Suchergebnisse

The following is a detailed description of a training program offered by the Self-Employed Women's Association (SEWA) Academy to introduce new members to the organization and its work. SEWA describes its main goals as "to organize women workers for full employment," by which it means "employment whereby workers obtain work security, income security, food security, and social security (at least health care, child care and shelter)." The organization works to achieve its goals "through the strategy of struggle and development. The struggle is against the many constraints and limitations imposed on them by society and the economy, while development activities strengthen women's bargaining power and offer them new alternatives." SEWA describes itself as "both an organisation and a movement," which is enhanced by "the sangama or confluence of three movements: the labour movement, the cooperative movement and the women's movement." SEWA also describes itself as a Gandhian movement: "Gandhian thinking is the guiding force for SEWA's poor, self-employed members in organising for social change. We follow the principles of satya (truth), ahimsa (nonviolence), sarvadharma (integrating all faiths, all people) and khadi (propagation of local employment and self-reliance)." In practical terms, SEWA carries out its strategy "through the joint action of union and cooperatives." As a trade union, it has nearly two million members, half of whom are in the organization's home state of Gujarat, India. It also operates or is affiliated with nearly two dozen sister organizations and cooperatives.

In summer 2015, the Iowa Supreme Court unanimously struck down a restriction that would have prevented physicians from administering a medication abortion remotely through video teleconferencing. In its ruling, the Iowa Supreme Court stated that the restriction would have placed an undue burden on a woman's right to access abortion services. It is crucially important for clinicians – especially primary care clinicians, obstetrician–gynecologists, and all health care providers of telemedicine services –to understand the implications of this recent ruling, especially in rural settings. The Court's decision has potential ramifications across the country, both for women's access to abortion, and for the field of telemedicine. Today telemedicine abortion is only available in Iowa and Minnesota, and 18 states have adopted bans on it. If telemedicine abortions are indeed being unconstitutionally restricted as the Iowa Supreme Court determined, court decisions reversing these bans could improve access to abortion services for the 21 million reproductive-age women living in these 18 states, which have a limited supply of obstetrician–gynecologists, mostly concentrated in urban, metropolitan areas. Beyond the potential effects on abortion access, we argue that the Court's decision also has broader implications for telemedicine, by limiting state boards of medicine's role regarding the restriction of politically controversial medical services when provided through telemedicine. The interplay between telemedicine policy, abortion politics, and the science of medicine is at the heart of the Court's decision, and has meaning beyond Iowa's boarders, for reproductive-age women across the United States.

In order to meet the increasing demand for housing care for Kuwaiti citizens, the government authorities in Kuwait are undertaking a series of projects in the form of new large cities, outside the current urban area. Al Mutlaa City located to the north-west of the Kuwait Metropolitan Area is one such project out of the 15 planned new cities. The city accommodates a wide variety of residential developments, employment opportunities, commercial, recreational, health care and institutional uses. This paper examines the application of comprehensive transportation demand modeling works undertaken in VISUM platform to understand the future intracity and intercity travel distribution patterns in Kuwait. The scope of models developed varied in levels of detail: strategic model update, sub-area models representing future demand of Al Mutlaa City, sub-area models built to estimate the demand in the residential neighborhoods of the city. This paper aims at offering model update framework that facilitates easy integration between sub-area models and strategic national models for unified traffic forecasts. This paper presents the transportation demand modeling results utilized in informing the planning of multi-modal transportation system for Al Mutlaa City. This paper also presents the household survey data collection efforts undertaken using GPS devices (first time in Kuwait) and notebook computer based digital survey forms for interviewing representative sample of citizens and residents. The survey results formed the basis of estimating trip generation rates and trip distribution coefficients used in the strategic base year model calibration and validation process.

