School-based community development as a health promotion strategy for children

In this paper we discuss our experience of engaging 9–10-year-oldchildren in grade 4 in a community development process to dealwith community health problems they consider important. Withguidance from a facilitator, young children can work cooperativelyto identify problems, set priorities, and design and implementactivities to address a community health issue. They can reflectupon their actions and the process within which they have workedand can realize that the process can be applied to the resolutionof other community problems. However, children's levels of cognitiveand social maturity and their position in society present specialissues for the use of community development as a health educationstrategy     

Stop the world, they want to get on

As life expectancy for many chronically ill children increases, new efforts are needed to make society more aware of the comprehensive needs of these children and their families. Chronically ill children must strive to succeed in two different worlds: the healthcare environment and the community. For the most part, there is a little networking between the two. And that is the problem. To develop their full potential, children with chronic health problems must be able to attend school, form friendships, and fulfill their desire to learn without being impeded by some uncontrollable factor such as a health problem. When significant people such as teachers and peers are misinformed about a child's illness, they may misinterpret what they observe about him or her, which can be a serious barrier to progress. The collective efforts of healthcare professionals, teachers, community groups, families, and the chronically ill children themselves are needed to improve the community's understanding of chronic illness. Educators can benefit from networking with healthcare professionals, who, in turn, can become better informed about the day-to-day concerns of school personnel when a pupil has a special health problem.     

The psychology of Colombian street children

This article calls into question the diverse perceptions of the street children in Colombia. Through the use of participant observations and the administration of the Bender-Gestalt, Kohs Block Designs, and Human Figure Drawing tests, the author explains the psychology of the street children. Their behavior on the streets is explained as being rational and appropriate to their circumstances. Since most of the children are not actively rejected by their families, and because they receive support among their peers and from private benefactors in the society, their mental health is not as bad as popularly believed. The misperceptions of them and of the way they are treated by the society are explained in the context of the family and class structure in Colombia. The dominant society consists of patrifocal families that raise children to be submissive to their fathers, whereas the lower social classes raise their children in matrifocal families, which do not have men in them, and which encourage their children to be independent at an early age. The children in their early public display of liberty symbolically threaten the man's dominance in the patrifocal family system. As a result the children's skills are devalued.     

Relevant Curriculum Planning in Health Education: A Methodology

Procedures proposed to present a methodology for planning relevant health education curriculum included having students write out questions they felt their peers had about health in the specific content areas of community health, consumer health, diseases, drugs, alcohol, and tobacco, ecology, family life, nutrition, mental health, personal health and safety and first aid. A sample survey was presented where 80 junior high school students wrote a total of 981 questions and 74 senior high school students wrote 786 questions. Implications for the health education curriculum would be as follows: (1) Curriculum can be made relevant if the specific content covered is directly related to problems of daily living: (2) Provide needed cognitive information to meet real or potential problems of students; and (3) Provide guidance for the health educator in planning the kind and the amount of emphasis within the total health education program.     

The Health Attitudes of Young Hispanic Women and the Health Status of Their Children on the Texas-Mexico Border

In this paper our objective was to identify child health problems as observed by young Hispanic mothers living along the Texas-Mexico border. Samples of 300 young Hispanic women living in each of the twin cities of El Paso and Juarez were interviewed regarding their knowledge, attitudes, and experiences with respect to birth control, pregnancy, maternal and child health, and health care services. Only 35 women in El Paso and 50 in Juarez were ever pregnant and their attitudes toward health issues were compared to the never pregnant women. Those with living children were also asked about the health problems they had observed in their children. The results indicate that the ever pregnant women were more positive toward both family planning and child bearing than were their never-pregnant peers. The ever-pregnant women were also less confident in family planning techniques. The mothers in Juarez generally reported more observed illness symptoms in their children than did the El Paso mothers.     

In what ways can lone parents be regarded as peripheral in British society?

