The Hindered Self-Help: Housing Policies, Politics And Poverty In Kolkata, India

The housing dimension in Kolkata has been changing in recent years. Since 1991, the city has initiated housing reform that has taken many forms and manifestations characterized by the reduction in social allocation, cutbacks in public funding and promotion of a real estate culture in close partnership between the state and private actors. There has been increasing concern about the housing condition of the poor in the deserted slums and bustee settlements amidst the evident ‘poor blindness’ in housing and investment policies. Against this background the paper discusses self-help housing in Kolkata. It seeks to answer a simple question – why the concept of self-help has not been recognised as a viable policy option for a city with widespread slums and bustee settlements by visiting the complex urban context of Kolkata set within the city's politics, poverty and policies. The paper concludes that there is a need to recognise the existing structural duality in the city and support self-help housing as a parallel housing approach.

Response shift in the assessment of quality of life among people attending cardiac rehabilitation

Objectives: To examine whether any response shift in quality of life assessment over the course of a cardiac rehabilitation programme could be explained by changes in individuals’ internal standards (recalibration), values (reprioritization) and/or conceptualization of quality of life and the extent to which any response shift could be explained by health locus of control, optimism and coping strategy. Design: Longitudinal survey design. Methods: The SEIQoL-DW was administered at the beginning and end of a cardiac rehabilitation programme. At the end of the programme, the SEIQoL-DW then-test was also administered to measure response shift. A total of 57 participants completed these measures and other measures to assess health locus of control, optimism and coping. Results: Response shift effects were observed in this population mainly due to recalibration. When response shift was incorporated into the analysis of QoL a larger treatment effect was observed. Active coping as a mechanism in the response shift model was found to have a significant positive correlation with response shift. Conclusion: This study showed that response shift occurs during cardiac rehabilitation. The occurrence of response shift in QoL ratings over time for this population could have implications for the estimation of the effectiveness of the intervention.

Pulmonary rehabilitation and follow-on services: a Northern Ireland survey

There should be a clear pathway through pulmonary rehabilitation and follow-on services. The aim of this survey was to determine the characteristics of the different components of the patient pathway, that is, pulmonary rehabilitation programs, ongoing exercise facilities, and support networks in Northern Ireland. Questionnaires were sent to current providers of pulmonary rehabilitation, providers of ongoing exercise, and support groups in Northern Ireland. Findings relating to the current status of pulmonary rehabilitation in Northern Ireland up to January 2007 are reported. There are currently 23 pulmonary rehabilitation programs in Northern Ireland. There appears to be a pathway through the short-term pulmonary rehabilitation program (6-8 weeks). Programs met standards for structure and format, except for the frequency of supervised exercise. Not all programs have links for the provision of ongoing exercise, but a range of exercise programs are available in leisure centers in Northern Ireland that include people with respiratory disease. There are 13 support groups for patients with respiratory disease in Northern Ireland and their function is diverse. Pulmonary rehabilitation is established in Northern Ireland, although not all patients are able to access these. Facilities for ongoing exercise and support groups are less developed. Improvements could be facilitated by better communication within the patient pathway and a strategic coordinated approach.

Perceptions of exercise among people who have not attended cardiac rehabilitation following myocardial infarction.

Perceptions of exercise among nonattenders of cardiac rehabilitation (CR) were explored using semistructured interviews. Analysis indicated that participants did not recognize the cardiovascular benefits of exercise, and perceived keeping
active through daily activities as sufficient for health. Health professionals were perceived to downplay the importance of exercise and CR, and medication was viewed as being more important than exercise for promoting health. The content of CR programmes and the benefits of exercise need to be further explained to patients post-MI, and in a manner that communicates to patients that these programmes are valued by significant others, particularly health professionals.

An Assessment of Sheltered Housing Design in Belfast, Northern Ireland

This article presents a UK-based research that has studied the existing sheltered or assisted living housing population and its future housing options and preferences. This meets an identified need to know and understand users' needs and requirements in much more detail that outlines what is liked and disliked by older people about sheltered housing, so that those who plan and design such housing can be aware of their views. The study also sought to understand the architects' challenges in designing and adapting this type of housing. The sheltered housing managed by housing associations in Belfast, Northern Ireland, was assessed through a series of site visits, structured interviews, and a focus group with stakeholders. Findings revealed older users' keen interest in participating in their housing needs assessment, identified building design concerns and provided recommendations for potential design guidelines. The findings of this research have provided important policy and design guidance to NI housing providers, and also allowed various stakeholders to participate in the debate about the quality of housing provided for the older people. This is a significant research study that generated considerable interest from various housing providers. This is an international peer reviewed journal.

Cardiac rehabilitation uptake following myocardial infarction: cross-sectional study in primary care

Background Policies suggest that primary care should be more involved in delivering cardiac rehabilitation. However, there is a lack of information about what is known in primary care regarding patients' invitation or attendance. Aim To determine, within primary care, how many patients are invited to and attend rehabilitation after myocardial infarction (MI), examine sociodemographic factors related to invitation, and compare quality of life between those who do and do not attend. Design of study Review of primary care paper and computer records; cross-sectional questionnaire. Setting Northern Ireland general practices (38); stratified sample, based on practice size and health board area. Method Patients, identified from primary care records, 12-16?weeks after a confirmed diagnosis of MI, were posted questionnaires, including a validated MacNew post-MI quality-of-life questionnaire. Practices returned anonymised data for non-responders. Results Information about rehabilitation was available for 332 of the 432 patients identified (76.9%): 162 (37.5%) returned questionnaires. Of the total sample, 54.4% (235/432) were invited and 37.0% (160/432) attended; of those invited, 68.1% (160/235) attended. Invited patients were younger than those not invited (mean age 63?years [standard deviation SD 16] versus 68.5?years [SD 16]); mean difference 5.5?years (95% confidence interval [CI] = 1.7 to 9.3). Among questionnaire responders, those who attended were younger and reported better emotional, physical, and social functioning than non-attenders (P = 0.01; mean differences 0.44 (95% CI = 0.11 to 0.77), 0.48 (95% CI = 0.10 to 0.85) and 0.54 (95% CI = 0.15 to 0.94) respectively). Conclusion Innovative strategies are needed to improve cardiac rehabilitation uptake, integration of hospital and primary care services, and healthcare professionals' awareness of patients' potential for health gain after MI.

A survey of sewer rehabilitation in Malaysia: application of trenchless technologies

This work presents a review of applicable sewer rehabilitation options using trenchless technology in Malaysia. The typical problems faced in wastewater collection systems are analysed and factors that determine the selection method are outlined. This study also highlights the necessary steps to be taken prior to the rehabilitation work. The trenchless technology reviewed here comprises repair, renovation and replacement options. The cost-effectiveness of different rehabilitation methods was identified to assess the economic viability of various options in the Malaysian context. This study reveals that not all the trenchless technologies available in the market are suitable for use in Malaysia, mainly due to incompatibility of the rehabilitation materials used. Furthermore, as trenchless rehabilitation generally involves higher capital outlay than open-cut methods, the choice of rehabilitation method has to be made on a case-to-case basis.