Social Contexts of Mental Weil-Being in Later Life

Extending the preceding review, this commentary argues for serious attention to the social contexts of mental health of older adults in research and practice. Social gerontology research focuses primarily on summative or aggregate variables with little focus on mechanism, despite growing evidence that mechanisms as diverse as immunosuppression and expressed emotion influence mental health. Increased linkages between the macro-level and microlevel data are required to provide the theoretical models needed to shape practice. Current evidence is deemed sufficient, however, to alter the frameworks we use for both diagnosis and treatment.     

Soul City: a sustainable edutainment vehicle facilitating social change

This paper outlines the programming model employed by the Soul City Institute for Health and Development Communication, a South African NGO, in using ‘edutainment’ to facilitate social change. The paper refers to the intersection of this model and current thought on health promotion and various social change theories. It also discusses key challenges and factors contributing to sustainability over 12 years.     

Caring for the patient with fibromyalgia: the rehabilitation nurse's role.

Fibromyalgia (FM) is a chronic, potentially disabling, cluster of symptoms that manifests as pain for 3 months or more and pain with pressure on 11 of 18 tender points throughout the body. Because there is no known cause, and therefore, no cure, treatment focuses on the control or relief of symptoms. Many patients are referred to rehabilitation settings for physical or exercise therapy. While exercise is helpful in the control of the pain, stiffness, fatigue, sleep disorders, and mood changes, a holistic approach to treatment is more effective. Rehabilitation nurses provide major support for patients with FM. Validation of the patients' experiences is essential for achieving quality of life. Many patients have a history of being undertreated because of a lack of credibility and invisibility of the illness. This article provides background information about FM, summarizes the FM trajectory, reviews approaches to management, and discusses the role of rehabilitation nurses in a holistic approach to care of clients with FM.     

An exploration of gifted programs

This article presents findings on an exploration of gifted programs in the state of Missouri. Over 60 percent of the state supported public school gifted programs participated in the study. The study concludes that the guidelines for gifted education in Missouri create extreme variability in the standards of the programs. Strong national policy for gifted education is needed to insure gifted children are properly served and protected by law.     

Nursing and motherhood constructions: implications for practice

The present paper addresses the relationship between community based child health nursing services and social constructions of motherhood within Australia during the 1920s. Following the First World War, child health nursing services (then generally known as infant welfare or child welfare services) were established in all Australian states. The focus of the paper is mainly upon the development of the Tasmanian child health service, with some reference to similar services in other states. Within two decades of their establishment, most child-bearing women in Tasmania were in contact with child health services and this apparent success meant that, thereafter, women in Tasmania cared for their children under the 'expert' guidance of nurses. As the 1920s progressed, child health nurses increasingly promoted one particular, and ultimately extremely influential, construction of motherhood, 'scientific motherhood', based upon the philosophy of Dr Truby King. I argue that an understanding of how nursing services have historically reinforced and promoted ideological constructions of motherhood enhances the practice of present day nurses working with women. This argument is supported by reference to present day nursing practice in relation to postnatal depression.     

行为异常儿童社交能力分析

目的探讨儿童行为问题与社交能力之间的的关孔方法使用Achenbach’s儿童行为量表对1051名儿童进行筛查，检出98名行为异常者，计数统计其社交项目与总体儿童社交项目人数比较之，x2统计分析。结果在活动的技巧水平上，在家庭关系中，在校学习对知识的理解、掌握程度、心情舒畅程度等方面，异常儿不如总体（P＜0．05），但在活动的时间、对外社交及学习成绩方面二者无明显差异（P＞0.05）。结论儿童行为问题与社交能力的关系。并不是单一的正、负相关所能概括的，应该具体问题具体分析，审视其全面。     

Dietary behaviour of an adolescent French male population

The dietary history method was used to determine the total energy and macronutrient intake, the distribution of daily energy from the different meals and the energy contribution of various food groups, in a population of 299 boys, aged between 10 and 15 years. The effects of age, the social status of the father (SPS), the ponderal index, the importance of breakfast or lunch, and the level of energy intake on dietary indicators, were studied. In our population, energy intake increased with increasing age but the energy contribution of macronutrients did not vary. The diet of boys whose fathers were in the upper SPS classes differed from the diet of those boys whose fathers were manual workers: for example they consumed less energy and pastries, but more animal protein (in percentage of energy intake), more dairy products, and more fruit. The ponderal index was negatively related to energy intake but positively related to protein intake, especially from meat and meat products. The energy intake from protein, animal protein and the energy contribution of dairy products, meat and meat products, fish and vegetables was lower among large eaters than among small eaters. The energy contribution of pastries, sugar and sweets was higher among large eaters.
Similarily, the energy intake from morning and evening snacks was also higher among large eaters. It should be noted that boys who had a substantial breakfast took in less energy from all other meals (including snacks and main meals). Such informaton is necessary in order to develop an effective health programme.     

