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PubMed1993

The normative and conceptual foundations of a clinical duty to protect.

The continuing controversy surrounding the Tarasoff inspired duty to protect as developed by the courts and legislatures has not adequately weighed the jurisprudential foundations of such an obligation. The authors argue that the duty's misguided thrust of social control grounded in character and status seriously violates broad principles of political morality underlying the law of social control. They conceptualize an alternative--a clinical duty to protect--that coheres with these underlying values and the limits of professional abilities. They contend that any extra-clinical intervention on the part of the psychotherapist entails a role transformation requiring independent justification.

Confidentiality↗
PubMedDate not supplied

[Reflections on the cause and consequences of exposure to violent presentations in children].

The article deals with the questions why children and adolescents nowadays have an intensive use of violent videos and which are the consequences of this use. The motives of the use are compensation and flight of daily problems and of inner psychic emptiness, identification with grandiose heroes, the experience of anxiety-joy, protest against the parents' generation and the test of courage to obtain a social status in the peer group. The consequences of violent presentations can be understood by different psychological concepts as social cognitive learning theory, suggestion hypothesis, justification hypothesis, habituation hypothesis, catharsis theory, priming effect, arousal theory. These findings lead to the following consequences: Media critical lectures at school, governmental protection of children against harmful products, solution of the underlying social problems which lead to resignation and hopelessness in children and adolescent.

Adolescent↗
PubMedDate not supplied

Newborn genetic screening: ethical and social considerations for the nineties.

As we head into the next decade, the impact of the use of genetic screening programs for immunological surveillance purposes (such as for HIV) and for possible DNA typing should not be underestimated. The authors present ten principles which seek to reaffirm the basic tenents of neonatal screening programs -- the benefit of newborns. These principles are both protective and yet open to the complex ethical and social considerations raised by such new uses of newborn genetic screening programs.

Coercion↗
PubMed1996

Individuality and community: the contrasting role of the state in family life in the United States and Sweden.

Underlying moral values of individuality versus community and assumptions about what is a "just society" make public policies toward children vastly different in Sweden and the United States. This article explores the origins, cost, and benefits of welfare policies that permit child poverty in the U.S. as a cost of the high value of autonomy/individuality, and policies that prevent child poverty in Sweden, at the cost of economic competitiveness and individual initiative. I conclude that both extremes of moral values have more social costs than benefits but that children should be protected in any nation as the future of the society.

Adult↗
PubMed2005

You can't use plywood: The perilous success of spirituality and medicine.

The Canadian sociologist Arthur Frank has thought deeply about both health and illness, especially life-threatening illness, and, by extension, the lack of distinction that exists between a spiritualized medicine or a medicalized spirituality. Professor Frank is known internationally for his pioneering work on illness narratives and has made significant contributions to the emergent field of Narrative Medicine. He has integrated the gleanings of personal experience and professional research into a cohesive whole and made such available in 3 richly nuanced and significant works of narrative medicine: At the Will of the Body, The Wounded Storyteller, and The Renewal of Generosity. With a voice that is soulful and wry, humble and fierce, Franks work chronicles and reflects on a full spectrum of human-making experiences as they relate to terminal illness, hope, intimacy, confusion, listening, and responding. Whether our readers are caregivers, clinicians, or individuals preparing for the transition called Death, this is one author who asks tough questions and makes room for delicate, paradoxical, out-of-the-box responses. In doing so, he brings that which is intimately personal into a larger discourse that is social, political, and cultural. At the same time, he protects the inviolate intimacy granted to each individual on the threshold. Bravo!

Adaptation, Psychological↗
PubMed1993

The impact of caring and connectedness on adolescent health and well-being.

This study of over 36,000 7th-12th grade students focused on protective factors against the quietly disturbed and acting out behaviours, which together represent the major social morbidities of adolescence. Multivariate models developed separately for girls and boys repeatedly demonstrated the protective function of caring and connectedness in the lives of youth, particularly a sense of connectedness to family and to school. A sense of spirituality, as well as low family stress (referring to poverty, unemployment, substance use and domestic violence) also functioned as protective factors. Measures of caring and connectedness surpassed demographic variables such as two parent vs single parent family structure as protective factors against high risk behaviours. Interventions for youth at-risk must critically examine the ways in which opportunities for a sense of belonging may be fostered, particularly among youth who do not report any significant caring relationships in their lives with adults.

Adolescent↗
PubMed2003

Social capital and the collective management of resources.

