bluuebunny/crossref_metadata_2025 huggingface dataset:
-The Nutritional Component of Health Education
Authors: Thomas Jane E.
Published: March 2007

THE AIM of health education is to equip people to make sound decisions on matters affecting their health, safety and welfare. It also tries to influence the outcome of such decisions towards the most beneficial course of action; in addition it aims to encourage the acceptance of such behaviour as 'the norm' within the social environment.
A Consideration of Dental Health Education
Authors: Clewett John A.
Published: March 2007

• Dental health education is an integral part of preventive dentistry. Some aspects of health education are considered. The problems of translating information into motivation remain unsolved.
Adolescence and weight control
Authors: Thomas Jane E.
Published: March 2007

OVERWEIGHT is associated with obvious aesthetic, social and mechanical liabilities and has been incriminated as a health hazard associated with a wide variety of diseases. The nutrition education problem with which most Western countries are concerned, is how behaviour and attitudes can be influenced in order to reduce the prevalence of overweight, whilst maintaining optimum nutrient intakes; since our appetites for food are no longer commensurate with the energy expenditure involved in our life style.
Laymens' knowledge on the correct use of drugs
Authors: Hemminki Elina , Vara Klaus
Published: March 2007

SEVERAL investigations have shown that patients use drugs improperly, including abundant self medication and neglect of directions of pre scribed drugs (Dunnel et al, 1972; Haggerty et al, 1972; Marston, 1970; Murray, 1972; Stewart et al, 1972; Stimson, 1974; Office of Health Economics, 1968). The reasons for this have been sought mainly by ex amining characteristics of the patients. The patients' know ledge on drugs has not been related to the habits of using drugs. This study surveys the extent of knowledge on drugs among people living in the countryside. It also reports data on whether written drug information given in con nection with a health ex amination increases know ledge on drugs.
Child nutrition — or adult indifference?
Authors: Parahoo A.K.
Published: March 2007

THE DIETS of British children and teenagers are a growing cause for concern. There is already enough evidence supporting the link between diet and heart disease, and early signs of atherosclerotic disease have been found in young people. Children consume more sweet and fatty food than average and are more susceptible to the claims of advertisers and the temptations of fast food. The 1980 Education Act exacerbated the problem by removing the local authority's statutory obligation to provide balanced school meals. Despite all this, nutrition education is rarely directed at children and teenagers. A pro gramme of nutrition education in schools is recommended.
Smoking attitudes and habits during pregnancy, Sheffield 1983
Authors: Dowsett Shirley J
Published: March 2007

INTERVIEWS with 206 women post partum, as sessed their knowledge of the risks of smoking to pregnancy and general health, their sources of information and smoking habits during pregnancy. Thirty four per cent smoked at the beginning of pregnancy; 25 per cent quit and 44 per cent reduced consumption during pregnancy. Seventy five per cent of smokers remember receiving advice not to smoke during pregnancy, but the general practition er was cited by only 25 per cent. However advice, knowledge of the risks of smoking to health and a pregnancy, and partners' smoking habits were not associated with quitting or reducing consumption. There was a social class gradient in the proportion of smokers who were aware of the risks of smoking to health and pregnancy, but among non-smokers the higher all-round level of awareness was not in fluenced by social class. Although exposed to anti- smoking propaganda, smokers in Social Classes IV and V are unlikely to admit the risks of smoking and it remains unclear how best to motivate them to give up.
Implementing a holistic approach to alcohol education
Authors: Harrison Lyn , Means Robin
Published: March 2007

THIS article begins by describing both an alcohol education programme in the south west, and the main activities carried out by the programme's research and evaluation team. It goes on to draw upon recent research among professionals working in four contrasting localities in the south west. It is shown how organisational role and professional training influence the capacity and sometimes the willingness to respond positively to this regional programme, with its desire to implement a holistic approach to alcohol education.
Smoking among primary and secondary schoolteachers
Authors: Nutbeam Don
Published: March 2007

A study of smoking among teachers found preva lence to be relatively low and showing signs of a downwards trend, particularly among women. Teachers who smoke cigarettes tend to have a lower consumption than is normal in the general popu lation - possibly reflecting restrictions on their habit associated with their working environment. Cigar and pipe smoking is a common alternative for men. A slightly higher proportion of teachers in primary and middle schools smoke than do secondary school teachers.

