952 resultados para social medicine


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If the current discourses of progress are to be believed, the new or social media promise a kaleidoscope of opportunity for connecting and informing citizens. This is by allegedly revitalizing the fading legitimacy and practice of institutions and providing an agent for social interaction. However, as social media adoption has increased, it has revealed a wealth of contradictions both of its own making and reproduction of past action. This has created a crisis for traditional media as well as for public relations. For example, social media such as WikiLeaks have bypassed official channels about government information. In other cases, social media such as Facebook and Twitter informed BBC coverage of the Rio Olympics. Although old media are unlikely to go away, social media have had an impact with several large familybased media companies collapsing or being reintegrated into the new paradigm. To use Walter Lippman’s analogy of the phantom public, the social media contradictorily serve to both disparate the phantom in part and reinforce it...

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This article presents a case study of corporate dialogue with vulnerable others. Dialogue with marginalized external groups is increasingly presented in the business literature as the key to making corporate social responsibility possible in particular through corporate learning. Corporate public communications at the same time promote community engagement as a core aspect of corporate social responsibility. This article examines the possibilities for and conditions underpinning corporate dialogue with marginalized stakeholders as occurred around the unexpected and sudden closure in January 2009 of the AU$2.2 billion BHP Billiton Ravensthorpe Nickel mine in rural Western Australia. In doing so we draw on John Roberts’ notion of dialogue with vulnerable others, and apply a discourse analysis approach to data spanning corporate public communications and interviews with residents affected by the decision to close the mine. In presenting this case study we contribute to the as yet limited organizational research concerned directly with marginalized stakeholders and argue that corporate social responsibility discourse and vulnerable other dialogue not only affirms the primacy of business interests but also co-opts vulnerable others in the pursuit of these interests. In conclusion we consider case study implications for critical understandings of corporate dialogue with vulnerable others.

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Purpose – While there have been numerous studies on the antecedents and consequences of service quality, there has been little investigation of the moderators of service quality. The purpose of this study is to demonstrate the effects of two moderators: service convenience and the social servicescape. The moderating effects are tested in two service settings: retail and hedonic (concert). Design/methodology/approach – A survey of 270 customers at kitchen display showrooms and 320 concert-goers was undertaken. The results were analysed using regression analysis. Findings – The results show support for ten of the 12 hypotheses. Service convenience moderated the relationships between perceived service quality and its three sub-dimensions (interaction, environment, and outcome quality), differently in different settings (retail vs hedonic). This supports the authors' general argument that the outcome dimension tends to be more important to customers in a retail setting, while interaction and environment quality dimensions tend to be more important in hedonic service consumption. Practical implications – These findings suggest that managers need to use different service management tactics in retail and hedonic service settings. Specifically managers in retail settings need to pay more attention to service convenience to achieve service quality and managers in hedonic settings should concentrate on the social servicescape. Originality/value – This paper is the first to test the moderating factors of service convenience and social servicescape on service quality.

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Young people seen as ‘at risk’ are a substantial focus across a wide range of policy and practice fields in national and international contexts. This article addresses two of those fields, youth homelessness and youth failing to obtain a basic education that will give them access to employment and full community participation as active citizens. By comparing solutions to the problems of youth homelessness and youth educationally at risk, the article distils key meta-characteristics useful for both social workers and educators in mutually supporting some of the most at risk young people in our communities today. This is what the authors term ‘a joined-up practice’.

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Objective: To evaluate the impact of a government triple zero community awareness campaign on the characteristics of patients attending an ED. Methods: A study using Emergency Department Information System data was conducted in an adult metropolitan tertiary-referral teaching hospital in Brisbane. The three outcomes measured in the 3 month post-campaign period were arrival mode, Australasian Triage Scale and departure status. These measures reflect ambulance usage, clinical urgency and illness severity, respectively. They were compared with those in the 3 month pre-campaign period. Multivariate logistic regression models were used to investigate the impacts of the campaign on each of the three outcome measures after controlling for age, sex, day and time of arrival, and daily minimum temperature. Results: There were 17 920 visits in the pre- and 17 793 visits in the post-campaign period. After the campaign, fewer patients arrived at the ED by road ambulance (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.80–1.00), although the impact of the campaign on the arrival mode was only close to statistical significance (Wald χ2-test, P= 0.055); and patients were significantly less likely to have higher clinical urgency (OR 0.86, 95% CI 0.79–0.94), while more likely to be admitted (OR 1.68, 95% CI 1.38–2.05) or complete treatment in the ED (OR 1.46, 95% CI 1.23–1.73) instead of leaving without waiting to be seen. Conclusions: The campaign had no significant impact on the arrival mode of the patients. After the campaign, the illness acuity of the patients decreased, whereas the illness severity of the patients increased.

