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PubMed2006

The making of an interdisciplinary partnership: the case of the Chicago Food System Collaborative.

Interdisciplinary partnerships foster innovation to address pressing social problems. This paper describes an interdisciplinary partnership called the Chicago Food System Collaborative (CFSC) composed of a team of partners from four academic institutions and three community-based organizations representing a total of eight disciplines that included: community development and community organizing, community psychology, geography, nursing, nutrition, public health, sociology, and urban planning and policy. Partners came together to address the issue of access to healthy foods and nutrition in a working class African American neighborhood. We analyze and discuss the core principles that guided the partnership and its impact across three dimensions: understanding through interdisciplinary action research, building capacity, and facilitating innovations in practices and policies. Despite the challenges of interdisciplinary partnerships, the potential benefits and impact of such efforts reflect their value as a comprehensive approach to addressing complex social problems.

Black or African American↗
PubMed1996

Ethical assumptions and ambiguities in the Americans With Disabilities Act.

The Americans With Disabilities Act (ADA) promotes social justice by protecting disabled persons from discrimination and prejudice. It seeks equality of opportunity for them and protects their well being by giving them fair access to goods, services and benefits. These rights are circumscribed in the ADA, however, by constraints of cost, efficiency, utility, and certain social mores. The ADA offers little direction about how to set priorities when these values come into conflict, or about whether equality or opportunity favors equivalent or preferential treatment for disadvantaged people. Until these ambiguities and potential value conflicts are resolved, a central moral and social problem remains unresolved: How can we demonstrate commitment to the rights and welfare of those with severe disabilities while placing fair limits upon their claims? Five special concerns are discussed: (1) eligibility and the allocation of health care; (2) the meaning of 'qualified but disabled' in employing people with mental disabilities; (3) equal opportunity and problems of envy and malingering; (4) ADA accommodation and public protection through testing and licensure; and (5) ADA protection and problems of backlash. Rather than simply wait to see what courts and administrative agencies decide, we should evaluate the moral conflicts, articulate criteria, and help make some difficult choices on morally defensible grounds.

Beneficence↗
PubMed1993

The social cost of alcohol abuse in Japan.

In recent years, alcohol-related health and social problems have become a serious concern in Japan because of the marked increase in per capita alcohol consumption. To facilitate forming a well-balanced policy on alcohol, the economic burden of alcohol abuse on Japanese society was estimated and has been presented in this study. In 1987, the alcohol attributable costs of medical care were estimated at 1,095.7 yen billion, representing 6.9% of the total national medical expenditure. The present amount of lifetime economic value based on age and sex for the Japanese population was calculated using the human capital method to estimate the alcohol attributable mortality costs. In 1987 this cost was estimated at 923 yen billion. By applying a 21% reduction rate, reduced productivity related to alcohol abuse was estimated at 4,257.3 yen billion. Summing up the costs of each component of the overall cost to society, the total cost of alcohol abuse was estimated at 6,637.5 yen billion, representing 1.9% of the gross national product in 1987, which was three times that of the national revenue from taxes on alcohol beverages. Along with the increase in city living, the economic burden of alcohol abuse on our society is expected to rise considerably. Public health intervention urgently needs to be administered in order to reduce the number of alcohol-related health and social problems.

Adolescent↗
PubMed2005

Demand for mental health care and changes in service use patterns in the Netherlands, 1979 to 1995.

OBJECTIVE: Mental health services appear increasingly incapable of satisfying the demand for care, which may cause some segments of the population to be less effectively reached. This study investigated the rates of use of mental health services in the Netherlands from 1979 to 1995 and examined whether particular sociodemographic groups made greater or lesser relative use of these services over time. METHODS: Data were derived from the Facilities Use Surveys, a series of Dutch cross-sectional population studies that have recorded household characteristics and service use since 1979. More than 28,000 households were included in the analyses. RESULTS: The overall use of mental health services virtually doubled from 1979 to 1995; a particularly steep rise was seen in the first half of the 1980s. Households that had one parent, that had low income, that were dependent on benefits, and that were younger all had greater odds of using both specialized mental health care (for example, prevention programs for mental health problems and psychotherapeutic and social psychiatric treatment offered by psychologists, psychotherapists, or psychiatrists) and social work services (for example, psychosocial counselling and practical support offered by social workers to people with social problems, such as housing, finances, and psychosocial issues). Households with low education were less likely to use specialized mental health care but were more likely to use social work services. Nonreligious households and urban households were more likely to use specialized mental health care and were equally likely to use social work services. Overall, these relative use patterns did not change over time. CONCLUSIONS: Despite greater pressures on mental health services and the many changes in service delivery in recent decades, relative patterns of help seeking and referral to mental health services have not varied systematically over time.