In general, teachers accept that they have an important exemplary role relating to smoking, and believe it important to try to influence young peoples' smoking habits. However, there is a marked resistance on the part of existing smokers to further restrictions on their habit, or to a total ban on smok ing in schools. Thought should be given by schools to ways in which health education taught in the class room is supported by the wider school environment, including exposure to tobacco smoke and teachers' own smoking habits.
Sparking up — smoking and style in school
Authors: Nash John
Published: March 2007

THE sociological concept of style has been employed to explore the social significance of cigarette smok ing to adolescent school pupils. A qualitative case study in one secondary school was undertaken to explore the phenomenon. Smoking was found to be an important source of self-esteem and fraternity to pupils who saw themselves as being in conflict with the authority of the school. The implications of these findings are discussed in terms of the relationship between classroom teaching of smoking education programmes and the hidden curriculum of personal relationships.
A pilot dental health programme for mentally handicapped students
Authors: Webb Kathleen A.
Published: March 2007

THE pilot study concerned the development and implementation of a dental health programme for sixteen to nineteen-year-old mentally handicapped people. Interviews and questionnaire were used to assess the students' knowledge, skills and abilities. Six teaching sessions involving group discussions, toothbrushing, and other practical skills were under taken with the students. Assessments were made before and after the programme. An improvement in the levels of abilities and skills was found.
Gums - teenagers' perceptions of health
Authors: Munday Polly , Nornoo Daniel
Published: March 2007

THE mutli-ethnic nature of inner city schools creates special problems for dental health educators. For young people to accept responsibility for their oral health there is a need for self-identification of what is healthy and a basic acceptance of self-image. This small study attempts to explore these points by rec ording the decisions children make about ethnically appropriate material. It highlights the hidden mess ages being given by current material on gum health and disease, and suggests the need for more research in this area in order to sponsor more appropriate visual aids for a multi-ethnic community.
Measurement and evaluation of community physical fitness — concept and controversy
Authors: Sykes Kevin
Published: March 2007

EXERCISE participation is a powerful motivator towards achieving generally healthier life-styles among the general public. Fitness-testing, together with appropriate advice to individuals on how to take safe levels of exercise, can act as the trigger for positive personal action. This paper reviews the de velopment of criteria and techniques for measuring fitness and argues that, if it is correctly applied, fit ness-testing has an invaluable and integral part to play in public health and fitness promotion.
Immunisation in Fife Part II — Failure to immunise against whooping cough — reasons given by parents
Authors: Barlow Helen , Walker Drew
Published: March 2007

IN this study in part of Fife, parents of children under 5 were interviewed about pertussis immunisation. Fifteen per cent of the children had not been immu nised. Parental decision was responsible for 31 per cent of unimmunised children and medical advice for the other 69 per cent, of whom 65 per cent had no valid contraindications. The results suggest that immunisation rates will not be significantly increased until health professionals give consistent and appropriate advice to parents about pertussis immunisation.
Health education and the national curriculum
Authors: Donoghue Janet
Published: March 2007

Last year (1990) saw the publication of Curriculum Guidance No 5. Health Education, from the National Curriculum Council. This followed growing concern about the possible fate of health education in schools once the provisions of the Education Reform Act came into being. In these two articles, Janet Donoghue and John Lloyd, both involved in the development of Curriculum Guidance No 5, give their separate views on the process of health education in the light of recent developments in schools.
Health visitors as dental health educators: their knowledge, attitudes and behaviours
Authors: Quinn Grainne , Freeman Ruth
Published: March 2007

