in Spain about electromagnetic fields (EMF) and their effects on human health. Some groups have expressed their opposition to antennas of base stations and high voltage power transmission lines. The present article discusses the current status of health protection against EMF in Spain. The assessment is based on the background and justification of the European Union Council Recommendation of 12 July 1999 on the limitation of exposure of the general population to electromagnetic fields (0 Hz to 300 GHz), the Spanish Royal Decree 1006/2001 on health protection against radioelectric emissions and the most relevant epidemiological studies. The need for implementation of a comprehensive approach based on risk assessment and the precaution principle is emphasized. In order to be coherent with the Council Recommendation and Spanish EMF legislation some strategies for health protection are proposed.

Electromagnetic Fields↗
PubMed1997

Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health.

CONTEXT: The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. OBJECTIVE: To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. DESIGN: Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. PARTICIPANTS: A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. SETTING: The interview was completed in the subject's home. MAIN OUTCOME MEASURES: Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. RESULTS: Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P<.001) and violence (grades 7-8: P<.001; grades 9-12: P<.001). Access to substances in the home was associated with use of cigarettes (P<.001), alcohol (P<.001), and marijuana (P<.001) among all students. Working 20 or more hours a week was associated with emotional distress of high school students (P<.01), cigarette use (P<.001), alcohol use (P<.001), and marijuana use (P<.001). Appearing "older than most" in class was associated with emotional distress and suicidal thoughts and behaviors among high school students (P<.001); it was also associated with substance use and an earlier age of sexual debut among both junior and senior high students. Repeating a grade in school was associated with emotional distress among students in junior high (P<.001) and high school (P<.01) and with tobacco use among junior high students (P<.001). On the other hand, parental expectations regarding school achievement were associated with lower levels of health risk behaviors; parental disapproval of early sexual debut was associated with a later age of onset of intercourse (P<.001). CONCLUSIONS: Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

Adolescent↗
PubMed2006

A multilevel analysis of key forms of community- and individual-level social capital as predictors of self-rated health in the United States.

Communities may be rich or poor in a variety of stocks of social capital. Studies that have investigated relations among these forms and their simultaneous and combined health effects are sparse. Using data on a sample of 24,835 adults (more than half of whom resided in core urban areas) nested within 40 U.S. communities from the Social Capital Benchmark Survey, correlational and factor analyses were applied to determine appropriate groupings among eight key social capital indicators (social trust, informal social interactions, formal group involvement, religious group involvement, giving and volunteering, diversity of friendship networks, electoral political participation, and non-electoral political participation) at each of the community and individual levels. Multilevel logistic regression models were estimated to analyze the associations between the grouped social capital forms and individual self-rated health. Adjusting the three identified community-level social capital groupings/scales for one another and community- and individual-level sociodemographic and socioeconomic characteristics, each of the odds ratios of fair/poor health associated with living in a community one standard deviation higher in the respective social capital form was modestly below one. Being high on all three (vs. none of the) scales was significantly associated with 18% lower odds of fair/poor health (odds ratio = 0.82, 95% confidence interval = 0.69-0.98). Adding individual-level social capital variables to the model attenuated two of the three community-level social capital associations, with a few of the former characteristics appearing to be moderately significantly protective of health. We further observed several significant interactions between community-level social capital and one's proximity to core urban areas, individual-level race/ethnicity, gender, and social capital. Overall, our results suggest primarily beneficial yet modest health effects of key summary forms of community social capital, and heterogeneity in some of these effects by urban context and population subgroup.

Adolescent↗
PubMed1983

Learning disabilities in the junior high school: creating the six-hour emotionally disturbed adolescent?

Special education programs for the learning disabled, junior high school adolescent must ecologically analyze and address the myriad variables which potentially affect self-concept. The present article reviews and coordinates recent literature which has investigated the interaction between learning disabled adolescents' self-concept and academic, peer, family, and community systems. A unique behavioral pattern, the six-hour emotionally disturbed/learning disabled adolescent may result from continuous, negative self-concept experiences. This pattern occurs when learning disabled adolescents develop expectations of constant academic or social failure, choose to avoid these situations, and engage in maladaptive, "emotionally disturbing" behaviors as protective mechanisms. In the family and/or community systems, however, these students can be socially and adaptively successful. Preventive programming for the learning disabled, junior high school adolescent is discussed across the above interdependent systems.