Health professionals, particularly those in the community, commonly encounter lone parents and their children. What are these professionals to make of lone parents? Do they, for example, have a unique health profile? Should health professionals take their family status into account as a means of explaining their health? Indeed, can lone parents be considered a group at all, in any meaningful sense? Since the late 1970s, British society has grown more and more divided. Alongside this division, the growth of new forms of work has led some theorists to argue that capitalism has entered a new ‘post-Fordist’ era. The divisions in society have led to the creation of a new ‘underclass’. This paper argues that the divisions are within the working class and are composed of a relatively well-off core, alongside a periphery of low-paid, temporary and part-time workers. Lone parents' position in the labour market means that they are part of the periphery. This is evidenced by data from the 1991 Census of Population and the 1992 General Household Survey. The ability of lone parents to change their position is mediated by the lack of affordable child care. The evidence presented is strongly indicative of the peripheral status of lone-parent households, with all that this implies for their health.     

Patients' use of GPs and community pharmacists in minor illness: a cross-sectional questionnaire-based study

BACKGROUND: Despite pharmacists having increased involvement in managing minor illness, many patients continue to attend their GP with problems that could be managed by community pharmacists. OBJECTIVE: Our aim was to investigate the prevalence of visits to the GP that GPs felt could be managed by a pharmacist, and to explore patients' reasons for such visits. METHODS: This cross-sectional questionnaire study was conducted at 13 general practices in West Sussex, UK. A questionnaire was given to all patients attending appointments with their GP in these practices over a 1-week period, asking what the presenting problem was and whether the advice of a pharmacist had been sought. If patients had not sought the advice of a pharmacist, they were asked why not. The GP was then asked to indicate whether, in their opinion, the patient's problem could have been managed by a community pharmacist. RESULTS: The response rate was 94% (3984), representing 87% of all patients consulting their doctor during the week of the study. GPs felt that only 7% (260) of these visits could have been managed by a community pharmacist. The proportion of 'unnecessary' visits was significantly higher (P < 0.001) amongst young adults, those presenting with new medical problems and those consulting about a child's health. Skin and musculoskeletal problems were the most common causes of 'unnecessary' visits to the GP. The majority of patients making 'unnecessary' visits (59%) disagreed with the GP and felt that the pharmacist would not have been appropriate for their problem. CONCLUSIONS: GPs and patients were, on the whole, in agreement over which conditions were appropriate for GP attention. There is, however, a need for education to increase awareness of the roles of pharmacists, aimed particularly at young adults and at those with children.     

儿童情绪早期社会化发展

儿童从出生即进入社会人际交往中,逐渐从生物人发展为社会人,其中关键的步骤是情绪的社会化。母婴依恋使婴儿获得安全感,随着年龄增长,儿童开始在母亲的支持下与同伴交往,学会了识别他人的表情和情绪,并能够调节自己的情绪以适应社会需要,实现了社会化。家庭结构及类型、家庭气氛、父母教育方式、父母对子女的期望等都对儿童的成长及社会化起着重要的作用。不良的家庭环境,不当的教养方式,早期亲子分离,母亲情绪问题等是儿童社会化不良的影响因素,应引起全社会的重视,及早进行干预。     

儿童情绪早期社会化发展

儿童从出生即进入社会人际交往中,逐渐从生物人发展为社会人,其中关键的步骤是情绪的社会化。母婴依恋使婴儿获得安全感,随着年龄增长,儿童开始在母亲的支持下与同伴交往,学会了识别他人的表情和情绪,并能够调节自己的情绪以适应社会需要,实现了社会化。家庭结构及类型、家庭气氛、父母教育方式、父母对子女的期望等都对儿童的成长及社会化起着重要的作用。不良的家庭环境,不当的教养方式,早期亲子分离,母亲情绪问题等是儿童社会化不良的影响因素,应引起全社会的重视,及早进行干预。     

Public response to community mitigation measures for pandemic influenza

We report the results of a national survey conducted to help public health officials understand the public's response to community mitigation interventions for a severe outbreak of pandemic influenza. Survey results suggest that if community mitigation measures are instituted, most respondents would comply with recommendations but would be challenged to do so if their income or job were severely compromised. The results also indicate that community mitigation measures could cause problems for persons with lower incomes and for racial and ethnic minorities. Twenty-four percent of respondents said that they would not have anyone available to take care of them if they became sick with pandemic influenza. Given these results, planning and public engagement will be needed to encourage the public to be prepared.     