THIS study examines health visitors' dental health knowledge, their attitudes and their personal dental health and working behaviours. Eighty-four per cent of health visitors employed in 1991 by the Western Health and Social Services Board in Northern Ireland participated in this study. The results suggested that their knowledge of dental health was high but there was confusion over some topics. Similarly, their atti tudes appeared positive, but many of them admitted only to giving dental health education if they felt the mother would be receptive. Personal health be haviours were not closely associated with working behaviour. The study demonstrates that while health visitors have the necessary qualities to act as dental health educators there is still a need to facili tate and improve their knowledge and attitudes to enable them to be effective dental health educators.
Healthy Sheffield: the consultation experiment
Authors: Halliday Maddy , Adams Lee
Published: March 2007

This paper is the first in a series about the Healthy Sheffield initiative. It describes Healthy Sheffield's philosophy and aims, and focuses upon the development of a draft public health strategy which is currently undergoing extensive facilitated consultation within the city. Future articles will describe the outcome of the consultation and the lessons to be learnt from the many activities associated with the initiative.
A study of the advisory and health promotion activity of community pharmacists
Authors: Smith Felicity J.
Published: March 2007

MUCH attention is currently being paid to the role of the community pharmacist in dealing with minor complaints. The most commonly presented symp toms are those concerning upper respiratory disease, and in particular, coughs. In these cases opportun ities for health promotion may be expected to arise. The quality of advice given to clients presenting with a cough was investigated using tape-record ings of consultations between pharmacists and cli ents. Many cases are associated with short-term self-limiting minor illness. However, there are a min ority of cases in which more serious underlying prob lems may be present. To ensure appropriate care, more systematic and comprehensive questioning is required. Despite the encouragement of and focus on the potential health promotion role of community pharmacists, opportunities for this were not often pursued.
Middle-class health behaviour: motivations and constraints in a sample of private patients
Authors: Wiles Rose
Published: March 2007

A SAMPLE of 60 middle-class private patients was asked about the actions they took to protect their health. The primary type of health-enhancing behav iour identified involved diet and exercise. The sam ple was divided into two age groups: 20-50 and 51-79. Within each of the age groups particular motivations and constraints concerning health-enhancing be haviour were reported. It is argued that while the people in this sample may have been orientated towards adopting health-enhancing behaviour, they faced specific constraints or motivations which influ enced their intentions. The implications for health educators are discussed.
Health education in schools: a survey of policy and implementation
Authors: Jamison Jim
Published: March 2007

THE National Foundation for Educational Research was commissioned by the Health Education Authority to carry out a survey of health education policies in English schools. Questionnaires were sent to a sample of over 800 schools and interviews were carried out in 110. Between one half and two thirds of the surveyed schools had written health education policies, while others were developing or updating them. Two thirds of the schools had identified a teacher responsible for coordinating health education. Many schools had broadened their health education provision beyond the curriculum, recognising the value of a whole school policy. Major areas of concern were the lack of resources for in-service training and the risk that health education may be increasingly marginalised, mainly because of the demands associated with the implementation of the National Curriculum.
A survey of consumer awareness of salt in food and reported purchasing activity towards low salt foods
Authors: Neale R.J. , Tilston C.H. , Gregson K. , Bourne S.
Published: March 2007

A MARKET research study of 160 adult respondents of both sexes subdivided into under-25 and over-25- year-old age groups was undertaken in Nottingham between January and April 1992. The aims of the study were to determine whether consumers per ceived salt in food as a health problem, their knowl edge of the salt content of selected foods, and whether they reported changes in purchasing ac tivity towards low salt food products. A high pro portion of respondents in this survey (83.8 per cent) believed salt to be detrimental to health but overall there was a poor level of knowledge of the salt con tent of a range of foods. Eighty-five per cent of re spondents had purchased reduced salt food products and 64.6 per cent of these had become regular users. Product development of actively promoted reduced salt foods offers potential, provided palatability and food safety problems are overcome.
Health and lifestyles of homeless people: an analysis of the North West Thames Regional Health Authority survey of the "temporary" homeless population
Authors: Victor Christina R.
Published: March 2007