Closed access until 1 July 2015 ; Postpartum physical activity can improve mood, maintain cardiorespiratory fitness, improve weight control, promote weight loss, and reduce depression and anxiety. This review summarizes current guidelines for postpartum physical activity worldwide. PubMed (MEDLINE) was searched for country-specific government and clinical guidelines on physical activity after pregnancy through the year 2013. Only the most recent guideline was included in the review. An abstraction form facilitated extraction of key details and helped to summarize results. Six guidelines were identified from 5 countries (Australia, Canada, Norway, United Kingdom, and United States). All guidelines were embedded within pregnancy-related physical activity recommendations. All provided physical activity advice related to breastfeeding and 3 remarked about physical activity after cesarean delivery. Recommended physical activities mentioned in the guidelines included aerobic (3/6), pelvic floor exercise (3/6), strengthening (2/6), stretching (2/6), and walking (2/6). None of the guidelines discussed sedentary behavior. The guidelines that were identified lacked specificity for physical activity. Greater clarity in guidelines would be more useful to both practitioners and the women they serve. Postpartum physical activity guidelines have the potential to assist women to initiate or resume physical activity after childbirth so that they can transition to meeting recommended levels of physical activity. Health care providers have a critical role in encouraging women to be active at this time, and the availability of more explicit guidelines may assist them to routinely include physical activity advice in their postpartum care.

The aging population of European cities raises enormous challenges with regard to employment, pensions, health care and other age-related services. The housing preferences of the aging population are changing rapidly where more and more people want to live independent lives for as long as possible. At the same time governments need to reduce the costs of expensive institutionalized care. A precondition for 'ageing in place' is that elderly people perceive their neighbourhoods as familiar and safe places. In the Netherlands, many neighbourhoods with a rapidly ageing population have been subject to urban regeneration policies. Hence, an important question is to what extent these policies affect the housing situation, social support networks and socioeconomic position of elderly people, because these factors strongly assist the ability of elderly people to live independently. We answer this question through the analysis of a small but unique panel data set with 2007 and 2012 measurements from Hoogvliet, a district of Rotterdam. Contrary to claims about large, disrupting impacts of urban regeneration, the results show that – even in times of economic crisis – regeneration in Hoogvliet has enabled 'ageing in place'. There appears no relationship between the Hoogvliet policies and changes in income of elderly people and their ability to get by financially. Those who have moved home often report regeneration benefits, mostly related to accessing better quality housing in the same area. Finally, we found no clear evidence of decreased social support or increased loneliness through regeneration-induced disruption of social networks.

Background: The symptoms of somatoform disorders are very distressing to the sufferer as well as pose significant burden on the health-care delivery system. Although the nature of symptoms is physical, the underlying mechanisms are not clearly understood. Objective: The purpose of this study was to assess the explanatory models of patients with somatoform disorders presenting to a tertiary care hospital in Northern India. Method: A total of 99 consecutive adult patients (≥18 years) with diagnosis of somatoform disorders according to the International Classification of Diseases–10th Revision (ICD-10) were evaluated for their explanatory models using the causal models section of Explanatory Model Interview Catalogue (EMIC). Results: The mean age of the study sample was 36.52 years, and the mean duration of illness was 59.39 ± 57.68 months. The most common clinical diagnosis was that of persistent somatoform pain disorder. The most common explanations given belonged to the category of psychological factors (68.7%) followed by weakness (67.7%), social causes (51%) and karma–deed–heredity (53.5%) category. The mean number of etiological categories reported were 2.6 (standard deviation ( SD) = 1.7). Among the various specific causes, the commonly reported explanations by one half of the sample in decreasing order were general weakness (63.6%), mind–thoughts–worry category (59.6%) and loneliness (53.5%). The mean number of specific etiologies was 4.9 ( SD = 3.83). Conclusion: Most of the patients with somatoform disorder attribute their symptoms to psychological factors. It also becomes imperative to understand the physical symptoms in somatoform disorders from the sociocultural aspects of patients.

Abstract Background Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. Methods A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Results Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Conclusions Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised.