Adolescent↗
PubMed1980

[Attitude of psychiatric personnel on the treatment of patients, psychometrics and results].

UNLABELLED: The therapeutic attitude of psychiatric nurses towards inpatients of a mental hospital was studied. Is there a correlation of nurses' attitude and their view of the patients' behaviour, social attractiveness, and prognosis? Are there differences in the therapeutic attitude in regard to different diagnostic groups? A questionnaire was constructed. Probands were 70 female, 40 male nurses. For every proband there was taken a patient: 70 female, 40 male patients (34 schizophrenics, 15 depressive patients, 15 psychogeriatric patients). The data were evaluated by path analysis and analysis of variance. THE RESULTS: Patients with more social interest and more psychotic symptomatology were rated as more socially attractive. The more pathologic patient's behaviour in the wards was judged the worse was the supposed prognosis. Dysphoric-morose patients and patients with low social attractiveness provoke an authoritarian and controlling attitude. Patients held as social competent stimulate nurses' attitude towards promotion of dependence and autonomy. The lower social competence and the worse prognosis is taken the more the attitude is inclined to protective control and isolation. The therapeutic value of personal humane communication and direct social contacts is taken for less important when patients seem to be socially inattractive and incompetent. We did not find any difference in the nurses' attitude in regard to schizophrenic or depressive patients. Schizophrenic patients did stimulate more intentions towards propagation of independence and autonomic activity than psychogeriatric patients do. Between male and female nurses we did not find any difference in their attitudes to the (same sex) patients.

Adult↗
PubMed1997

Affiliative relationships between adult males and immature group members in naturally occurring ringtailed lemurs (Lemur catta).

Affiliative relations between adult males and immature group members were studied in three naturally occurring groups of ringtailed lemurs (Lemur catta) over a 12-month period at Beza-Mahafaly Reserve, southwestern Madagascar. No statistically significant difference was found in rates of affiliative interactions between adult males and older immatures (juveniles and adolescents) over reproductive seasons. However, some of the adult males in two focal groups increased their rates of affiliative behaviors with older immatures during the lactation and subsequent 1993 postmigration periods. Female involvement with infants during lactation season, the increasing independence of juveniles and adolescents, and length of male tenure may be factors contributing to such a pattern. Neither adult males nor immatures were significantly responsible for the initiation and maintenance of proximity in male-immature dyadic interactions. Neither dominance rank nor age-class of the adult male affected their rates of affiliative behavior with immatures. The majority of focal males exhibited an interest in infants and occasionally participated in alloparental care. It is suggested that adult males can benefit from affiliative relations with immatures in terms of opportunities for greater spatial centrality in the group, which can lead to enhanced predator protection and greater opportunities to develop affiliative relationships with females. Immatures can benefit from affiliation with males in relation to enhanced predator detection and protection, alloparental care, and opportunities to develop social skills.

Age Factors↗
PubMed2006

Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature.

OBJECTIVE: To systematically review studies describing the course of functioning in patients with osteoarthritis (OA) of the hip or knee and identifying potential prognostic factors. METHODS: A systematic search was performed. Studies involving patients with hip or knee OA, >6 months of followup, and outcome measures on functional status or pain were included. Methodologic quality was assessed using a standardized set of 11 criteria; a qualitative data analysis was performed. RESULTS: Approximately 6,500 titles and abstracts were screened and 48 publications were considered for inclusion. Eighteen studies, 4 of which met the high methodologic quality criteria, were included. For hip OA, there was limited evidence that functional status and pain do not change during the first 3 years of followup. After 3 years, however, a worsening of functional status and pain was seen. For knee OA, there was conflicting evidence for the first 3 years and limited evidence for worsening of pain and functional status after 3 years. Furthermore, limited evidence was established for negative associations between future functional status and laxity, proprioceptive inaccuracy, age, body mass index, and knee pain intensity. In contrast, greater muscle strength, better mental health, better self-efficacy, social support, and more aerobic exercise were protective factors in the first 3 years. CONCLUSION: Pain and functional status in hip or knee OA seem to deteriorate slowly, with limited evidence for worsening after 3 years of followup. In specific subgroups, prognosis in the first 3 years of followup was either worse or better, as both risk factors and protective factors were identified. Prognostic factors included biomechanical factors, psychological factors, clinical factors, and treatment modalities. To strengthen the evidence, further high-quality longitudinal research on hip or knee OA functioning is needed.