EVIDENCE of the extensive interest now exhibited in the lifestyle of different populations is provided by the growth of district and regionally based health and lifestyle surveys. Typically, such studies under-represent the less privileged members of society such as homeless people. In North West Thames RHA such a survey was undertaken in spring 1991 amongst the 'temporary' homeless population living in bed and breakfast hotels, as well as regional residents. Overall, 319 homeless people and 8,251 regional residents were interviewed. A high prevalence of smoking, low rates of exercise and poor diet were observed amongst the homeless sample as compared to the resident population. Rates of completed childhood immunisation compared favourably with that observed for the regional resident population. Implications for policy-making are discussed, including the need to address the root causes of homeless people's disadvantage, linking health promotion and the wider arena of social policy.
A survey of practice nurses' views of health promotion
Authors: Bradford Martin , Winn Sandra
Published: March 2007

THE workload generated by the new contract for GPs is centred on health promoting activities, many of which may be delegated to the practice nurse. This paper examines the views of practice nurses in the Brighton district on health promotion and suggests that health promotion may be an appropriate focus for developing of the role of the practice nurse.
Attitudes to mammography among women in ethnic minority groups in three areas of England
Authors: McAllister Gillian , Bowling Ann
Published: March 2007

THIS paper reports the findings of a Department of Health funded study to assess the attitudes to, and uptake of, breast-screening among Chinese women in Liverpool, Afro-Caribbean women in Camberwell, and Asian women in Huddersfield in 1991/92. Face- to-face interviews with 50 women in each of the three localities were carried out. A key finding was that most women had received their invitations for breast screening and over three-quarters of the women in each ethnic group who had received invi tations had taken them up. In general, there were positive attitudes towards both breast and cervical screening programmes, though education was needed to correct some misconceptions. Recommen dations from the study centred on the need to make services more culturally acceptable and accessible.
Drinkwise Wales 1992: an evaluation of the campaign
Authors: Murphy Simon , Smith Christopher
Published: March 2007

THIS paper reports on a study which examined pub lic awareness of the 1992 Drinkwise Wales campaign and its effect on alcohol-related knowledge and be haviour. Face-to-face interviews using a structured questionnaire were conducted with a representative sample of just over 1000 adults resident in Wales. The data showed that fewer respondents (23 per cent) had heard of Drinkwise Wales than of other health projects such as No Smoking Day and Heartbeat Wales. The most frequently cited source of infor mation about Drinkwise Wales was television. Those who had heard of Drinkwise Wales were more likely to be weekly drinkers and the majority had picked up the 'right' messages from the campaign, although women and older adults were more likely to attri bute erroneous messages to it. Self-reported knowl edge increase as a result of Drinkwise Wales was high, while a significant percentage claimed it had made them discuss their own or others' drinking and change their drinking habits.
Smoking prevalence among 16-19-year-olds related to staff and student smoking policies in sixth forms and further education
Authors: Charlton Anne , While David
Published: March 2007

The purpose of this study was to identify the policies, if any, regulating where and when smoking was allowed in educational establishments for students aged 16 and over, and to relate them to smoking prevalence. The methods used were postal questionnaires to all directors of local education authorities in England and Wales and to a sample of school and college principals in 1990. Self-administered questionnaires were used for the sample of students, supervised by staff. The results showed that 37 per cent of the responding local directors of education had a written policy on smoking for the schools and colleges in their area. Responses from principals showed that 83 per cent of colleges and 14 per cent of schools officially allowed students aged 16 and over to smoke. Eighty-three per cent of colleges and 97 per cent of schools allowed staff to smoke, but not usually in front of students. Policy and prevalence were strongly related in colleges, but not in the schools. The possible reasons for and implications of these findings are discussed. Overall, smoking students smoked fewer cigarettes (7 per week during attendance hours and 18 outside) in establishments where they were not allowed to smoke, as against 17 during attendance hours and 28 outside when the policy allowed smoking. The policy was still significantly related to lower smoking prevalence in colleges when other factors were taken into account. The response rates were low and the risk of bias is high, however; the findings suggest the need to investigate the topic further.
One big rush: dinner-time at school
Authors: Turner Sheila , Mayall Berry , Mauthner Melanie
Published: March 2007

The qualitatiye study described in this paper considers the social context of school meals in an urban primary school in southern England. The study was designed to provide information about the factors affecting children's food consumption, the contexts in which food is eaten in school and rushed and stressful occasion rather than a pleasant social experience. rerely related to teaching and learning about food in the classroom.