The proposition that natural resources need protection from the destructive actions of people is widely accepted. Yet communities have shown in the past and increasingly today that they can collaborate for long-term resource management. The term social capital captures the idea that social bonds and norms are critical for sustainability. Where social capital is high in formalized groups, people have the confidence to invest in collective activities, knowing that others will do so too. Some 0.4 to 0.5 million groups have been established since the early 1990s for watershed, forest, irrigation, pest, wildlife, fishery, and microfinance management. These offer a route to sustainable management and governance of common resources.

Animals↗
PubMedDate not supplied

[The logistics of population health protection].

The health protection of population is a subsystem of a macrosystem, i.e. of social sphere. The social sphere, in its turn, is a logistic macrosystem, therefore, the logistical principles can be applied to its subsystems. The system of population health protection is regarded from such standpoint in the paper; the dynamics of human resources are described in detail including an independent author's classification of it. A scheme is presented of how to manage the human resources evolution; effects exerted by the subsystem through the infrastructure on human resources are elucidated.

Health Services Administration↗
PubMed1997

[Psycho-social work conditions as risk factors for premature birth and newborn hypotrophy].

On the basis of the studies carried out the authors verified a hypothesis that psychosocial work conditions and occupational stress are risk factors for premature birth and newborn hypotrophy. The following aspects were considered in the evaluation of psycho-social work conditions: (a) work-related psychological demands; (b) the extent to what an employee is able to control the situation at work; (c) occupational stress arising from the discrepancy between work-related demands and the extent of control over the work situation; and (d) interpersonal relations at work. The analysis covered 219 cases of premature births and 159 cases of newborn hypotrophy. The control group comprised 586 women sampled randomly who gave birth at term to a healthy baby with correct birth weight. The authors found that ill interpersonal relations and a low level of control over the situation at work elevate the risk of giving birth to a baby with hypotrophy, while good interpersonal relations and a high level of control over the situation at work play a protective role. The effect of these psycho-social factors applied only to hypotrophy of a newborn and it was related neither to other features of occupational work nor to biomedical factors. It seems that this kind of factors may have generally less pronounced impact on premature birth.

Adult↗
PubMed2004

Salutogenesis as a framework for child protection: literature review.

AIM: The aim of this paper is to demonstrate the usefulness of salutogenesis in work relating to child protection. METHODS: A systematic review to explore the links between parenting, social factors and failure to thrive was carried out using 17 CD ROM and online databases using keywords in appropriate medical subject headings (MeSH terms) and Boolean operators refined for the studies. The salutogenic framework was then used as a way of clarifying what benefit particular research findings may have in identifying and using factors which can be associated with protection, safety and well being of children. Cross-referencing the evidence from the systematic review against Antonovsky's generalized resistance resources created a salutogenic matrix. FINDINGS: Four factors in the systematic review were found crucially important: parent factors; parenting factors; child factors; and social factors. However, it is probable that these are useful within all child protection research and the evidence gathered in particular cases (here failure to thrive) could be plotted against each factor. Application of a salutogenic framework to the results was further illuminating and has utility for both systematic review methodology and other child protection explorations. The matrix created a warp and weft effect that identified gaps in current evidence and practice and was able to disentangle some of the complexities inherent within failure to thrive situations. By beginning to shed understanding on such processes, the concept of salutogenesis added further depth and rigour to the analysis. CONCLUSIONS: The concept of salutogenesis is widely used in some areas of nursing practice and research, and can also be regarded as a theoretical tool that has potential in child care and protection research, development and practice. The paper also illustrates the importance of a sound theoretical framework in ensuring depth and rigour in analyses of literature review findings.

Child↗
PubMed2004

[Education in family medicine at the Medical School in Sarajevo].