Cross-Sectional Studies↗
PubMed2006

Characteristics and profile of boys and girls with emotional and behavioural disorders in Flanders mental health institutes: a quantitative study.

BACKGROUND: In this article, we search for gender differences and outline a detailed gender profile for children and youngsters with emotional and behavioural disorders who are placed in Flemish residential care institutes. METHODS: Data were collected of all placements (517 children) in six residential and semi-residential mental health care centres for children and youngsters with emotional and behavioural disorders in East Flanders, Belgium. File data (gender, age, retention, current treatment, type of referral, education, intelligence, Diagnostic and Statistical Manual IV-diagnoses and medication use) were gathered. The Child Behaviour Check List (CBCL) was implemented and completed for each child. On the basis of the CBCL, a behaviour profile was developed by means of correlation tables (Pearson correlation coefficient) and cross tabulations. Finally, the profile was compared with the file data of the boys and the girls. RESULTS: Significant gender differences were found for type of referral, intelligence and diagnoses. The same profile was developed for both genders separately, based on variables Externalizing and Social Problems. The file data associated with the profile groups differ for boys and girls. CONCLUSIONS: The results of our study show the complexity and diversity of the needs of boys and girls with disruptive behaviour in Flemish residential care institutes. Flemish government has to be aware of the fact that the current referral system selects the children with outspoken externalizing and problematic behaviour towards special health care and special schools. They are relegated because the mainstream system is not equipped well enough to cope with their disruptive, aggressive behaviour. Even if governments are in favour of inclusive education, it seems that in practice a rest group is created, in which girls are selected through the same mechanisms as boys, in this case for the same reasons of negative externalizing behaviour and social problems. For this it seems appropriate that school and (semi)-residential institutes apply a specific and adapted methodology.

Adolescent↗
PubMed1975

Missing links in the human services nonsystem.

Four separate human services programs and their West Philadelphia service consumers were studied by the 1971 Health Network Project: a hospital receiving ward, a community mental health satellite center, a public assistance district office, and a public child welfare agency. The basic hypotheses were that 1) the four consumer groups present common health, economic, and social problems, and 2) each agency confines its services to its own specialized range of problems and provides minimal linkages to other service facilities, including those available within its own subdivisions. Data were obtained by interview and record review from over 600 patients and clients. Each agency was found to respond to presenting problems with specific interventions. However, failure to detect, treat, or refer concurrent problems was pronounced. Despite the great prevalence of physical and mental illness, compounded by economic marginality, each agency made minimal use of internal support services and external referrals. The human services nonsystem is discussed conceptually in light of specialization and fragmentation. Proposals for shifting the nonsystem toward a responsive service network include the introduction of comprehensive screening devices and of service generalists for case management.

Child↗
PubMed1986

High-risk youth and health: the case of excessive school absence.

Excessive school absence is a major educational and social problem in the United States, yet very little is known about its etiology or how to prevent or ameliorate it. This paper reports results from a series of related studies conducted in seven Boston middle schools (grades 6, 7, and 8) to test the hypotheses that health problems and unmet health needs are major characteristics distinguishing excessively absent students from regular attenders and that a health-oriented approach using medically mediated interventions is effective in reducing absences among excessively absent students. There were no significant differences between regular attenders and excessively absent students on multiple measures of student and family health status, health habits, and health service utilization patterns in a case-control study. The intervention program was not associated with a significant decrease in absence school-wide or for participating students. We conclude that demographic and educational characteristics of students exert a greater effect on their behavior in regard to absence from school than do health status or receipt of health services and that a health-oriented approach, such as the one used here, will not have a major impact on what remains one of the most profound educational and social problems involving children in the United States today.

Absenteeism↗
PubMed2006

Examining characteristics and associated distress related to Internet harassment: findings from the Second Youth Internet Safety Survey.