Lunch break is too long ... You have twenty minutes in the canteen for your lunch and it's a scramble and you have an hour outside and they lock the classrooms so you have to stay outside1 .
Women's preferences for cervical screening: who, where and when
Authors: Johnston Gail , Orbell Sheina , Crombie Iain , Robertson Alistair , Kenicer Margaret
Published: March 2007

Three hundred and seven valid non-users and 307 matched users of cervical screening were interviewed about who they would prefer to take the smear test, where it was carried out and at what time. Fifty-five per cent of non-users and 48 per cent of users had no preference as to whether the smear taker was a doctor or nurse but these previously unscreened women who did state a preference preferred a nurse. A female smear- taker was preferred by most non-users (77 per cent) and most users (60 per cent), the stronger preferences among non-users being statistically sig nificant (χ2 = 20.9, p < 0.0001). Only 2 per cent of non-users and 7 per cent of users specifically wanted a male to do the test while the remainder had no preference. Familiarity with the smear-taker was a more divided issue with 40 per cent of non-users and 42 per cent of users having no preference as to whether they knew the tester or not. The most popular place to have the test carried out was the GP surgery or health centre for all women. However, a minority of both groups requested a hospital well-woman or domiciliary service. There was little demand for a workplace service or weekend clinics from either group but 15 per cent of all women who wanted to attend on a weekday wanted an evening service. Preferences for smear-taker and location were not associated with age, social class or marital status. Service providers must take into account the needs of all women if they are to provide a service which will be suited to those women they want to use it. Above all, women need to know that there is a choice available if voluntary participation in the screening programme is to be encouraged.
HIV theatre in health education: an evaluation of Someone Like You
Authors: Denman Susan , Davis Pauline , Pearson James , Madeley Richard
Published: March 2007

This paper presents part of the findings of an evaluation study which measured the impact of Someone Like You, a theatre in HIV and AIDS education programme, devised for schoolchildren. The programme toured 16 schools in Nottinghamshire in 1994. A survey by self-completed questionnaire was used to gain insight into the teachers' perceptions of the educational value of the programme and to assess the effectiveness of its implementation. The principal findings indicate that the programme was highly acceptable to teachers in terms of content and process. However, an examination of the effectiveness of the implementation of the project suggests that there was some scope for improvement. Recommendations are made for health authority purchasers and providers to maximise the potential of theatre in education on HIV and AIDS to influence both the development of school policies and the quality and quantity of teaching about HIV and AIDS in the classroom.
Preventing skin cancer through mass media: process evaluation of a collaboration of health promotion agencies
Authors: Delaney Faith , Adams Lee
Published: March 2007

Nine health authorities and one Trust across two health regions in Northern England formed a consortium to develop a mass media campaign to reduce incidence of skin cancer. Children and their carers were the main target of the campaign, which featured the development of a local television advertisement. This paper is devoted to the process evaluation of the development of the consortium and the campaign, that is the degree to which the working methods were successful, as judged by all of the professionals involved, and by an external evaluation team. Overall success was the majority verdict, with many participants reporting great satisfac tion with the collaborative working process. Some problems of com munication and decision-making are noted, and recommendations are offered for future collaborative ventures.
Journey to work: the potential for modal shift?
Authors: Joshi Mary Sissons , Senior Victoria
Published: March 2007

A questionnaire about mode of transport to work was posted to the entire workforce of Oxford Brookes University. Replies were received from 926 people which constituted a 62 per cent return rate: 87 per cent of the sample owned or had access to a car, and 67 per cent owned or had access to a bicycle; 16 per cent usually walked to work, 17 per cent cycled, 2 per cent rode a moped or a motorbike, 8 per cent used public transport, and 57 per cent travelled to work by car (5 per cent as a passenger and 52 per cent as a driver). When those who lived within two miles were asked what would persuade them to walk to work, approximately 60 per cent saw time or distance as the greatest barrier. A change in their personal circumstances such as their childcare responsibilities was nominated by 11 per cent as their most important requirement. Sixteen per cent stated that nothing would persuade them to walk to work. When those who lived within five miles were asked what would persuade them to cycle to work, approximately one third saw distance as the greatest barrier. Only 6 per cent gave less risk of an accident as their main reason, and 25 per cent stated that nothing would persuade them to cycle to work. The implications of the results of the survey for employers and others interested in health pro motion and environmental awareness are discussed.
Dance drug education in clubs: evaluation of the London Dance Safety Campaign
Authors: Branigan Patrick , Wellings Kaye
Published: March 2007

