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Results for “Mainstreaming”

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PubMed2001

First Nations women's encounters with mainstream health care services.

Health care encounters are important areas for study because they reflect social, political, economic, and ideological relations between patients and the dominant health care system. This study examines mainstream health care encounters from the viewpoint of First Nations women from a reserve community in northwestern Canada. Perspectives from critical medical anthropology and the concept of cultural safety provided the theoretical orientation for the study. Critical and feminist ethnographic approaches were used to guide in-depth interviews conducted with 10 First Nations women. Findings were organized around two broad themes that characterized women's descriptions of "invalidating" and "affirming" encounters. These narratives revealed that women's encounters were shaped by racism, discrimination, and structural inequities that continue to marginalize and disadvantage First Nations women. The women's health care experiences have historical, political, and economic significance and are reflective of wider postcolonial relations that shape their everyday lives.

Attitude of Health Personnel↗

PubMed2006

Out of the mainstream: low-income, lone mothers' life experiences and perspectives on heart health.

Cardiovascular disease remains a health issue in North America, particularly for marginalized citizens. Although lifestyle issues and behavioral risk reduction continue to dominate prevention initiatives, an emerging literature suggests that contextual factors such as poverty and social exclusion also influence health. Using group and personal interviews (N = 38), this research explored the social and economic contexts shaping heart health-related experiences from the perspectives of low-income, lone mothers. The transcripts were analyzed using McKinlay and Marceau's upstream-midstream-downstream framework. The overriding pattern characterizing lone mothers' discussions was that the women felt out of the mainstream of everyday life. They lacked the resources and power to effect change, particularly regarding heart health behaviors that were not perceived to be a priority compared to more pressing survival issues. Results are discussed in terms of concepts from the population health and social determinants literature, concluding with policy implications for enhancing health while living in poverty.

Adolescent↗

PubMed2006

Food for nutrition: mainstreaming nutrition in WFP.

Most preventable deaths among hungry people take place outside of emergency contexts. In countries not involved in conflicts or natural disasters malnutrition is directly implicated in the deaths of millions of children and mothers each year. Thus, WFP's great efforts focused on saving lives in emergencies should be mirrored by efforts aimed at tackling malnutrition, and hence saving lives, beyond emergencies as well. While food sufficiency is not the same as good nutrition, food is nevertheless an important part of the nutrition equation. New scientific evidence confirms that it is possible to have positive nutritional impacts with food aid. Consistent with Strategic Priority No. 3, WFP seeks to use food resources to achieve nutritional impacts in three complementary ways: a) enhancing the effectiveness and impact of targeted mother and child health and nutrition interventions (MCHN) that combine food and appropriate nonfood inputs; b) enhancing the nutritional value of WFP food (for instance, through micronutrient fortification); and c) enhancing the nutritional impact of other WFP (non-MCHN) interventions. These approaches represent a mainstreaming of nutrition across WFP's activities. Adoption of evidence-based programming, joint interventions with partners, and new project designs offer the promise of greater WFP effectiveness and impact in the coming years.

Developing Countries↗

PubMed2001

Mainstreaming palliative care for cancer patients in the acute hospital setting.

Palliative care is now emerging as an integrated part of mainstream health care delivery. The importance of patient choice regarding place of dying means that a substantial proportion of palliative care provision occurs in community settings. In part, this is due to the inappropriateness of the acute hospital setting for the care of dying patients. However, most patients with cancer and other terminal illnesses are diagnosed and treated in acute hospitals. Acute hospitals are also the most common setting where people actually die. Therefore, there remains a need for skilled and compassionate provision for the care of dying patients in the acute hospital setting. This paper presents a case for the provision of palliative care services in teaching hospitals. It further argues that a high level of integration between cancer treatment services and palliative care services is needed to optimize the care of cancer patients.

Attitude of Health Personnel↗

PubMed1999

Mainstream and sidestream cigarette smoke condensates suppress macrophage responsiveness to interferon gamma.

Sidestream smoke evolves from the smoldering end of a cigarette while the smoker is not puffing, and contributes substantially to environmental tobacco smoke (ETS). In contrast, main stream smoke emerges from the butt end of the cigarette and is mainly inhaled by the smoker. This study was performed to compare the effects of short-term exposure to cigarette smoke condensates prepared from sidestream (CSC-SS) and mainstream cigarette smoke (CSC-MS) on macrophage basal metabolism and responsiveness to two different stimuli, bacterial lipopolysaccharide (LPS) and interferon gamma (IFNgamma). Despite their generation at different temperatures and their different chemical composition, CSC - SS and CSC - MS had similar effects on macrophages. Both enhanced macrophage basal metabolism and responsiveness to LPS. Macrophage responsiveness to IFNgamma, assessed by their expression of four functional capacities, was suppressed by both CSC-SS and CSC-MS. The four assessed IFNgamma-inducible functional capacities were: enhanced phagocytosis of immuoglobulin-opsonized sheep red blood cells, TPA-induced peroxide production, class II major histocompatibility complex expression, and nitric oxide synthesis with LPS co-stimulation. The effects of CSC - SS and CSC - MS were similar qualitatively; they differ quantitatively in some cases, with CSC-MS generally effective at lower concentrations (expressed as cigarette-equivalents) than CSC-SS. Considering dilution of sidestream smoke in room air and loss during passage through the respiratory system, we expect to deliver the maximal dose to lung macrophages in situ only in rooms dense with smokers. However, only a fraction of the maximal dose can partially suppress induction of some functions, such as nitric oxide production and MHC expression. Macrophages play critical roles in tissue modeling during development. Of particular concern are neonates, whose organs are still undergoing growth and development, and are therefore susceptible to impaired development. If involuntary exposure to ETS hinders induction of macrophage functional capacities by cytokines, then development of the lungs and perhaps other organs would be impaired. In general, since macrophages are potent effectors and regulators of immunity, impairment of their responsiveness to cytokine must disrupt the proper functioning of the immune system.