At the Medical faculty of the University of Sarajevo in the 11th semester of the instruction is organized the turnus training from family medicine, and according to the instructive plan and programme of the medical faculty defined in the statute from 1991 year, as well as the rest turnus instruction which the students of medicine pass in the sixth year of studies, and this instruction is imagined as a way and the path that the future physicians as better as possible prepare for the individual work with the patients after acquiring of the diploma. The instruction obligations according to this form of the instruction as that which is being produced are getting performed in the frame of the subject the social medicine and the organization of the healthcare protection. True, the subject family medicine will be independent of the school year 2005/06 for the registration generation 200/01. The momentary plan and programmee (turn) instruction is coinciped so that the teachers and assistants perform 20 hours of the theoretic instruction in the amphitheaters of the Medical faculty and the practical instructions perform the assistants for the family medicine by the fund from 75 hours of the instruction in units of the Health center on the localities Visnjik and Grbavica. The content of the programme encircles the method units which have lead professor Hodgets and the collaborators from Quins' university in Canada and according to the project concipied according to the regulations inter-university agreement of the mentioned university in Canada and the ours in Sarajevo, and the agreement between the Federal ministry of health in Sarajevo and Canada government and which we shall shortly present in this paper. After the heard theoretical and performed practical instruction is being performed the evaluation of knowledge by the corresponding test, which well also be shortly explained in this article. True, there are the definite misunderstandings and the different attitudes whether this concept is adequate for the users of the healthcare protection in B&H regarding the momentary limited resources for any innovations in the individual segments of the healthcare, because there is the anxiety that in the case of the breakdown of financing of the mentioned concept of the family medicine in B&H because of these we discussed publicly herr the thoughts and the attitudes also those who have the experiences from earlier, because we had also their own concepts of the organization of the family medicine, and eventually reflect also about implementation of some other models or modification of the existing which momentary gets realized. At the Cathedre for the family medicine at the Medical faculty of the University in Sarajevo is formed the lecture which make the chiefs of six other cathedres (of pediatry, gynecology, psychiatry, of internal medicine, surgery and social medicine) which have the task that in the following three years get concipied some kind of the optimal programmee of education from the family medicine at our faculty.

Bosnia and Herzegovina↗
PubMed2004

The precautionary principle, toxicological science, and European-U.S. scientific cooperation.

Although it is an ages old concept, the precautionary principle is only a few decades old as a formal expression of a philosophy guiding protection of the environment and of human health. The emergence of the precautionary principle in the European Community and its relatively slower acceptance in the United States reflects differences in underlying social, cultural, and legal approaches to environmental and public health protection. Unfortunately, this poorly defined principle in some of its manifestations can lead to a loss of the toxicological scientific base that is necessary for short-term and long-term protection of the environment and public health. Examples of problems caused by using the precautionary principle include trade barriers erected by the European Community, and the loss of the impetus to develop understanding of the toxicity of hazardous air pollutants due to precautionary aspects of the 1990 U.S. Clean Air Act amendments. There are other U.S.-European differences in the organization and funding of science that are threatening the legacy of Herbert Remmer which was built on close trans-Atlantic scientific cooperation to the benefit of all.

Animals↗
PubMed1997

A critique of the case for privatizing Social Security.

This article presents and then critiques arguments made by those advocating the privatization of Social Security. It refutes the argument that baby boomers will find themselves without Social Security pensions unless fundamental changes are made. It questions the claims that privatization would increase economic growth, reduce the federal deficit, make the nation more competitive in the global economy, protect workers against payroll tax increases, protect boomers against pension benefit cuts, and increase confidence in Social Security. It argues that for low-wage workers, returns on contributions would probably decrease and future benefits would become politically more vulnerable.

Aged↗
PubMed1997

Infant development and developmental risk: a review of the past 10 years.

OBJECTIVE: To review critically the research on infant developmental risk published in the past 10 years. METHOD: A brief framework on development in the first 3 years is provided. This is followed by a review of pertinent studies of developmental risk, chosen to illustrate major risk conditions and the protective factors known to affect infant development. Illustrative risk conditions include prematurity and serious medical illness and infant temperament, infant-caregiver attachment, parental psychopathology, marital quality and interactions, poverty and social class, adolescent parenthood, and family violence. RESULTS: Risk and protective factors interact complexly. There are few examples of specific or linear links between risk conditions and outcomes during or beyond the first 3 years of life. Infant development is best appreciated within the context of caregiving relationships, which mediate the effects of both intrinsic and extrinsic risk conditions. CONCLUSIONS: Complex and evolving interrelationships among risk factors are beginning to be elucidated. Linear models of cause and effect are of little use in understanding the development of psychopathology. Refining our markers of risk and demonstrating effective preventive interventions are the next important challenges.

Child Development↗
PubMed2005

Associations between BMI, social strata and the estimated energy content of foods.