OBJECTIVE: We sought to identify the characteristics of youth who are targets of Internet harassment and characteristics related to reporting distress as a result of the incident. PARTICIPANTS AND METHODS: The Second Youth Internet Safety Survey is a national telephone survey of a random sample of 1500 Internet users between the ages of 10 and 17 years conducted between March and June 2005. Participants had used the Internet at least once a month for the previous 6 months. RESULTS: Nine percent of the youth who used the Internet were targets of online harassment in the previous year. Thirty-two percent of the targets reported chronic harassment (ie, harassment > or = 3 times in the previous year). In specific incidents, almost half (45%) knew the harasser in person before the incident. Half of the harassers (50%) were reportedly male, and half (51%) were adolescents. One in 4 targets reported an aggressive offline contact (eg, the harasser telephoned, came to the youth's home, or sent gifts); 2 in 3 disclosed the incident to another person. Among otherwise similar youth, the odds of being a target of Internet harassment were higher for those youth who harassed others online, reported borderline/clinically significant social problems, and were victimized in other contexts. Likewise, using the Internet for instant messaging, blogging, and chat room use each elevated the odds of being a target of Internet harassment versus those who did not engage in these online activities. All other demographic, Internet-use, and psychosocial characteristics were not related to reports of online harassment. Thirty-eight percent of the harassed youth reported distress as a result of the incident. Those who were targeted by adults, asked to send a picture of themselves, received an aggressive offline contact (eg, the harasser telephoned or came to the youth's home), and were preadolescents were each significantly more likely to report distress because of the experience. Conversely, the youth who visited chat rooms were significantly less likely to be distressed by the harassment. CONCLUSIONS: Internet harassment can be a serious event for some youth. Because there has been a significant increase in the prevalence of Internet harassment from 2000 to 2005, adolescent health professionals should continue to be vigilant about such experiences in the lives of young people with whom they interact. Social problems and online aggressive behavior are each associated with elevated odds of being the target of harassment. Thus, prevention efforts may be best aimed at improving the interpersonal skills of young people who choose to communicate with others using these online tools. Adolescent health professionals should be especially aware of events that include aggressive offline contacts by adult harassers or asking the child or adolescent to send a picture of themselves, because each of these scenarios increase the odds of reporting distress by more than threefold. Findings further support the call for the inclusion of Internet-harassment prevention in conventional antibullying programs empowering schools to address Internet bullying situations that occur between students. This will not solve all situations, however. We also must encourage Internet service providers to partner with consumers to be proactive in serious harassment episodes that violate criminal laws and service-provider codes of conduct.

Adolescent↗
PubMed1990

The homeless: social isolates.

Within the last 10 years, homelessness has emerged as one of the leading social problems in the United States. This article contains the findings of a descriptive study of the characteristics and health status of a homeless population in a southeastern city. The homeless population is of interest to nurses because it is representative of a specific disadvantaged group, seriously at risk for a myriad of physical and mental problems. The theoretical model, Social Disaffiliation, can serve as a basis for intervention with a variety of underserved or unserved population groups and the data presented provide opportunities for designing nursing intervention strategies. The study was conceived as a way to gather empirical evidence about the specific health-care needs of the community's homeless, to generate a data base on which to estimate that need, and to use the findings to support the establishment of an innovative practice model, a nurse-managed clinic. The literature suggests that on-site clinics, located in emergency shelters, are effective approaches to providing acceptable and accessible health care to the homeless. Nurses are well prepared to be a key part of the solution to one of the most serious problems facing health care in the U.S. today.

Adult↗
PubMedDate not supplied

Follow-up to 16 years of school children who had marked speech defects at 7 years.

In this paper we present the results of a follow-up study to age 16 years of 215 children in the National Child Development Study who were reported to show marked speech defects with normal hearing at 7 years. At 16 years information was available for 180 (85%) of the surviving 212 children. 30% of these children were in special schools and of the 70% in ordinary schools, 51% were reported still to have a residual speech problem. Additional health and social problems were frequent among the study group children and with very few exceptions they did badly at school. The findings at 16 years strongly reinforce our earlier conclusions that markedly defective speech at 7 years indicates the likelihood of continued backwardness in the development of acceptable verbal communication, social maturity and scholastic attainments.

Abnormalities, Multiple↗
PubMed1995

Youth risk behavior surveillance--United States, 1993.

Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and youth adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other intentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never use a safety belt, 35.3% had ridden during the 30 days preceding the survey with a driver who had been drinking alcohol, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases including HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Youth risk behavior surveillance--United States, 1993.

