Aspects of health among an employed population

This survey collected information on aspects of health amongst an employed population, employees in 14 different organisations in the West Midlands Regional Health Authority; and was a stratified sample of senior managers, middle managers and operatives. Nine hundred and sixty questionnaires were distributed asking for both quantitative and qualitative information on 58 questions covering health, work, family, leisure activities and life-style. A response rate of 48% (459 returned questionnaires) came from 290 men (63%), 165 women (36%) and four people (1%) who did not answer the gender question. The initial findings from this study are unique in that there has not been a specific review of the health of people at work. In answer to the main research questions, 92% felt they were healthy. Compared to others of a similar age, 34% felt their health was `above average', 58% `average', and 7&37 `below average'. Thirty two percent of respondents had visited their GP in the past 1-2 months; the highest reason given was disorders of the respiratory system, 20%. People's perceptions on the effects of work on their health were: good effect, 13% fair effect, 20% no effect, 27% poor effect, 27% and bad effect, 7%. The effects of leisure activities on health were thought to be more positive: good effect, 46% fair effect, 20% no effect, 21% poor effect, 3% and bad effect, 2%. The perceptions of effects of life-style on health were considered to be: good effect, 32% fair effect, 32% no effect, 20% poor effect, 9% and bad effect, 1%.  In this survey, leisure and life-style were seen by employees to have more beneficial effects on health than work. Future implications include a review of occupational health as a major policy development area within primary care. There is a need to influence the education and training of health care practitioners in order to affect their ability to practise effectively in this new and challenging area of work.

Education and racism:a study of the teachers' and the pupils' relations in the schooling of black boys

This thesis examines the teachers' and the pupils' relations in the schooling of black boys. The study using the methodology of participant observation focusses on one school (Kilby) in an area of black population in an English city. The thesis’s intentions are two fold: firstly, in order to examine these relations, two major aspects of their interaction are addressed, that of the absence of teachers from conventional 'race-relations' research, and, the identification and examination of the anti-school pupils' sub-cultures. Two substantive questions are asked: what is the response of the teachers to the schooling of black pupils? and, what is the meaning of the pupils' resistance to schooling? Secondly, in attempting to answer these questions and offer a critique of the dominant 'race-relations' culturalist explanation of black youth's response to schooling, a theoretical framework has been developed which takes account of both the 'economic' and the 'sociological' perspectives. Methodology allowed and pointed to the importance of examining the teachers' ideologies and practices as well as those of the black boys. It is argued that a class analysis of the racially structured British society is more adequate than the conventional ethnic approach in explaining the black boys' location within Kilby School. Hence, it is posited that the major problem in the schooling of black youth is not that of their culture but of racism, which pervasively structures the social reality at Kilby school. Racism is mediated both through the existing institutional framework that discriminates against working-class youth and through the operation of race specific mechanisms, such as the process of racist stereotyping. It is thus further argued that the Kilby school teachers are of central causal significance to the - problems that the boys encounter. Furthermore, it is in response to these racist ideologies and practices that both West Indian and Asian pupils develop specific forms of collective resistance, which are seen to be linked to the wider black community, as legitimate strategies of survival.

Diabetic patient education and motivation. Available in 2 volumes.

Diabetes mellitus is a condition which requires a high degree of patient cooperation in self-management to achieve optimal glycaemic control. The concept of patient education, to enhance the treatment and management of diabetes, is well recognised. Several diabetes education programmes have already been described, but increased knowledge of diabetes did not necessarily result in improved self-mangement or glycaemic control. Other factors, such as attitudes and motivations, may therefore be particuarly important. The aims of the present study were to investigate the influence of patients' attitudes to diabetes, and to develop motivational aspects which enable the application of knowledge to enhance self-management and compliance with treatment. Thirty-one insulin-dependent diabetic (IDD) patients entered into a 12 month educational programme, particularly designed to increase motivation. Patients' attitudes to diabetes, their knowledge and self-management skills were assessed using questionnaires and practical tests, and parameters of glycaemic control were measured. The progress of these patients was compared at intervals with a close matched group of 25 control IFF patients who continued to receive routine clinic care. Patients completing the educational programme achieved better glycaemic control (p< 0.05), greater knowledge (p< 0.001), more favourable attitudes (p< 0.03) and increased competence in management skills (p< 0.02) compared with the control group. Evaluation procedures indicated that the programme was acceptable to the patients, and was successful in terms of increasing patient motivation. Six months after completion of the programme, glycaemic control deteriorated, although knowledge, attitudes and management skills were unchanged. This might reflect the withdrawal of extrinsic motivation, attention and supervision provided during the programme. It is recommended that consideration be given to the development of patients' intrinsic motivation to achieve maximum benefit from diabetes education programmes.