Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Social Protection”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,441 records · Page 80Linked to original sources
PubMed1997

Social factors and the process of risk construction in HIV sexual transmission.

This paper reviews different approaches used to analyse the process of risk construction as concerns the sexual transmission of HIV. Individualistic approaches focus on understanding how individual risk representation is constructed. Constructivist approaches consider that the process of risk construction occurs in relation with other people and is affected by social context. The specificities of these procedures are considered from theoretical and methodological points of view, and by using examples taken from quantitative and qualitative research in different countries. Zero exposure to HIV risk does not exist in reality, and people tend to reduce their risk through condom use and other prevention strategies. Prevention campaigns should thus aim for risk reduction instead of risk elimination. Constructivist research elucidates why some people do not protect themselves, notably because of marginalization processes and social normalization of gender roles. It also elucidates why preventive behaviour differs according to type of partner by showing how preventive behaviour depends on power role relationships and social, sexual or confidential relationships, and feelings of love.

Attitude to Health↗
PubMed2003

HIV risk and prevention among Asian/Pacific Islander men who have sex with men: listen to our stories.

Despite increasing need for HIV prevention research and intervention programs, the voices and stories of Asian and Pacific Islander men who have sex with men (API MSM) have remained absent from HIV prevention literature. Five focus groups with API MSM (N = 38) were conducted to identify psychological, social, and cultural factors related to HIV risk and protection. Six themes were identified based on focus group discussion: (a) dual-identity status, (b) coming out and disclosure issues, (c) relationships and dating, (d) substance use, (e) sexual risk reduction strategies, and (f) health and social services. Narrative data indicate that multilevel HIV prevention intervention strategies are necessary for addressing the unique psychosocial and behavioral HIV risk factors among API MSM, such as dual stigma stemming from homophobia and racism, discomfort with sexuality, power dynamics and stereotypes in relationships with White men, substance use, and low utilization of health and social services.

Adult↗
PubMed1999

[Rehabilitation of psychiatric patients in the halfway house--a 10-year retrospective study].

In a period of ten years 159 residents were admitted to a transitional home. 90% of them were diagnosed as chronic schizophrenics with a marked psychic and social handicap. With an average age of 28.7 years and a mean duration of illness of 6.8 years most of the patients had been hospitalized several times; 95% had no job, lived on social assistance or were invalidity pensioners. There was poor success in vocational rehabilitation (22%). Better results were seen in solving the housing problems, showing a clear-cut tendency to move from the family of origin into protected group homes or independent living. Positive effects of social training with gains in life-coping abilities and social competence, i.e., in autonomy in everyday life could be observed as well.

Activities of Daily Living↗
PubMed1991

Social behavior and gender in biomedical investigations using monkeys: studies in atherogenesis.

We review the use of socially housed cynomolgus monkeys (Macaca fascicularis) in biomedical research with emphasis on studies of atherosclerosis, particularly in the two specific domains of atherosclerosis investigation for which nonhuman primates are especially well-suited as animal models: gender differences and psychosocial influences. We found that the presence of normal ovarian function prevented exacerbation of diet-induced coronary artery atherosclerosis in female monkeys. However, any manipulation or condition which impaired ovarian function tended to diminish or abolish this "female" protection. Among group-housed female monkeys, low social status was accompanied by ovarian dysfunction and, not surprisingly, by exacerbated coronary artery atherosclerosis as well. Surgical menopause (ovariectomy) also induced exacerbation of coronary atherosclerosis in monkeys, a situation which was prevented by estrogen replacement therapy. Conversely, pregnancy (a hyperestrogenic state) resulted in markedly diminished atherosclerosis. A somewhat different pattern of atherogenesis emerged among socially-housed males. Here, socially dominant animals developed exacerbated coronary artery atherosclerosis, but only under conditions of social stress (viz., disruption caused by periodic reorganization of social group membership). We hypothesized that exposure to repeated group reorganizations provoked activation of the sympathetic nervous system among dominant animals; in turn, the hemodynamic and metabolic concomitants of sympathetic activation may have damaged the coronary arteries of these monkeys, potentiating atherogenesis. To test this hypothesis, males were housed in unstable social groupings, with half of the monkeys administered a beta-adrenergic blocking agent (to attenuate heart rate and blood pressure responses to stress). The beta-blocker inhibited atherosclerosis, but only among those animals behaviorally predisposed to develop exacerbated lesions (i.e. dominant monkeys). These results support the view that monkeys are suitable research models of atherosclerosis, a disease that affects millions of humans.