PROBLEM/CONDITION: Priority health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. REPORTING PERIOD: February through May 1993. DESCRIPTION OF SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. The YRBSS includes a national, school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 24 state surveys, and nine local surveys conducted among high school students during February through May 1993. RESULTS AND INTERPRETATION: In the United States, 72% of all deaths among school-age youth and young adults are from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1993 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 19.1% rarely or never used a safety belt, 35.3% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 22.1% had carried a weapon during the 30 days preceding the survey, 80.9% ever drank alcohol, 32.8% ever used marijuana, and 8.6% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among adolescents also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection. YRBSS results indicate that in 1993, 53.0% of high school students had had sexual intercourse, 52.8% of sexually active students had used a condom during last sexual intercourse, and 1.4% ever injected an illegal drug. Among adults, 67% of all deaths are from three causes: heart disease, cancer, and stroke. In 1993, many high school students practiced behaviors that may increase the risk for these health problems: 30.5% of high school students had smoked cigarettes during the 30 days preceding the survey, only 15.4% had eaten five or more servings of fruits and vegetables during the day preceding the survey, and only 34.3% had attended physical education class daily. ACTIONS TAKEN: YRBSS data are being used nationwide by health and education officials to improve school health policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. At the national level, YRBSS data are being used to measure progress toward achieving 26 national health objectives and one of eight National Education Goals.

Accidents↗
PubMed1996

Youth risk behavior surveillance--United States, 1995.

Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995. In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including HIV infection. YRBSS results indicate that in 1995, 53.1% of high school students had experienced sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer, and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals.

Adolescent↗
PubMed1996

Youth Risk Behavior Surveillance--United States, 1995.

PROBLEM/CONDITION: Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. REPORTING PERIOD: February through May 1995. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995. RESULTS AND INTERPRETATION: In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection. YRBSS results indicate that in 1995, 53.1% of high school students had had sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. ACTIONS TAKEN: YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals.

Accidents↗
PubMed2000

Day care for pre-school children.

BACKGROUND: The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provision are not simply a response to different levels of demand for day-care, but reflect cultural and economic interests concerning the welfare of children, the need to promote mothers' participation in paid work, and the importance of socialising children into society's values. At a time when a decline in family values is held responsible for a range of social problems, the day-care debate has a special prominence. OBJECTIVES: To quantify the effects of out-of-home day-care for preschool children on educational, health and welfare outcomes for children and their families. SEARCH STRATEGY: Randomised controlled trials of day-care for pre-school children were identified using electronic databases, hand searches of relevant literature, and contact with authors. SELECTION CRITERIA: Studies were included in the review if the intervention involved the provision of non-parental day care for children under 5 years of age, and the evaluation design was that of a randomised or quasi-randomised controlled trial. DATA COLLECTION AND ANALYSIS: A total of eight trials were identified after examining 920 abstracts and 19 books. The trials were assessed for methodological quality. MAIN RESULTS: Day-care increases children's IQ, and has beneficial effects on behavioural development and school achievement. Long-term follow up demonstrates increased employment, lower teenage pregnancy rates, higher socio-economic status and decreased criminal behaviour. There are positive effects on mothers' education, employment and interaction with children. Effects on fathers have not been examined. Few studies look at a range of outcomes spanning the health, education and welfare domains. Most of the trials combined non-parental day-care with some element of parent training or education (mostly targeted at mothers); they did not disentangle the possible effects of these two interventions. The trials had other significant methodological weaknesses, pointing to the importance of improving on study design in this field. All the trials were carried out in the USA. REVIEWER'S CONCLUSIONS: Day care has beneficial effect on children's development, school success and adult life patterns. To date, all randomised trials have been conducted among disadvantaged populations in the USA. The extent to which the results are generaliseable to other cultures and socioeconomic groups has yet to be evaluated.

Child Day Care Centers↗
PubMed1983

Preschool teachers' ratings of behavioral problems: observational, sociometric, and social-cognitive correlates.

Behar and Stringfield (1974) have suggested that the Preschool Behavior Questionnaire (PBQ) is a reliable index of young children's social competence. However, there are few extant data in which teacher ratings of children on the PBQ have been correlated with independent assessments of social competence. In this study PBQ ratings of 123 preschoolers were correlated with observations of in-class social and cognitive play behaviors, sociometric status, and social problem-solving skills. Analyses indicated that children rated highly on the PBQ's Anxious-Fearful, Hostile-Aggressive, and Hyperactive-Distractible factors (a) displayed less mature and more aggressive in-class behaviors, (b) were less popular among their peers, and (c) were more likely to suggest negative affect strategies on the social problem-solving measure. Thus, the PBQ appears to be a useful instrument for identifying children with social problems.

Affective Symptoms↗
PubMed1985

Utility of cognitive-behavioral procedures for social skills training with children: a critical review.

Thirty-three studies that have used cognitive-behavioral social skills training procedures were critically reviewed. These studies were classified under four broad categories: modeling, coaching, treatment packages, and social problem solving. Seven criteria were used to critically evaluate these studies: subject characteristics, treatment specification, outcome measures, statistical analyses, experimental design, generalization, and cost effectiveness.

Adolescent↗