Disease Progression↗
PubMed1995

Urine marking and maternal aggression of wild female mice in relation to anogenital distance at birth.

A series of experiments were conducted with wild house mice to verify the effect of intrauterine position on females' anogenital distance at birth (AGD) and to examine the relationships between a female's AGD, used as a bioassay of androgen exposure during fetal life, and her social behavior and reproductive success in adulthood. Experiment 1 showed that cesarean-delivered females that developed in utero between two males (2 M females) have significantly longer AGD's than females positioned between two females (0 M females). We then categorized naturally delivered females shortly after birth as having a long, medium or short AGD. In adulthood, these females were tested for their behavior towards unfamiliar pups, their rate of urine-marking in response to a variety of social stimuli, postpartum aggression and success in protecting their litters in response to male and female intruders. Adult females with different AGD's at birth did not differ either in their behavior toward pups or in their rate of urine marking. Conversely, males housed across a wire mesh partition from a long-AGD female deposited a higher number of urine marks than those exposed to a short-AGD female. When tested after delivering a litter, long-AGD females displayed more tail-rattling (a component of agonistic behavior) towards intruders of both sexes in comparison to short-AGD females. These results are consistent with the hypothesis that females with a long AGD are exposed to higher levels of Testosterone during fetal life than females with a short AGD. Although not related to AGD, other measures of maternal aggression were affected by postpartum day, sex of intruders and a female's infanticidal potential while a virgin.

Aggression↗
PubMed1998

Possible objectives and resulting entitlements of essential health care packages.

The notion of a defined 'core package of essential health care services' has appeared in many different health reform proposals in the 1990s. This paper attempts to explore the possible objectives of the 'core package' component of health care reform. Two board applications are apparent: the use of essential packages to ration scarce public funds and the incorporation of a minimum benefit package into 'managed competition' type reforms, where they constitute a mandated minimum level of private insurance cover. Eight possible objectives for an essential benefit package are described: To protect against catastrophic illness events; to ensure social risk pooling; to improve allocative efficiency in the health system; to eliminate 'high burden of disease' conditions; to improve equity of access to services; to combat cost-escalation; to encourage competition between insurers; and to facilitate public participation and transparency in decision making. Closer examination of objectives reveals that they often conflict, which suggests that a clear understanding of the purpose of reform is essential before it is worthwhile devoting energy to the development of essential benefit packages. It is argued that two main clusters of objectives emerge from the eight described, representing Rawlsian (risk avoidance) and utilitarian (efficiency improvement) social welfare philosophies, respectively. Practical experience suggests that priority setting exercises have been unsuccessful in meeting efficiency objectives, but that they may well be quite useful in fulfilling risk-pooling aims.

Cost-Benefit Analysis↗
PubMed2002

Determinants of and inequalities in self-perceived health in Ukraine.

Ukraine is the second most populous of the former Soviet Republics and since transition its economy has fared even more poorly than Russia. Although the impact of the collapse of the former Soviet Union on health in Russia has been investigated, little is known of its impact in other post-Soviet republics. We report a cross-sectional study undertaken in Ukraine in March 2000. A multi-stage random sampling technique was used and 1600 interviews completed (72% response rate) with a representative national sample of Ukrainian adults. We investigated socioeconomic and psychosocial determinants of self-perceived health, which has been shown to be a valid and reliable measure of overall health and predictive of mortality. Odds ratios for less than good physical health were calculated using logistic regression. The self-rated health of Ukrainians was poor, 25% of men and 43% of women rated their health as poor or very poor. This is worse than levels recorded in Russia and considerably worse than levels seen in western Europe. Marked gender, geographical and socioeconomic inequalities in health were recorded. Women are at increased risk of poor self-rated health compared with men (OR 3.58, 2.50-5.14) as are women living in villages compared with those in cities (OR 3.24, 1.30-8.07). Socioeconomic factors including poor material situation (OR 1.64, 1.01-2.67), and psychosocial factors including low control over life (OR 1.89, 1.15-3.11) were identified as independent health determinants. Control over life was found to account for the negative impact of low social position on health. Good family relations protected against poor health. The findings suggest that a decrease in control, arising from an increasingly uncertain political and economic environment, a reduction in material wealth and the stress of change may all have contributed to the decline in life expectancy seen with transition.