Animals↗
PubMed2002

Risk factors for depression in the survivors of the 1988 earthquake in Armenia.

Most studies of psychopathology following disasters are concerned with posttraumatic stress disorder (PTSD). The present analyses sought to assess the rate and determinants of depression in adult survivors of the 1988 earthquake in Armenia. Unlike previous studies of earthquakes, the present analyses derive from a well-defined cohort of survivors who underwent diagnostic interviewing to characterize psychiatric morbidity. As part of a cohort study of 32,743 survivors of the 1988 earthquake in Armenia, a stratified population sample of 1,785 persons was interviewed about 2 years following the disaster using a special questionnaire based on the National Institute of Mental Health (NIMH) Disaster Interview Schedule/Disaster Supplement. 52% met the criteria for major depression. Of these, a total of 177 cases of depression with no other psychiatric diagnosis or comorbidity were compared with 583 controls from the same interviewed group who did not fulfill the criteria for any psychiatric disorder. Cases and controls were compared as to data obtained independently at the aftermath of the disaster on a number of exposures and characteristics related to the earthquake. More of the cases involved females (odds ratio [OR] for males 0.7 [95% confidence interval [CI] 0.5-0.9]) and from the city of Gumri, which had some of the worst destruction (OR for residents of Gumri 5.9 [95% CI 4.0-8.8]). Being with someone in the same building at the moment of the earthquake was protective for depression (OR for presence of other people 0.5 [95% CI 0.3-0.6]), and the risk of depression increased with the amount of loss that the family sustained as a result of the earthquake (OR for highest level of loss 2.5 [95% CI 1.3-4.8]). The use of alcohol was protective for depression (OR for those who drink 0.5 [95% CI 0.3-0.8]). In various models of multivariate adjustment and analysis, the increased risk of depression with loss, geographic location, and female gender was maintained. Also, being with someone during the disaster, receiving assistance and support after the earthquake, and alcohol use were protective for depression in these multivariate analyses. Depression is a common sequel to an earthquake. As with our previous study of PTSD, we were able to relate intensity of the disaster and loss to the risk of depression in a general population sample. The role of social support during and after the disaster as a protective mechanism against adverse psychological outcome was highlighted again. Whereas alcohol use in our previous study was not related to PTSD outcome, it is noteworthy that in the present analyses it emerged as a protective factor for depression.

Adolescent↗
PubMed2003

Sexual harassment and social justice: reflections on the distance yet to go.

Despite progress, protections remain inadequate for victims who bring legal claims of sexual harassment. The process for damages determination frequently increases harm and undercuts the policy initiatives enshrined in Title VII. The author critiques this process, focusing on misuse of psychological examinations and failure of the federal "rape shield" law to adequately protect plaintiffs. The author suggests possible reforms, including removing caps on Title VII damages, minimum awards (i.e., liquidated damages) upon proof of liability, and strategies for educating juries on the harms of harassment that do not exacerbate them, and concludes with a call for professional guidelines for conducting forensic evaluations in sexual harassment cases, thus advancing the policy goal of combating discrimination by encouraging victims to come forward.

Adult↗
PubMed1991

[Clinical analysis of urinary incontinence in the institutionalized elderly].

Urinary incontinence among institutionalized elderly were analyzed from clinical and social viewpoints. The patient group included 25 males and 107 females with an average age of 78 years (ranged from 66 to 92). They had neither highly impaired performance status nor severe dementia. Forty-nine of them (37%) underwent urological examination. Urge incontinence was common among male patients, while urge, stress or mixed incontinence were prevalent in female patients. Thirty-six per cent of the patients had to use pads, diapers and others for their incontinence, while other needed no special protection for their incontinence. Incontinence caused limitation of social activity in 30% of the patients. Many causal factors were assumed for incontinence in elderly; weakness of the pelvic muscles, urinary tract infection, cerebrovascular disorders, neurological disorders and prior pelvic surgery. Prostatic carcinoma or urethral stricture caused overflow incontinence in a few patients. Diuretics or tranquilizers appeared to lead incontinence in some patients. Nine of 18 patients undergoing cystometry had overactive detrusor. Majority of the incontinent elderly showed no intention to visit clinics. Therefore, it recommended to keep staffs in elderly institutions as well as elderly themselves informed that incontinence in the elderly should be treated, which in turn improves the quality of life.