Abstract Background In Pakistan, preference for boys over girls is deeply culturally embedded. From birth, many women experience gendered disadvantages; less access to scarce resources, poorer health care, higher child mortality, limited education, less employment outside of the home and circumscribed autonomy. The prevalence of psychological morbidity is exceptionally high among women. We hypothesise that, among women of childbearing age, gender disadvantage is an independent risk factor for psychological morbidity Methods A cross-sectional catchment area survey of 525 women aged 18 to 35 years living in Islamabad and Rawalpindi. The effect of gender disadvantage was assessed as a latent variable using structural equation modelling. Indicators were parental gender preference, low parental care, parental overprotection, limited education, early age at marriage, marital dissatisfaction and low autonomy. Psychological morbidity was assessed using the 20 item Self Reporting Questionnaire (SRQ). Results Gender disadvantage was independently predictive of psychological morbidity. Among married women, socio-economic status did not predict psychological morbidity, and the effect of education was mediated through gender disadvantage rather than socioeconomic status (SES). The women's own preference for a male child was strongly predicted by their perceptions of having been disadvantaged by their gender in their families of origin. Conclusions The high prevalence of psychological morbidity among women in Pakistan is concerning given recently reported strong associations with low birth weight and infant stunting. Social action, public policies and legislation are indicated to reduce culturally embedded preferences. Neglect of these fundamentals will entrench consequent inequities including gender bias in access to education, a key millennium development goal.

How genes contribute to cognition is a perennial question for psychologists and geneticists. In the early 21st century, familial studies, including twin studies, supported the theory that genetic variations contribute to differences in cognition, but have been of little practical use to clinical and educational practitioners as no individual predictions can be made using such data; heritability cannot predict the impact of environmental factors or intervention programs. With the sequencing of animal genomes and the development of molecular genetics, new methodologies have been developed: gene targeting (replacing a functional gene with a neutral gene by homologous recombination), transgenesis (overexpressing one gene or a set of genes from one species in another species), and genome-wide scans and quantitative trait loci mapping (a strategy for identifying chromosomal regions involved in complex traits). Association studies can be performed to find associations between allelic forms and variations in IQ. Genes linked to "normal" variations in cognition have been detected but for the moment such discoveries have had no direct applications in a clinical setting; the number of genes identified as being linked to intellectual impairment has increased rapidly. Links have been reported between chromosomal deletions and triplications and behavioral phenotypes. The identification of mechanisms involved in genetic diseases should have long-term consequences on educational and/or psychological support programs as well as on health care. Psychologists need to keep up to date on advances in research establishing relationships between genetics and intellectual disability and will thus be able to refer children with cognitive impairments to specialized care services.

1980s in Germany, Britain, France and Italy suggests a convergent and consistent process of homogenisation driven chiefly by institutional mimetic isomorphism. This new 'organisational settlement' is increasingly shaped by the structural autonomisation of individual service delivery units. This paper argues that, when organisational autonomy becomes normatively sanctioned, that this increases the likelihood of its adoption, even in the face of different institutional conditions and welfare regimes. Hence, the paper is foremost concerned with explaining similarities and decreasing variance across countries and across sectors, and with accounting for the main driver of this homogenisation process. Why would different organisational fields across countries and welfare regimes adopt similar structures, in light of inconclusive evidence of economic efficiency gains? The convergence of the organisational settlement of the welfare delivery state is not only driven by economic globalisation or efficiency linked to performance, but primarily by the political demand to find new sources of legitimation in an age of increasing displacement of political authority to managers. The paper is structured in three main parts. First, it revisits the theory of organisational isomorphism by its application to the new patterns of change of welfare delivery. Secondly, it discusses the reform trajectories of autonomisation in schooling and hospital care in Britain, in comparative terms with France and Italy. Thirdly, it concentrates on Germany and it establishes empirically how this case does no longer fit the characterisation of 'immobilisme', especially in the health care sector. Lastly, the wider implications of organisational homogenisation for the TRUDI constellation are discussed.