1996-2000年某医院五种恶性肿瘤例均住院费用分析

恶性肿瘤是给群众带来严重健康损害的经济负担的疾病之一,已经列居我国城市 疾病死亡原因的第一位。本研究利用医院为基础的五种恶性肿瘤住院患者的费用数据,分析1996-2000年五种恶性肿瘤患者例均住院费用的变化趋势,比较自费患者和公费患者之间的例均费用差异。根据恶性肿瘤费用水平高、增长幅度快,且公费患者费用明显高于自费患者的情况,提出在医疗保障制度改革的社会环境下,医院必须加强病种费用管理,主动控制医疗费用水平。     

Structured treatment and teaching of patients with Type 2 diabetes mellitus and impaired cognitive function--the DICOF trial.

BACKGROUND: Patient education is integral part of any diabetes therapy in Germany, but elderly patients are not able to follow the variety of topics comprising standard treatment and teaching programmes (TTP), primarily due to impaired neuropsychological function. This leads to deficits in diabetes knowledge and hindered ability for diabetes self-management. AIM: To evaluate structured TTP for geriatric patients with impaired cognitive function. PATIENTS AND METHODS: A neuropsychological examination was performed on all patients over 54 years [n=102, age 68.6 +/- 8.7 years, diabetes duration 10.3 (0.03-35.4) years, HbA1c 10.3 +/- 1.7% (HPLC, Diamat, NR 4.5-6.3%), cognitive function 87.7 +/- 12.3 IQ points] who took part in TTP for insulin therapy. Patients with impaired cognitive function participated either in the standard TTP of Berger [n = 35, age 67.6 +/- 8.9 years, diabetes duration 9.9 (0.04-35.4) years, HbA1c 10.3 +/- 2.0%] or in the specialized structured geriatric DICOF-TTP [n=33, age 70.4 +/- 8.2 years, diabetes duration 10.4 (0.03-24.9) years, HbA1c 10.7 +/- 1.8%]. RESULTS: After TTP there were no differences in knowledge and ability for diabetes self-management (standard/DICOF: knowledge 11.0 +/- 2.6 vs. 12.2 +/- 2.7 points, P = 0.11; handling 14.9 +/- 3.3 vs. 15.9 +/- 2.5 points, P = 0.18). However, patients who took part in the DICOF programme showed better scores in satisfaction with the education programme [standard/DICOF 44.7 (31-57) vs. 52.5 (45-59) points, P < 0.001]. Six months later the DICOF participants showed better results regarding diabetes self-management (standard/DICOF: handling 12.5 +/- 4.1 vs. 15.9 +/- 3.1 points, P = 0.001). Both groups showed HbA1c decrease (8.3 +/- 1.4 vs. 8.5 +/- 1.3%, P=0.62) and similar incidence of acute complications. CONCLUSIONS: Elderly patients with impaired cognitive function should take part in specialized structured TTP. This leads to both better satisfaction with the education programme and an improved ability for diabetes self-management.     

Le miroir social des souffrances adolescentes : entre maladie du symbolique et aveu généralisé

The psychological suffering of adolescents is a subject that has drawn an increasing amount of attention on the part of the public authorities, local and associative bodies, and of course psychotherapists themselves. While the psychiatric treatment of adolescent disorders is based upon wide ranging nosographic categories that are specific to this age group, new and clinical forms are appearing on the scene, as if they were, an expression of new suffering. This sudden visibility on the social front regarding problematical adolescent behavior has brought with it a concomitant increase in explanations attempting to put into perspective the diversity of so-called “deviant” behavioral patterns in adolescents in relation to the development of a new malaise in contemporary civilization. The author of this study has examined this phenomenon from an anthropological point of view, and has critically examined the possible link between the modifications in the present-day social environment, and the various types of behaviour that are considered to be indicative of underlying psychic suffering. By puting the social explanations of adolescent suffering into perspective vis a vis the proposed solution, such as this multiplied counselling services, the author shows the emergence of a widespread system involving and promoting a generalized “confession” and disclosure of the intimate, in wich listening to what is been said becomes less important than the underlying constraints on expression that it imposes.