Aged↗
PubMedDate not supplied

Are black Americans entitled to equal health care? a new research paradigm.

This paper analyzes the health, economic and legal implications of most major health systems' reform initiatives in the 20th century and, briefly, the 19th century. The paper suggests that models of analysis grounded in science deter the development of claims for racial equality in health care. Because race is a legal construct, the paper suggests that the 14th Amendment's Equal Protection Clause is an analytical framework that better accommodates the complexity of the health system, is at the heart of our national laws and ethos, and has political rhetorical power to further the political and policy debate. Major components of the health care system, including professional training, hospital construction, and health care financing, are analyzed for racially discriminatory purpose or impact and the extent of government participation. The paper gives particular attention to: the Flexner Report and the limited number of black physicians; the Hill-Burton program and the disproportionate assistance it gave to white controlled hospitals; and, efforts to expand health insurance coverage that also disproportionately favored the needs of the white community. Given the compounding effects of numerous policy decisions made over many years, there should not be any great wonder that such gross disparities in morbidity and mortality exist between black and white Americans. Further research and analysis of the policy decisions that have constructed the current health care system as well as framing those analyses as claims for racial fairness will better develop the policy debate than more narrowly focused analytical models from biomedical science or epidemiology. The law produced slavery and segregation, which usually determined where you lived, where you went, what work you could do, and what you learned. That legally constructed system significantly determined what you earned and what health you had. The biomedical models of analysis of our health system are too narrowly focused and temporally limited to identify the broad systemic barriers to equal health and health care. An analytical framework from law more easily accommodates the complex dynamics of our health care system. The equal protection clause of the 14th amendment has been used to analyze complex social and economic models, such as housing and education and has moved those systems to greater racial equality. The equal protection clause is at the heart of our national laws and ethos and, as a claim for fair treatment from government, has considerable rhetorical power. Menefee presents an analysis of major health policies dealing with training of physicians, construction of hospitals, and financing of personal health care. He suggests it demonstrates a health system rooted in racial discrimination and perpetuating racial discrimination in education, employment and housing. The history of successes using this analytical framework in other areas of social policy validates its consideration by health policy analysts for further research.

Black or African American↗
PubMed1995

Passive smoking and lung cancer.

Evidence that environmental tobacco smoke may be a risk factor for lung cancer among individuals who themselves have never smoked tobacco products has been the subject of expert review over the last decade by several United States and international agencies. The most recent comprehensive review, published in 1993 by the United States Environmental Protection Agency, concluded that environmental tobacco smoke is a Group A (known human) carcinogen. This report, coming in the midst of rapid social and political change in attitudes towards public policy implications for protecting human health, has been the subject of considerable discussion. Issues involved in these discussions, as well as more recently published studies on the topic, are reviewed with respect to current thinking about the risk of lung cancer in passive smokers, particularly women, who are lifetime never-smokers.

Epidemiologic Factors↗
PubMed2005

Depression in older people in rural China.

BACKGROUND: In Western countries depression is the most common psychiatric condition in older persons and related to low socioeconomic status and low social supports. Along with social deprivation, the rural communities in China retain many Chinese traditions that involve high levels of social supports. Studying such a population might offer insights into the cause and prevention of depression that may be applicable in developing and developed countries. METHODS: Using a cross-sectional, household-based, community survey in rural China, we aimed to determine the prevalence of and risk factors for depression among older people who had a low income (mean annual per capita income of about 280 US dollars) and high social support in 16 villages in Anhui Province. Participants included 754 men and 846 women aged 60 years or older. Depression was diagnosed using the Geriatric Mental State and the Automated Geriatric Examination for Computer Assisted Taxonomy. Risk factors, collected from the standard questionnaire and physical measurements, were examined in a stepwise multiple logistic regression model. RESULTS: The prevalence of depression (world age standardized) was 6.0% (95% confidence interval [CI], 4.8%-7.3%). Of all persons, 1374 older persons (85.9%) living with family members. Depression was significantly and independently associated with female gender, low family income, lack of social support, relationship problems, poor health status, and adverse life events in the past 2 years. The risk of depression increased in those eating meat less than once a week (multiple-adjusted odds ratio, 2.20; 95% CI, 1.20-4.03), not watching television (odds ratio, 1.76; 95% confidence interval, 1.03-3.00), and having undetected hypertension (odds ratio, 1.78; 95% CI, 1.05-3.01). CONCLUSIONS: Older people in rural China have a lower risk of depression than those in Western countries. Low socioeconomic status showed a "dose-response" relationship with depression, and social supports were much more common, which were protective for depression. Further exploration of Chinese culture and tradition may yield universal insights into preventive factors for depression in older people.

