Illness Labels and Social Distance

The authors examine a key proposition in the modified labeling theory—that a psychiatric label increases vulnerability to negative evaluation and social rejection—using an experimental design wherein female participants interact with a female teammate over a computer. The authors also evaluate a hypothesis derived from the disease-avoidance account of disgust by examining this same process for a nonpsychiatric illness: food poisoning. In addition, they introduce a composite measure of social distance behavior that is easy to implement in a laboratory experiment. The authors find, as predicted, that women seek greater social distance from teammates with a history of psychiatric or food poisoning hospitalization than they do from teammates with no hospitalization history. But, contrary to predictions, a teammate’s hospitalization history does not affect participants’ ratings of her likability. The results also do not vary significantly by psychiatric diagnosis (depression vs. schizophrenia), suggesting that the stigma of depression may be just as strong as the stigma of schizophrenia when information about symptoms is not available. The authors discuss the implications of these findings for the modified labeling theory of mental illness and for the literature on disgust and stigma. They also outline avenues for future research.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

BACKGROUND: On the 26th December 2004 the Asian tsunami devastated the Sri Lankan coastline. More than two years later, over 14,500 families were still living in transitional shelters. This study compares the health of the internally displaced people (IDP), living in transitional camps with those in permanent housing projects provided by government and non-government organisations in Sri Lanka. METHODS: This study was conducted in seven transitional camps and five permanent housing projects in the south west of Sri Lanka. Using an interviewer-led questionnaire, data on the IDPs' self-reported health and housing conditions were collected from 154 participants from transitional camps and 147 participants from permanent housing projects. Simple tabulation with non-parametric tests and logistic regression were used to identify and analyse relationships between housing conditions and the reported prevalence of specific symptoms. RESULTS: Analysis showed that living conditions were significantly worse in transitional camps than in permanent housing projects for all factors investigated, except 'having a leaking roof'. Transitional camp participants scored significantly lower on self-perceived overall health scores than those living in housing projects. After controlling for gender, age and marital status, living in a transitional camp compared to a housing project was found to be a significant risk factor for the following symptoms; coughs OR: 3.53 (CI: 2.11-5.89), stomach ache 4.82 (2.19-10.82), headache 5.20 (3.09-8.76), general aches and pains 6.44 (3.67-11.33) and feeling generally unwell 2.28 (2.51-7.29). Within transitional camp data, the only condition shown to be a significant risk factor for any symptom was household population density, which increased the risk of stomach aches 1.40 (1.09-1.79) and headaches 1.33 (1.01-1.77). CONCLUSION: Internally displaced people living in transitional camps are a vulnerable population and specific interventions need to be targeted at this population to address the health inequalities that they report to be experiencing. Further studies need to be conducted to establish which aspects of their housing environment predispose them to poorer health

IMCI and ETAT Integration at a Primary Healthcare Facility in Malawi:A Human Factors Approach

Abstract Background Integrated Management of Childhood Illness (IMCI) and Emergency Triage, Assessment and Treatment (ETAT) are guidelines developed by the World Health Organization to reach targets for reducing under-5 mortality. They were set out in the Millennium Development Goals. Each guideline was established separately so the purpose of this study was to understand how these systems have been integrated in a primary care setting and identify barriers and facilitators to this integration using a systems approach. Method Interviews were carried out with members of staff of different levels within a primary healthcare clinic in Malawi. Along with observations from the clinic this provided a well-rounded view of the running of the clinic. This data was then analysed using the SEIPS 2.0 work systems framework. The work system elements specified in this model were used to identify and categorise themes that influenced the clinic’s efficiency. Results A process map of the flow of patients through the clinic was created, showing the tasks undertaken and the interactions between staff and patients. In their interviews, staff identified several organisational elements that served as barriers to the implementation of care. They included workload, available resources, ineffective time management, delegation of roles and adaptation of care. In terms of the external environment there was a lack of clarity over the two sets of guidelines and how they were to be integrated which was a key barrier to the process. Under the heading of tools and technology a lack of guideline copies was identified as a barrier. However, the health passport system and other forms of recording were highlighted as being important facilitators. Other issues highlighted were the lack of transport provided, challenges regarding teamwork and attitudes of members of staff, patient factors such as their beliefs and regard for the care and education provided by the clinic. Conclusions This study provides the first information on the challenges and issues involved in combining IMCI and ETAT and identified a number of barriers. These barriers included a lack of resources, staff training and heavy workload. This provided areas to work on in order to improve implementation

At home and at work: the family s allocation of lahor/ Geerken

165 hal.: tab.; 21 cm

At home and at work: the family s allocation of lahor/ Geerken

165 hal.: tab.; 21 cm

Determinants of drug use: A test of the coping hypothesis

This paper uses a national probability sample to examine major correlates of drug use among American adults. Demographic correlates of alcohol, cigarette, marijuana, tranquilizer, sleeping pill and stimulant use are explained in terms of a self medication or coping perspective of drug use. Two analysis procedures are used. In the first, respondents were asked to list strategies they use when they have problems. These responses are 'broken down' by drug use categories or 'taking pills'. In the second procedure, attempts are made to interpret the correlations between age, sex, marital status, education and drug use by introducing variables which measure how respondents were experiencing fundamental aspects of their lives (role stress items) and mental health variables. A substantial portion of the variance in drug use that is explained by demographic variables appears to operate through social role and mental health variables, that is, these latter variables interpret the demographic/drug use relationships in a way that is consistent with a coping perspective. The authors conclude that these data and this analysis provided cautious support for a coping perspective.