Animals↗

PubMed2005

Meeting government objectives for telecare in moving from local implementation to mainstream services.

The UK government wishes to deploy a mainstream telecare service by 2010. We believe that it will be necessary to overcome the organizational and structural barriers to such an implementation. A better understanding of the effect of telecare across the care system as a whole will also be needed. In the absence of rigorous data from trials and because of the time taken for systemic effects to emerge, the evidence for the benefits of telecare needs to be explored through simulation modelling.

Aged↗

PubMedDate not supplied

Working complementary therapies into mainstream health care.

Complementary and alternative medicine (CAM) is speculative and practitioners and policy makers question its validity in the care of people within the NHS. However, increasing numbers of people are using private CAM therapists to address their health needs. This has consequences in terms of cost to the patient, of using CAM instead of traditional health care, and for policy makers and educators raises questions of competency, regulation and research to validate its efficacy. This article provides a personal account of a nurse educator's discovery of homeopathy as a complementary therapy, its impact upon health status, training undertaken and action taken as a result. It outlines the potential use of CAM as a holistic approach that embraces the interprofessional framework and suggests CAM practitioner inclusion within mainstream healthcare provision. The article emphasizes the need for further quantitative and qualitative research of CAM treatment.

Attitude of Health Personnel↗

PubMed1991

Out of the mainstream: sexual minorities and the mass media.

In a society dominated by centralized sources of information and imagery, in which economic imperatives and pervasive sources of values promote the search for large, common-denominator audiences, it is useful to look at the fate of those who, for one reason or another, find themselves outside of the mainstream. This paper addresses the general questions of minority perspectives in the context of the study of mass media content and effects. More specific attention is paid to the situation of lesbian women and gay men as members of the mass media audience.

Communication↗

PubMed2006

Mainstreaming kink: the politics of BDSM representation in U.S. popular media.

This article explores nonpractitioners' understandings of and responses to the increasingly mainstream representation of BDSM in U.S. media, focusing on the film Secretary (Shainberg, 2002). Survey, focus group, and interview data indicate that popular images of SM promote the acceptance and understanding of sexual minorities through two mechanisms: acceptance via normalization, and understanding via pathologizing. Rather than challenging the privileged status of normative sexuality, these mechanisms reinforce boundaries between protected/privileged and policed/pathological sexualities. Instead of celebrating increased representation, this article argues that political energy might be directed toward the desire that the popularity of BDSM representations signifies: the desire to encounter authentic, undisciplined, and noncommodified representations that would transgress the sexual norms of American postmodern consumer culture.

Adult↗

PubMed2006

Lesbian discourses in mainstream magazines of post-war Japan: is onabe distinct from rezubian?

This paper elucidates the changes in the meanings associated with the term rezubian (the Japanese term for "lesbian") through an analysis of its discourse in magazines for general readership published in post-war Japan. The category of "rezubian" first appeared in mainstream magazines in the 1960s as a generic category that referred to both "masculinized women" and "women who engage in sexual acts with other women." Masculinized women, in particular, were called "onabe." At first "onabe" denoted "a tachi rezubian," meaning a lesbian who plays "top," but gradually a distinction came to be made between "rezubian who are onabe" and "rezubian who aren't." The early 1990s saw the differentiation of "onabe" as a category distinct from that of "rezubian." Focusing particularly on this process of differentiation, this paper traces the transitions in the signifying practices pertaining to the category rezubian. doi:10.1300/J155v10n03_09.

Female↗

PubMed2006

Detection and quantification of multiple molecular species in mainstream cigarette smoke by continuous-wave terahertz spectroscopy.

Continuous-wave terahertz spectroscopy by photomixing is applied to the analysis of mainstream cigarette smoke. Using the wide tunability of the source, spectral signatures of hydrogen cyanide (HCN), carbon monoxide (CO), formaldehyde (H2CO), and water (H2O) have been observed from 500 to 2400 GHz. The fine spectral purity allows direct concentration measurement from the pure rotational transitions of HCN and CO. The quantification of the measurement was validated by the means of a calibration gas containing CO. The potential of this technique for trace gas detection is demonstrated with an estimated detection limit of HCN equal to 9 parts in 10(6).