Age Factors↗
PubMed1997

[Self determination of patients in social psychiatric practice. A medical ethics model and its practical application].

To protect patients' autonomy, valid informed consent must be given prior to medical treatment. This includes disclosure of information, understanding, ability to decide freely, and competence/capacity of the patient. However, a psychiatric disorder may disturb the ability to make a choice of their own. These patients have lost their competence to give valid informed consent. In everyday practice of social psychiatry, it is of particular interest to have objective and valid criteria to identify the incompetent patient. These problems are discussed in a case report, and four criteria (understanding, reasoning, decision making and appreciation of the disorder) are presented to diagnose the patients' competence.

Adult↗
PubMed2005

What do patients consider when making decisions about treatment for hepatitis C?

PURPOSE: There are few data describing decision-making in chronic hepatitis C infection from the patient's perspective. In this study, we sought to investigate the factors that influence patients' decisions as they consider treatment for hepatitis C infection. SUBJECTS: Consecutive patients attending outpatient liver clinics were recruited. Purposeful sampling was employed to include patients who were currently being treated or had recently been treated for chronic hepatitis C infection with pegylated-interferon and ribavirin as well as patients who had refused therapy. METHODS: We conducted focus groups until thematic saturation was reached. All focus groups were facilitated by the same PhD-level senior research scientist, and constant comparative methods were used to analyze the data. RESULTS: A total of 40 patients (80% male) participated in 8 focus groups. The factors influencing patients' decision-making that emerged most frequently during the focus groups were consideration of risk benefit tradeoffs, protected values, heuristics, participants' conceptualization of hepatitis C infection, social issues, and physicians' recommendations. CONCLUSION: Ideally, complex decision-making is based on careful consideration of the tradeoffs related to available options. Our findings suggest that patients' treatment decisions are influenced by multiple factors besides the risks and benefits of interferon and ribavirin. By being aware of these factors physicians can improve decision-making in hepatitis C infection by 1) determining whether patients' decisions are biased by heuristics or protect values, 2) understanding how patients' conceptualization of their illness influences their attitudes toward therapy, and by 3) ensuring that patients understand that social responsibilities need not necessarily preclude treatment because therapy can be discontinued if adverse effects become intolerable.

Adult↗
PubMed1977

Treatment of chronic schizophrenia.

The comprehensive treatment of schizophrenia requires the full resources of a clinical team that is able to offer treatment for the acute psychotic state in a hospital environment, and appropriate rehabilitation following resolution of the florid symptoms. Following a second or subsequent relapse, maintenance therapy with long-acting injections of depot antipsychotics will be required for an unknown period. Although drugs form an essential part of all treatments, it is essential to examine the environment for precipitating factors and to involve the patient's family in the rehabilitation. Recent studies have reported that some patients still have a relatively poor prognosis; although this proportion may be in the minority, the strain on the whole family of an even moderately handicapped patient can be enormous, and it is important to examine the needs of the whole family in evaluating care within the community. The effect of antipsychotic drugs is much wider that the mere control of acute symptoms and can influence the patterns of social behaviour and rehabilitation, in addition to offering protection against stress. The proper use of depot injections requires that they be kept under constant review. The current widespread practice of prescribing anti-cholinergic drugs on a prophylactic basis, or even as the inital treatment of extrapyramidal side-effects, needs revision.

Antipsychotic Agents↗
PubMedDate not supplied

Developmental antecedents of borderline personality disorder.

Developmental antecedents of borderline personality disorders (BPDs) were examined in 25 DSM-IV-diagnosed subjects with BPD and 107 non-borderline control subjects on the basis of medical records and 28 years follow-up. Abuse, neglect, environmental instability, paternal psychopathology, and lower score on protective factors differentiated significantly between the groups. Environmental instability and lower score on protective factors such as artistic talents, superior school performance, above average intellectual skills, and talents in other areas were found to be independent predictors of BPD diagnosis. The results of this study suggest that both abuse and neglect, unpredictable and unstable early environment, as well as deficit in protective factors may substantially contribute to the development of BPD in persons constitutionally predisposed for the disorder. The results of the study also suggest that future research should address the impact of social and cultural context, as well as the absence of protective factors, on the development of the BPD.

