[Examination of healthy people and its medical and social implications].
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A Parent x Child model of socialization was applied to the development of depressive symptoms. It was expected that when parents used intrusive support frequently, children engaging in negative self-evaluative processes would be more vulnerable to depressive symptoms than children engaging in positive self-evaluative processes. Children in the 5th through 7th grades took part in a 2-wave longitudinal study over 6 months. Parents' use of intrusive support was assessed using reports from children (N = 806) and mothers (N = 74). Children's self-evaluative processes and depressive symptoms were assessed using reports from children. The results suggest that both parents and children contribute to the development of depressive symptoms. When parental intrusive support was high, children engaging in negative self-evaluative processes experienced more depressive symptoms over time than did children engaging in positive self-evaluative processes.
OBJECTIVE: To compare the social effects of urinary diversion, undiversion and orthotopic bladder reconstruction performed during childhood. PATIENTS AND METHODS: Of 99 patients treated at the Wessex Centre for Paediatric Surgery between 1960 and 1993, 46 (16 with a urinary diversion, eight with an undiversion and 22 with bladder reconstruction) were interviewed using a standardized questionnaire. Information was collected about the types and results of surgery, the medical support received and the social effects of the different treatments. RESULTS: By day, continence or only occasional wetting was achieved in 13 patients with diversions, all those with undiversions and 16 of those with reconstructions. At night, 13 patients with diversions, seven with undiversions and 18 with reconstructions were dry or only occasionally wet. Re-operation rates were higher in those with reconstruction and undiversion. Only five of the diversion group were satisfied with their management compared to all patients in the other two groups. The social effects in terms of employment, schooling, independence, body image and social interactions were also better in those with undiversions and reconstructions. CONCLUSIONS: The social effects of undiversion and bladder reconstruction were better than those following urinary diversion despite the higher re-operation rates and the need for a rigid regimen of post-operative care. However, the need for continuing medical support in this group of patients cannot be over emphasized, and the vital role of the urological nurse specialist is stressed.
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Besides its toxicity, groundwater arsenic contamination creates widespread social problems for its victims and their families in Bangladesh. There is, for instance, a tendency to ostracise arsenic-affected people, arsenicosis being thought of as a contagious disease. Within the community, arsenic-affected people are barred from social activities and often face rejection, even by their immediate family members. Women with visible arsenicosis symptoms are unable to get married and some affected housewives are divorced by their husbands. Children with symptoms are not sent to school in an effort to hide the problem. This paper employs mainly qualitative methods to interpret people's understandings about the toxic impact of groundwater arsenic poisoning on their social lives. Arsenic-affected patients in southwest Bangladesh were asked to determine their 'own priorities' in measuring arsenic toxicity on their social activities and to explore their perceptions about their own survival strategies. We found that patients' experiences reveal severe negative social impacts, and a sharp difference of perceptions about arsenic and social issues between arsenicosis patients and unaffected people.
The development of an identity and pattern of practice in the health care professions is based on a process of socialization into the roles and norms of a particular discipline and has important implications for clinical practice with elderly persons. Presented is a model for understanding the socialization process of physicians, nurses, and social workers as the development of professional meaning ("voice") based on the acquisition of value orientations or themes intrinsic to their education and training. The implications of these patterns for the abilities of different professions to work together collaboratively in the care of older persons are highlighted as a framework for developing new interdisciplinary curricular models in gerontological and geriatric education.
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Constant urinary leakage is a serious social and physical problem accompanying a vesicovaginal fistula in curable and incurable patients. The method of linking vesical catheterization is presented as a useful adjunct available to the urologic surgeon. Its applicability in the curable patient awaiting operation and the incurable or inoperable patient is described.
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The thermal injury, personal and social factors affecting the short-term outcome responses of thermally injured children under 5 years of age and their mothers are reported. Statistical analysis of factors influencing the mother and child outcome responses uses data from serial interviews with mothers of 57 thermally injured children which took place whilst the child was in hospital, and at home, at 1 week, 2 months and 6 months following hospital discharge. A relationship was found between the child's behaviour and the mother's outcome response at 6 months. Essentially, for the mother, the qualitative outcome response of the Maternal Thermal Injury Response Pattern was associated with the severity of the child's thermal injury and the quantitative General Health Questionnaire scores were associated with a previous tendency to depression and increased stress on the mother existing prior to the accident. For the child, no thermal injury factor appeared to affect behavioural outcome. The child was disturbed behaviour following a thermal injury, however, was more likely to have a mother with a history of depression, and added stress (lower socioeconomic status, and additional worries) and have a mother who was blamed for the accident. Thus, mothers whose child has a more severe thermal injury will take longer to come to terms with it ('rationalize' the thermal injury) and those mothers who were most stressed prior to the accident and who had a previous tendency to depression, will have more psychiatric morbidity (a higher GHQ score) as a result. Both these groups will require particular support.
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