Air Pollutants↗

PubMedDate not supplied

Depression in primary care: bringing behavioral health care into the mainstream.

The Robert Wood Johnson Foundation's national program, Depression in Primary Care: Linking Clinical and Systems Strategies, funds three related components to stimulate innovation in primary depression care. The incentives, value, and leadership components evaluate and implement strategies for financing and sustaining use of clinical best practices despite barriers created by economic and organizational structures that fragment behavioral and general health care. A challenge for policymakers is how to link depression care with the management of other chronic conditions, so that they are integrated into the quality improvement agenda of purchasers, payers, and providers without becoming submerged in health care's mainstream.

Depression↗

PubMedDate not supplied

Mainstreaming complementary therapies: new directions in health care.

Within the past decade, complementary and alternative medicine (CAM) has penetrated mainstream U.S. health care. Major medical journals are publishing research on the efficacy of specific CAM therapies, physicians are attending oversubscribed continuing medical education courses on CAM, and hospitals are offering CAM services, sometimes through outpatient integrative medicine clinics. This paper presents factors behind the growth of CAM, analyzes its relationship with conventional medicine, and suggests how the integration of CAM and conventional medicine can be more effectively guided.

Attitude of Health Personnel↗

PubMed2002

Quality, mainstream services with proactive and targeted outreach: a model of contraceptive service provision for young people.

INTRODUCTION: High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service. METHODS: Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service. RESULTS: The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold. CONCLUSION: This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.

Adolescent↗

PubMed1991

Adult foster care for the elderly in Oregon: a mainstream alternative to nursing homes?

BACKGROUND: In Oregon, adult foster care (AFC) homes, which are private residences where a live-in manager cares for one to five disabled residents, have been covered by Medicaid since 1981 and seem to offer a mainstream alternative to nursing homes. They house almost 6000 older people, two thirds of which pay privately. METHODS: In a cross-sectional study, we interviewed 400 AFC and 400 nursing home residents. Data analyses included descriptive cross-tabulations; hierarchial loglinear models for judging the effects of care setting and payment status on resident characteristics; and logit analyses for predicting care setting and payment status within care settings. RESULTS: On average, nursing home residents were more physically and cognitively impaired than AFC residents, but there was considerable overlap in patterns of frailty in the two settings. Medicaid AFC residents were less disabled than privately paying AFC residents. AFC residents reported more social activity, even when we controlled for disability status. AFC residents and their families were more likely to value privacy and homelike settings when choosing a care setting, whereas nursing home residents were more likely to value rehabilitation and organized activity programs. CONCLUSIONS: Both AFC and nursing homes are viable components of a long-term care repertoire. The greater disability levels of private-pay AFC residents refutes the criticisms that disabled Medicaid residents were being inappropriately channeled to AFC.

Aged↗

PubMed1978

A look at mainstreaming in light of children's attitudes toward the handicapped.

Mainstreaming is a legislative reality, yet there is still a question as to whether non-handicapped students are prepared for it. In the present study 131 grade school students were each asked to select from the Personal Attribute Inventory for Children 15 adjectives which best fit three groups of handicapped children as well as normal children. The groups were described in a hierarchical fashion: "normal children" were rated most favorably, then "physically handicapped children," "learning disabled children," and "emotionally disturbed children.".

Adolescent↗

PubMed1981

Teachers' expectations for handicapped and non-handicapped children in mainstreamed physical education classes.

The purpose of this study was to describe the differences of 27 handicapped and 27 non-handicapped youngsters in terms of the teachers' expectation for their physical performance, social relations, cooperative behavior and ability to reason during physical education instruction. Matched pairs of handicapped and non-handicapped elementary school-aged children were taught by three elementary physical education specialists in mainstreamed physical education classes. At the beginning of the fall term, teachers were asked to rate their students according to how they expected them to perform in terms of the four expectancy variables. All three teachers had significantly lower expectations for the handicapped students' social relations with peers than the non-handicapped. Non-significant differences were found for the remaining expectancy variables.

Child↗

PubMed1982

Differential influence of various instructional factors on self-concepts of handicapped and non-handicapped children in mainstreamed physical education classes.

The purpose of this study was to determine the differential influence of students' expression of effort, school, teachers' expectations, sex, being handicapped/non-handicapped, grade, teachers, and race on self-concept of 28 handicapped and 108 non-handicapped children in mainstreamed physical education classes (K-3). The Martinek-Zaichkowsky Self-concept Scale measured self-concept and two unpublished tests were used to test students' expression of effort and teachers' expectations. A stepwise multiple regression technique was applied to self-concept to determine the comparative influence of the eight independent variables. Data analysis showed that three of the independent variables contributed significantly to the variability of self-concept. Students' expression of effort had the strongest influence followed by school and teachers' expectation of students' ability to reason.

Child↗