Adolescent↗
PubMed1999

Less pain and more to gain: why high-status group members blame their failure on discrimination.

Members of high-status groups are more likely than members of low-status groups to blame their failure on discrimination and are less likely to blame it on themselves. This tendency was demonstrated in 3 experiments comparing men and women, White and Black students, and members of experimentally created high- and low-status groups. Results also showed that when making an attribution to discrimination, high-status group members were less likely to experience a threat to their social state self-esteem, performance perceived control, and social perceived control and were more likely to protect their performance state self-esteem. These findings help to explain why high-status group members are more willing to blame their failure on discrimination by showing that it is less harmful for them than for low-status group members.

Adult↗
PubMed1997

Risk and protective factors as predictors of adolescent alcohol involvement and transitions in alcohol use: a prospective analysis.

OBJECTIVE: Determinants of initial alcohol use may differ from predictors of accelerated or problematic consumption. Social influences may be strong predictors of initial drinking; however, later stages of problem drinking may be linked developmentally to intrapersonal deficits. This study prospectively examined the influence of chronic and changing risk and protective status in predicting adolescent alcohol involvement and transitions in alcohol use. METHOD: Data were obtained from a three-wave cohort (N = 823) of 8th-10th grade nonintervention students participating in a school-based drug abuse prevention trial. Cognitive, attitudinal and social influence measures were dichotomized using empirical cut-offs to designate risk or protective status. Using a conceptually based assignment scheme, additive risk indices were created assessing chronic (averaging across time) and changing features of competence, psychological and interpersonal functioning, cognitive-affective and social influences. Three chronic and change protective indices were created tapping competence, psychological, and interpersonal functioning. RESULTS: Controlling for initial drinking and gender, chronic risk for social influence and psychological functioning and increased risk for social influences and competency predicted subsequent drinking behavior. Chronic psychological protection attenuated subsequent drinking. Using categorical measures of drinking behavior to designate nonuse, experimental or moderate-heavy use, chronic social influence and competency risk were associated with an increased likelihood of accelerated drinking, whereas improved psychological functioning diminished the likelihood of increased drinking behavior. CONCLUSIONS: Findings underscore the need for implementing prevention strategies that reinforce developmentally appropriate skills and enhance personal competence and psychological functioning as effective barriers against initial and more problematic alcohol use. The unique contribution of protective forces also underscores that risk reduction and protection enhancement are complementary processes and are both required to offset social influences for alcohol consumption.

Adolescent↗
PubMed1995

[Chemoprevention of cancers, the point of view of health insurance].

Faced with scientific progress, social security must be concerned by ethics, especially by protection of personal integrity. Financial necessities lead to take into account the efficiency of public health interventions. But in front of potentially toxic drug, are we allowed to compare possible advantages with potentially serious risks for healthy women? For these reasons, social security takes a stand in favour of carefully controlled trials, focused on restricted target populations which are estimated at high risk of cancer. Research of side effects should be included in the follow of the patients and special caution should be taken to avoid premature spreading of this behaviour. About a financial contribution of social security, the National fund for health prevention, education and information (FNPEIS) could perhaps not support such a project, regarding to his experimental nature. CNAMTS-INSERM research contracts could be an alternative.

Antineoplastic Agents↗
PubMed1993

Hodgkin's disease: the protective effect of childbearing.

Register and census data for complete cohorts of Norwegian men and women born between 1935 and 1974 were used to examine the relationship between reproductive factors and the incidence of Hodgkin's disease (HD). Among 1.3 million men and 1.3 million women under observation, 695 male and 441 female cases of HD were diagnosed during the period of follow-up. Our hazard model estimates showed that women, at a given age and in a given birth cohort, have an HD incidence inversely related to current parity. A clear relationship was found only for the nodular sclerosis subtype. In men, the risk of HD development was higher than that in childless women, and there was no parity effect. The lower HD incidence among high-parity women could not be ascribed to their lower social status. Presumably, there is a still unidentified protective factor associated with the biology of childbearing, the effect of which possibly wears off with increasing length of time since childbirth. In addition, there are indications of a net effect of age at entry into motherhood, which may explain part of the estimated parity effect.

Adolescent↗