Adult↗
PubMed2003

A quantitative method for accounting human opinion, preferences and perceptions in ecosystem management.

Ecosystem management (EM) is a holistic approach, in which public participation in decision-making, and incorporation of human preferences, needs and perceptions in management plans is a main element. The decision-making from human opinion method (DeMHO), presented here, can be used in EM in selecting the more suitable and socially acceptable management plan, in order to protect or restore an ecosystem. The method focuses on the quantification of the human opinion, preferences and perceptions, which are investigated after research on the local population of the ecosystem. The results of this research are the inputs of the method; multi-criteria decision-making procedures, such as the analytic hierarchy process (AHP), the expected utility method (EUM) and compromise programming (CP) are used to assign the appropriate weights and rank according to their importance the interest groups, the issues to be studied, and the alternative management plans. The alternatives are also evaluated by assessing their sustainable character. The paper presents DeMHO and its application in the National Park of Eastern Macedonia and Thrace in Greece, after a research through a questionnaire on the local population.

Attitude↗
PubMed2000

The conflict between ethics and business in community pharmacy: what about patient counseling?

Patient counseling is a cornerstone of ethical pharmacy practice and high quality pharmaceutical care. Counseling promotes patient compliance with prescription regimens and prevents dangerous drug interactions and medication errors. Counseling also promotes informed consent and protects pharmacists against legal risks. However, economic, social, and technological changes in pharmacy practice often force community pharmacists to choose between their professional obligations to counsel patients and business objectives. State and federal legislatures have enacted laws that require pharmacists to counsel patients, but these laws have had mixed results. This essay argues that community pharmacy's patient counseling conundrum can be solved through additional moral education persuasion, not through additional legal mandates.

Community Pharmacy Services↗
PubMed2003

Employment frustration and alcohol abuse/dependence among labor migrants in California.

We test whether or not labor market frustration is associated with clinical alcohol abuse/dependence diagnoses among labor migrants living in California. Our sample consists of 1576 Mexican labor migrants in Fresno, CA, who migrated for the purpose of seeking employment. Using clinical criterion (DSM-III-R), we find that frustrating experiences resulting from labor market exclusion and discrimination are significantly related to past-year alcohol abuse/dependence. Similarly, although high levels of social support are salutary, they are not protective among those who experience moderate/high levels of employment frustration. Since Mexican-origin immigrants have low rates of health insurance coverage and lower propensities for formal help-seeking, community outreach programs that target labor migrants are essential to this population's mental health maintenance.

Adolescent↗
PubMed2004

Service quality as measured by service fit and mortality among public mental health system service recipients.

Service fit, defined as consistency between mental health services judged needed and services received was measured for a random sample of service recipients in a public mental health system (N = 6588). A variant of small area analysis was used to measure the relationship between catchment area mortality rates from natural causes, suicide, and medicolegal causes and area fit scores for a variety of services. We tested the theory-based hypothesis that service fit would predict interarea variations in mortality better than simple measures of amount of service prescribed and received. We also tested the hypothesis that, controlling for relevant demographic and clinical factors, fit would be protective for mortality from all causes. Findings supported the first hypothesis. With respect to the second, service fit for only certain services was protective. Housing and clubhouses services were particularly protective, suggesting the importance of services providing social support.

Adult↗
PubMed1997

Vulnerability on the streets: female sex workers and HIV risk.

In-depth interviews were conducted with 24 purposively selected female sex workers who were perceived to be vulnerable to risks associated with their lifestyle and occupation. Brothel workers were found to be considerably less exposed to risk than the women working on the streets. Client resistance was the major obstacle to women maintaining safe sex practices. Physical threats and coercion from clients, the absence of legal protection for street workers, the workers' extreme social isolation and lack of community support added to the difficulties experienced by women in their attempts to insist on condoms for all sex services. Youth, homelessness and heavy drug use had contributed to women being at times even more vulnerable because they had less capacity to manage situations of potential violence or STD risk. Whether through sex work or in their private relationships, HIV remains a risk for some of these women. This study highlights the dangers associated with illegal sex work. While decriminalization of prostitution would reduce some of the dangers to which women were exposed and increase women's capacity to insist on safe sex practices, it is also important for community education programmes to address men's failure to accept responsibility for condom use when seeking the services of sex workers.

Adolescent↗