In the absence of manipulation, both the sex ratio at birth and the population sex ratio are remarkably constant in human populations. Small alterations do occur naturally; for example, a small excess of male births has been reported to occur during and after war. The tradition of son preference, however, has distorted these natural sex ratios in large parts of Asia and North Africa. This son preference is manifest in sex-selective abortion and in discrimination in care practices for girls, both of which lead to higher female mortality. Differential gender mortality has been a documented problem for decades and led to reports in the early 1990s of 100 million "missing women" across the developing world. Since that time, improved health care and conditions for women have resulted in reductions in female mortality, but these advances have now been offset by a huge increase in the use of sex-selective abortion, which became available in the mid-1980s. Largely as a result of this practice, there are now an estimated 80 million missing females in India and China alone. The large cohorts of "surplus" males now reaching adulthood are predominantly of low socioeconomic class, and concerns have been expressed that their lack of marriageability, and consequent marginalization in society, may lead to antisocial behavior and violence, threatening societal stability and security. Measures to reduce sex selection must include strict enforcement of existing legislation, the ensuring of equal rights for women, and public awareness campaigns about the dangers of gender imbalance.

It has long been recognized that work can influence mental well-being. Quality of medical care is dependent upon the mental well-being of health care professionals. Determination of factors in job stress is important, because it will help to prevent it. The aim of this study was to
evaluate the relationship of work-related stress with work life variables by using The Brief Symptom Inventory (BSI) and Brief Coping Styles Inventory (BCSI). A survey was conducted among hospital staff of a university teaching hospital in Turkey. Response rate was 52.4 % (N=152).
A questionnaire included 47 questions on sociodemographic variables and lifestyle. Nineteen questions were derived from the Work-life Evaluation Scales. Psychological symptom status was assessed with BSI. Coping styles with stress behavior was evaluated with BCSI. Most participants showed
medium level BSI subscale scores, but global indexes were at a higher level. Females had higher depression and anxiety scores than did males; graduates of university programs (mostly nurses) had higher somatisation, obsessive compulsive interpersonal sensitivity, depression, hostility, paranoid
ideation, global severity index, positive symptom total and positive symptom distress index scores than did other respondents of other educational levels, staff who were employed by the university (i.e., residents and nurses) had higher BSI symptom scores. In conclusion, even though the respondents
did not seem generally to be dissatisfied concerning their work-life, the majority of staff had depressive symptoms and were distressed. Nurses and residents in particular, should receive counseling concerning coping styles with stress.

There is a determination within health and social care to make leaders and leadership better and more able to face the challenges presented by an ever-changing social, political and organisational landscape. However, this determination is not without difficulties, especially the challenge of changing existing work place culture and climate. This paper reports on the findings of an evaluation of a leadership development programme delivered to senior leaders in health and social care. It uses qualitative data to demonstrate that even in a safe and risk-free environment health and social care leaders approached a hypothetical scenario in a defensive, hierarchical and expert-led manner and only after they were given 'expert' permission to change leadership style did they act collectively and seek to adopt a transformational style of leadership.

This commentary compares Israel's COVID-10 vaccination response to the much slower and less successful vaccination campaign in Canada. Although Canada did start with some structural disadvantages relative to Israel including less centralized and coherent emergency planning and a more complex demographic geography, there are, nonetheless, some important policy lessons Canada can draw from Israel. These include a more strategic use of national leadership in the vaccination campaign and the greater use of primary care resources and providers.

Recent cases have drawn attention to the issue of individual autonomy and what is sometimes referred to as 'the right to die'. Adult patients who are mentally competent have the right to refuse medical treatment even when that refusal can lead to worsening ill health and even death. This refusal of treatment may only be ignored when statutory law provides for treatment without consent, or a judge makes an order that overrides the patient's consent. While this is largely accepted when patients are physically and mentally competent, it becomes a complex issue when a person is mentally competent but due to physical incapacity are in care because they are unable to care for themselves.