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In this chapter we look at inclusive education as part of a number of wider social movements for social justice. Inclusive education is thus understood as a transformation of education systems, rather than simply the addition of new groups of students to schools, or the development of new techniques (Slee, 2006). We illustrate the ways movements for social change can occur at many levels. Resistance to social change also occurs at many levels. Movements for social justice often include a goal of changing what happens in education. This is because education is often seen as one of the important social institutions that can reinforce the status quo. Education is also seen as an important means of changing the status quo, giving more people access to a more meaningful education. It’s not uncommon to hear various political parties criticising each other’s educational policies as ‘social engineering.’ Movements for social justice in education understand that education has always been about social engineering. The questions of interest are thus: Social engineering for what?; Who benefits; and At whose expense?

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The present research examined the effects of occupational stress in psychiatric nursing on employee well!being using the full Job Strain Model.The Job Strain Model was assessed for its ability to predict employee well!being in terms of job satisfaction and mental health. The original Job Strain Model was expanded to include social support based on previous research concerning the impact of social support on well!being[ In the present study\ both work support and non-work were assessed for their contribution to wellbeing.The results of this study indicate that the full Job Strain Model can be used to significantly predict job satisfaction and mental health in this sample of Australian psychiatric nurses. Furthermore social support was shown to be an important component of the Job Strain Model.

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Objective To assess the effects of the 2011 floods in Brisbane, Australia, on residents’ physical and mental health. Methods Residents who had been affected by the floods completed a community-based survey that examined the direct impact of flooding on households and their perceived physical and mental health. Outcome variables included overall and respiratory health and mental health outcomes related to psychological distress, sleep quality, and posttraumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and perceived health outcome variables, adjusted for current health status and sociodemographic factors. Results Residents whose households were directly affected by flooding were more likely to report poor overall (Odds Ratio [OR] 5.3; 95% CI, 2.8-10.1) and respiratory (OR 2.3; 95% CI, 1.1-4.6) health, psychological distress (OR 1.9; 95% CI, 1.1-3.5), poor sleep quality (OR 2.3; 95% CI, 1.2-4.4), and probable PTSD (OR 2.3; 95% CI, 1.2-4.5). Conclusions The 2011 Brisbane floods had significant impact on the physical and psychosocial health of residents. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts, particularly those related to mental health.

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Background: Extreme temperatures are associated with cardiovascular disease (CVD) deaths. Previous studies have investigated the relative CVD mortality risk of temperature, but this risk is heavily influenced by deaths in frail elderly persons. To better estimate the burden of extreme temperatures we estimated their effects on years of life lost due to CVD. Methods and Results: The data were daily observations on weather and CVD mortality for Brisbane, Australia between 1996 and 2004. We estimated the association between daily mean temperature and years of life lost due to CVD, after adjusting for trend, season, day of the week, and humidity. To examine the non-linear and delayed effects of temperature, a distributed lag non-linear model was used. The model’s residuals were examined to investigate if there were any added effects due to cold spells and heat waves. The exposure-response curve between temperature and years of life lost was U-shaped, with the lowest years of life lost at 24 °C. The curve had a sharper rise at extremes of heat than of cold. The effect of cold peaked two days after exposure, whereas the greatest effect of heat occurred on the day of exposure. There were significantly added effects of heat waves on years of life lost. Conclusions: Increased years of life lost due to CVD are associated with both cold and hot temperatures. Research on specific interventions is needed to reduce temperature-related years of life lost from CVD deaths.