Multiple roles and health among British and Finnish women: the influence of socioeconomic circumstances

Two contrasting hypotheses have been presented to predict women's health variations. The Multiple burden hypothesis predicts that combining a paid job, being married, and having children is likely to be detrimental to women's health. The multiple attachment hypothesis predicts that multiple roles provide attachment to the community, which is likely to be beneficial to women's health. These hypotheses are examined in Britain and Finland, which have different patterns of women's employment participation. Lone mothers form a critical case, since they have fewer attachments and greater burdens, and therefore are expected to have poorer health. The socioeconomic position of lone mothers differs in Britain and Finland, but in both societies they are likely to have fewer attachments. We assess the extent to which health variations between women with different family and parental role combinations are because of the differences in their socioeconomic status and material circumstances. Comparable surveys from Britain and Finland from 1994 were used. Perceived general health and limiting long-standing illness were analysed for working age women (20-49 years) by family type and employment status. as well as other socioeconomic variables. In both countries, women living in two parent families and having children had better health than women living in other family types or on their own. Lone mothers form a disadvantaged group and showed overall worse health in both countries. Adjusting for employment status. education and household income weakened the association between family type and poor health. The findings are broadly in accordance with the multiple attachment hypothesis. Despite the more generous welfare state and high full-time employment among Finnish women, single lone mothers report poorer health than other women in Finland as well as in Britain. However, in Britain the disadvantaged social position of lone mothers accounts for a greater proportion of their poor health than in Finland.     

从一次义诊看北京市社区儿童就医需求及其影响因素

目的：通过北京市某三甲医院儿科的一次义诊,了解北京市社区儿童健康需求、就医现状及其影响因素.方法采取横断面调查的方法,对参加“社区儿童义诊”的111名儿童及其家长进行问卷调查.结果①家长在社区最需要解决的儿童问题排在前5位的是喂养、饮食问题,皮疹,生长发育,呼吸和消化系统相关问题.②孩子生病就诊首选医疗机构,以儿童专科医院(44?1％)和三级医院(39?6％)为主.选择大医院就诊的主要原因是医生水平高、医院有名气和就近方便.③一半家长认为平时带孩子看病很困难/困难,最主要原因是挂不上号和等候时间长.④若社区医院有能看儿童疾病医生的情况下,76?6％家长会选择带儿童在社区卫生服务中心就诊.结论儿童医疗卫生服务水平和就近方便是影响家长就医机构选择的重要因素.加强社区卫生服务中心对于儿童常见健康问题及常见疾病的诊疗能力,通过宣传引导家长合理就医,是实现儿童就医分层诊疗的必备条件.     

The dark world of toiling children in India

Children should develop in loving, nurturing, safe environments in which they do not have to worry about or endure physical and/or emotional abuse. Children are a nation's most important asset. They really should be concerned only with pursuing their education, learning how to socialize with their peers and elders, learning from their peers and role models, and performing light, household chores which are commonly expected of other members of the family. Life is difficult for most families and households in the majority of developing countries, and survival is an ongoing challenge. In such settings, children are called upon to help supplement family income. Many children in India begin working by the age of four years. They then spend their childhood in 12-hour workdays to earn Rs. 90 per month. 20% of India's GNP is produced by the largest number of child laborers in any country worldwide. Children in India work under exploitative and inhuman conditions. They are inadequately compensated financially, suffer emotional and physical abuse, and have extremely limited access to education, food, water, and shelter. After losing their childhood, these individuals spend their futures in poor health and poverty. The hazardous working conditions of the bangle industry are described. For these children, the UN Convention on the Rights of the Child has no meaning. It is the duty of the state and society to ensure that children receive the opportunity for education, growth, and health mental and physical development. Measures must be undertaken to that end.     