Drugs have long been associated with music and youth culture. This paper reports on the evaluation of the London Dance Safety Campaign 1997, an intervention designed to reduce the harmful effects of drug use in dance venues. Surveys of London clubbers were carried out prior to the campaign, and following its inception. Posters on London Underground were shown to be .a successful medium for raising awareness of the campaign in this target audi ence. The campaign was positively perceived as realistic, non-moralistic and factual. The take-home message was a little unclear, possibly a result of the contradictory and confusing drugs information received from other sources. Evidence of high recreational drug usage among London dance-club attenders justifies targeting this subgroup of the population in future similar drug cam paigns.
Meeting at the threshold, at the edge of the carpet or somewhere in between? Questions of ceremonial in princely India
Authors: Kooiman Dick
Published: March 2007

In the interaction between Indian princes and British political officers, ceremonial played a prominent part, especially in forms of salutation and seating arrangements. Hence, the question of a British Resident, quoted in the title of this article, on the proper ceremonial at a Maharaja's visit. The Political Departmentfelt convinced that ceremonial, 'a bit of bunting' in Lord Lytton's patronising words, met a deeply felt oriental need for pomp and circumstance. Some officers, however, acknowledged that in princely states, the maintenance of regal splendour could be more important than sound administration. Similar shades of opinion can be found among social scientists studying court ceremonial. Is ceremonial the hand- maiden of political power or is it rather the other way round?
Is there overestimation of 'British capital' outflow? Keynes' Indo-British trade and transfer accounts re-examined with alternative evidence
Authors: Banerjee Debdas
Published: March 2007

An excessive export of capitalfrom Britain during 1870-1914 allegedly reduced the domestic rate of investment. Few studies have really tried to find out how much of the nominal sum in each case was taken up by British investors, and how much of that, in turn, actually found its way abroad. The profits that accrued from trade in colonial products are either ignored altogether or grossly underestimated in the usual accounts of 'benefits of imperialism'. Drawing on Indo-British official trade statistics as well as on private papers, this article re- examines Keynes'estimate of 'drain' from England into India based on the sales of Council Bills. The conclusions of this study are: (a) the profits on Indo-British commodity value chains were much higher than they were assumed to be; and (b) a very large part of the 'British'capital outflom to colonies was in fact recycled profits made on colonial trade.
'Regularly brought up medical men': Nineteenth-century Grant Medical College graduates, medical rationalism and leprosy
Authors: Pandya Shubhada
Published: March 2007

This article deals with a hitherto overlooked aspect of Western medical education in nineteenth-century colonial India, namely the initiation of the early generations of Indian medical students into the principles and practice of 'rational' enquiry. The manner in which recipients of the instruction subsequently demonstrated their entry into the 'rational' world in the field of therapeutics and their responses to the germ theory of disease is explored with respect to four graduates of the Grant Medical College, Bombay. The approach they adopted when confronted with two major issues—treatment and causation-thrown up by leprosy provides the vehicle for the study. It is concluded that Western medicine-trained Indian physicians were not passive receptacles of the received 'rational' wisdom. They interpreted, utilised and exploited it in highly individualistic and revealing ways.
The Ethnic Density Effect: Results From a National Community Survey of England and Wales
Authors: Halpern David , Nazroo James
Published: March 2007