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and sexual violence on the social adjustment of Grade 8 and 9 school children in the state of Tripura, India. The study participants, 160 boys and 160 girls, were randomly selected from classes in eight English and Bengali medium schools in Agartala city, Tripura. Data were collected using a self-administered Semi-structured Questionnaire for Children/Students and a Social Adjustment Inventory which were custom-made for the study based on measures in the extant research adapted for the Indian context. Findings revealed that students experienced physical (21.9%), psychological (20.9%), and sexual (18.1%) violence at home, and 29.7% of the children had witnessed family violence. Boys were more often victims of physical and psychological violence while girls were more often victims of sexual violence. The social adjustment scores of school children who experienced violence, regardless of the nature of the violence, was significantly lower when compared with scores of those who had not experienced violence (p<0.001). Social adjustment was poorer for girls than boys (p<0.001). The study speaks in favour of early detection and intervention for all child maltreatment subtypes and for children exposed to interparental violence, and highlights the crucial role of schools and school psychology in addressing the problem.

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Objective: To evaluate the feasibility and effect of a water-based exercise (WBE) program on lymphedema status and shoulder range of motion (ROM) among women with breast cancer related lymphedema. Design: Single-blinded, randomized controlled pilot trial. Twenty-nine eligible breast cancer survivors (median 10 years after surgery) with arm lymphedema (median 21% inter limb difference) were included and randomized into intervention (n= 15) or control (n=14). Twenty-five participants completed the study. The intervention was at least twice weekly WBE for 8 weeks; supervised initially but performed independently during the study period. Outcomes of interest were feasibility as measured by retention and adherence, lymphedema status as measured by optoelectronic perometry, bioimpedance spectroscopy and tissue dielectric constant, and shoulder range of motion (ROM) as measured by goniometer. Results: Four participants were not measured at post-intervention and were not included in the analysis (retention). Four participants in the intervention group did not perform the minimum WBE criteria set (adherence). No effect was found on lymphedema status. Compared to the control group, median ROM change for flexion was 6 (1-10) degrees (p<0.001) and 6 (0-15.5) degrees (p=0,07) for external rotation. Clinically relevant increase in the intervention group was found for 36% in flexion (p≤0.05) and (57%) in external rotation (p≤0.05) compared to controls. Conclusions: This study shows WBE is feasible for breast cancer survivors with arm lymphedema and that shoulder ROM can be improved years after cancer treatment has been completed.

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Hypertension is a global health issue among the adult population. Adherence to antihypertensive medications is an effective step for better control of blood pressure and preventing the risk of complications. Several factors support or hinder hypertensive patients’ adherence. Objectives: This article reviews the factors affecting adherence to antihypertensive treatments, and reflects on these factors from a Saudi Arabian perspective. Methods: Papers and studies about antihypertensive medication adherence were reviewed from different databases including MEDLINE, PubMed, ScienceDirect and Google scholar. Results: Factors affecting antihypertensive treatments adherence are classified into three domains: Patient (e.g. sociodemographic, individual knowledge and skills), Health System, and Provider related factors.

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BACKGROUND: This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China. METHODS: An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals. RESULTS: There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7% were treated for poisoning; 3) 1.4% for cerebral vascular disease; 4) 1.7% for cardiac disease; and 5) 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population. CONCLUSIONS: Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.

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Abstract The Chinese Emergency Medicine System is primarily composed of three sectors; prehospital care, emergency department in a city hospital, and intensive care unit ward. While all sectors are integral to the system, the prehospital care system is less developed than the others. There are many possible contributors to the under-development of the prehospital care system, however, workforce issues may play a significant role. Firstly, there is no officially recognised paramedic profession in China. The staff members working in the prehospital care system are medical doctors, registered nurses, patient-carriers, and drivers. Secondly, these doctors and nurses are either over-qualified or under-qualified for practicing in the prehospital care system. Lastly, Chinese health professionals have taken actions to improve the current workforce status with initiatives such as short-term training workshops for doctors and nurses, implementation of a trial unit in a university, and development of a Major Degree of Emergency Medicine in a medical university. All of these actions are important steps toward improving the current workforce status in the prehospital care system. However, a long term workforce development plan is still essential for the Chinese system, and implementation of a professional paramedic education system in a medical university/college in China, may provide the solution. Keywords: China; emergency medicine system; health services; prehospital care system; workforce; service delivery