Exposure to community violence and depressive symptoms: Examining community,family, and peer effects among public housing youth

Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.     

God should give daughters to rich families only: attitudes towards childbearing among low-income women in Punjab, Pakistan

We evaluated perceptions and experiences of bearing sons and daughters among 42 women in Punjab, Pakistan, with special emphasis on son preference, changes in women's status within the marital family and resulting health effects. Data were collected through repeated, in-depth interviews in Urdu or Punjabi in an urban area in Lahore and a village 40 km. outside of Lahore. For triangulation purposes, four focus group discussions were performed with additional women, as well as in-depth interviews with eight mothers-in-law, three traditional practitioners and three medical practitioners. In general, these women felt that they had limited control over their lives, and this was exemplified by early marriages, high expectations on newly wed women to conceive and poor access to contraceptives. Women frequently expressed a strong preference for sons, mostly for economic reasons, reflecting women's subordinate position in society and the low economic value placed on women's work. Mothers of sons mainly discussed health problems during pregnancy and health effects of repeated childbearing. Mothers of daughters and women without children spoke of harassment in the family as well as in society. The results should be of importance in the public health planning in Pakistan as well as for those engaged in women's health issues internationally.     

Comprehensive Health Screening in Elementary Schools: An Outcome Evaluation

A health screening program, piloted in 14 school districts in Texas from 1977 to 1979, was evaluated to determine the outcome of the screenings. Outcome measures used were the number of completed referrals, the number of conditions judged by health care providers not to exist and the number of problems of potential educational significance identified. While several problems were detected, the high rate of false positives and low referral completion reported from community health care providers leads to questions concerning the effectiveness of comprehensive health screening in the schools. However, the emphasis placed on identification during the screening of children with educationally significant problems may enable the schools to better serve these children. Referral follow-up in the community and schools to address identified problems would assure that the expenditure of funds for screening would not be futile.     

邯郸市某社区更年期妇女家属对更年期知识的认知情况

目的了解家属对更年期相关知识的认知状况及重视程度并比较其差异,制定有针对性的方案对其进行相关知识的健康教育。方法对邯郸市某社区45～55岁共100例已婚妇女家属以访问形式进行问卷调查。结果对丈夫的调查中,只有32%对更年期知识非常了解,有35%对妻子的变化可以理解;对子女的调查中,22%对更年期知识非常了解,有28%对母亲的变化可以理解。结论家属对妇女更年期的认识并不是很多,重视程度还不够,妇女更年期的问题常常被忽视,表现为对妇女缺乏关爱,家属需要接受更年期知识的教育。     

Health among teenagers and young adults

The objective of this article is to analyse different behaviours and opinions about health and health determinants of Spanish young people by age, sex, and place of residence. They have a broad concept of their health, tending to identify health as physical activity and healthy eating behaviours. Most of them (91%) declared enjoying good or very good health. Depending upon the age, sex, and place of residence 10 to 20% could have mental health problems. Young people consider illegal drugs as their main health problem. Boys have higher prevalence of overweight and obesity than girls. However, girls reported more often than boys that they perceived themselves as obese. Practice of sporting activities is influenced by family and friends. The proportion of young people that practice sport declines after the age of 15, both in boys and girls. Young people perceive cannabis consumption as normal, but remain ambivalent towards other illegal drugs and asked for more information about drugs. We found a high proportion of young people declaring that they not would try illegal drugs. In the urban settings, smoking is more common among girls than among boys, but the contrary happens in rural areas. Most of them know that smoking is harmful for health, and among those who are smokers, 20 to 40% declared that they want to stop smoking. They consider that health care services are useless for preventing health problems. It is necessary to improve behaviours involving safety, such as use of seat belts and helmets, mainly in rural areas. Young people associated traffic accidents with driving conditions rather than with identification of risk.