OBJECTIVE: Many studies have shown that the prevalence of obesity is greater in lower social classes. The reasons for this effect however are unclear. Since there is also a link between education and social class, and an association between education and prevalence of obesity, one hypothesis is that lack of education about energy contents of foods may contribute to the effects of social class on obesity. SUBJECTS: We tested the hypothesis that knowledge of food energy contents is associated with differences in body mass index (BMI) in a sample of 346 people of both genders, aged between 18 and 45 y, of variable body mass index and drawn from different social strata. RESULTS: Estimates of food energy contents were on average well correlated with the actual energy contents, but individual estimates were very poor in all subpopulations of this sample. We found that subjects of different BMIs did not differentially estimate the energy contents of foods high in carbohydrate, but low in fat and protein (fruit and bread). However, foods that contained high fat contents, independent of the other macronutrients present, were generally perceived to have significantly lower energy contents by obese people than nonobese subjects (although this was not observed for all high-fat foods). Overall, this difference interacted with social class, such that the difference between the BMI groups was exaggerated in the lower social stratum but abolished in the higher social class. Binary logistic regressions revealed that the probability of being obese (BMI>30 kg/m2) in the lower social class group was significantly negatively associated with the estimated food energy content of most high-fat foods. Such an association was not found in the higher social class group. In the lower social class group, overall food knowledge appeared superior in the leaner subject group (BMI<30 kg/m2), but obese subjects were actually better at estimating the energy contents of snacks and alcoholic beverages. The leaner group significantly overestimated the energy contents of these items. CONCLUSION: Differences between individuals in estimates of food energy contents may contribute to the development of obesity in lower social strata. Whether this is driven by a protective effect in lean subjects of overestimating the energy contents of certain foods (snacks and alcoholic beverages) or a susceptibility in the obese because they underestimate the energy contents of other foods is not certain. Knowing which of these alternatives is true is important and may help design public health education programmes directed at these people to help alleviate the obesity epidemic.

Adolescent↗
PubMed1993

Vascular dementia in the Lundby study. 2. An attempt to identify possible risk factors.

Vascular dementia represents a group of diseases of great medical and social impact. Its etiology is largely unknown but is most likely multifactorial. Factors related to the brain circulation are involved. The aim of the present study was to find out if personality and social background factors might have a clear precipitating or protective value. This study comprises a total population of 2,612 individuals from a geographically delimited area, Lundby, in southern Sweden. In 1957, Hagnell personally examined 99% of the population. A follow-up study of the same individuals, irrespective of domicile, was performed 15 years later. No social background factors proved to be relevant in this study. Personality factors, including psychosomatic reactions, did, however, demonstrate a highly predictive influence on the risk of developing vascular dementia.

Cohort Studies↗
PubMed1987

Social support and the chronically ill individual.

Nurses caring for the chronically ill need to be alert for the problems of social isolation and social impairment. Families often respond initially to serious illness by becoming over-protective and fostering dependence and a sense of impaired competence in the ill person. As the illness continues, families often experience exhaustion because of the demands of new roles, depleted finances, and other aspects of a changed lifestyle. Feelings of anger, guilt, and helplessness occur in the network, often leading to withdrawal of support--especially as the ill person's ability to reciprocate support is impaired. Nursing interventions in situations of social isolation focus on reducing isolation by promoting social interaction as appropriate, and by directly or indirectly mobilizing or expanding the social network. The problem of impaired social interaction may occur secondary to the personality changes that often accompany chronic illnesses, or as a function of the chronic illness or disability itself, as in the case of mental illnesses. Social impairment is an appropriate nursing diagnosis in abusive families. Nursing interventions range from educational programs for social skill development to reduction of the amount of contact within the network to involvement of protective and psychotherapy services. Chronic illness has profound effects on social support and the social network of both the ill person and his or her family. As both long-term illnesses and family involvement in care giving increase, nursing care in situations of chronic illness must include attention to issues of social support. Nursing diagnosis provides a framework for nurses to include social support in their care of the chronically ill patient. Social isolation and social impairment can be reduced by nursing interventions.

Chronic Disease↗
PubMed2006

Motives of Belgian adolescents for using sunscreen: the role of action plans.

The first objective of this study was to analyze the differences between adolescents who use sunscreen frequently and those who do not. The second objective was to explore the importance of specific action plans when planning sunscreen use. Data was gathered among 602 Belgian secondary school students. Frequent and infrequent users of sunscreen were compared on several determinants related with sunscreen use, and a regression analysis on sunscreen use was done. Frequent users of sunscreen measures had significantly higher scores on attitudes, social influence, self-efficacy, some awareness factors, intention, and action plans. The integrated model for exploring motivational and behavioral change (I-Change model) explained 57% of the total variance of using sunscreen every 2 hours. Frequent sunscreen use was most strongly predicted by action plans, followed by positive intentions to use sunscreen, wearing protective clothing, seeking shade, attitude toward sunscreen use, education, social influence, and exposure to the sun. Our results suggest that skin cancer prevention programs aimed at promoting sunscreen use need to emphasize the advantages of sunscreen to infrequent users and to increase feelings of self-efficacy. Moreover, support by friends and parents should be stimulated. Finally, developing specific action plans for the use of sunscreen should be promoted to more effectively translate general intentions into actual sunscreen use.

Adolescent↗