Using data from a community survey of 5196 ethnic minority and 2867 white respondents, together with data on local group concentration from the 1991 Census, the hypothesis was tested that ethnic group concentration is associated with lower levels of reported psychiatric symptoms. The hypothesis was broadly confirmed, both for within- and between-group differences. However, the effect was found to be modest in size and in one group, the Pakistani sample, was reversed. The findings are inconsistent with an explanation based on selection or drift. Linguistic factors contributed to, but did not explain the effects. Evidence on victimisation and mutual support suggests that social causation, in the form of reduced exposure to direct prejudice and increased social support, is a likely cause of the effect.
The Burden of Personality Disorder: a District-Based Survey
Authors: Montgomery Charles , Lloyd Keith , Holmes Jeremy
Published: March 2007

Patients with a clinical diagnosis of personality disorder (PD) often suffer prolonged distress. They are a considerable burden on psychiatric services and they are experienced as difficult to manage by their keyworkers. This paper describes the creation of a community-based case register of patients suffering from PD. It explores the relationship between psychological distress, personality dysfunction, service utilisation and keyworker stress.

Mental Health workers were asked to identify those patients on their caseload whose primary problem was PD. This list provided the basis for the case register. Patients completed the revised Personality Diagnostic Questionnaire IV (PDQ 4); the General Health Questionnaire (GHQ); and the Beck Depression Inventory - 21 item (BDI). A brief, semi-structured interview was conducted by Community Psychiatric Nurses to estimate service utilisation and keyworker stress.

The mean GHQ was 14.58; the mean BDI score was 28.22. The mean number of PDs per patient was 4.5. One quarter of patients (21/80) had been admitted at least once to a psychiatric ward in the previous year and 17% (13/80) had presented to casualty at least once in the previous two months. 57% of the patients had weekly or more contacts with a helping agency. The number of PD diagnoses per patient as measured by the PDQ 4 was not found to be predictive of stress experienced by CPNs, whereas high BDI and GHQ scores were strongly correlated. Similarly, the number of admissions to a psychiatric ward was associated with high BDI and GHQ scores but not with number of PDs per patient.

It is feasible to establish a case register of all patients in the district with PD. There are high levels of depression and distress amorsgst patients with PD being treated as outpatients. Service utilisation and keyworker stress are not predicted by number of PDs per patient but are strongly associated with distress as measured by the GHQ and BDI, The implications of these findings are discussed.
Attitudes Towards Mental Health in an Urban Pakistani Community in the United Kingdom
Authors: Tabassum Rashda , Macaskill Ann , Ahmad Iftikhar
Published: March 2007

The aim of this study was to investigate the attitudes of Pakistani families living in an urban area of the United Kingdom, towards mental health issues, to identify the emic models used and compare them with the etic model, predominant in Western medicine. This would allow the exploration of some of the inconsistencies in the research literature relating to the incidence of mental illness in this cultural group. The second aim was to explore the needs of this community, particularly women, in relation to mental health services. Due to problems gaining access to females on their own, interviews were held with family groups. Findings suggested that there were differences in the models of mental illness being employed with greater somatisation of symptoms in the Pakistani group and an emphasis on aggressive behaviour as a significant symptom. Treatment expectations also varied with some emphasis on traditional Pakistani treatments such as Faith healers and Hakims as well as General Practitioners and hospital treatments. Language difficulties, religious and cultural practices were also identified as barriers to female treatment in particular. Recommendations were made for improved training for interpreters and more emphasis on cultural factors and emic models of mental illness as part of medical training.
A Delphi Approach To Characterising 'Relapse' as Used in Uk Clinical Practice
Authors: Burns Tom , Fiander Matthew , Audini Bernard
Published: March 2007

Background: 'Relapse' is a common outcome indicator in intervention studies in schizophrenia. In community studies it is froqucntly equated with hospitalisation and in psychopharmacological studies with predetermined symptom scores. Its clinical meaning, however, remains undefined.

Method: Consensus on the defining features of 'relapse' in schizophrenia used by academic and clinical schizophrenia experts in the UK, was investigated using a four stage Delphi process. A two panel, four stage, Delphi based methodology was used to investigate the implicit meanings of 'relapse' in clinical practice. A multi disciplinary panel of twelve members each listed anonymously ten indicators of relapse. A second panel, of ten experienced psychiatrists, rated the 188 submitted indicators from essential-unimportant (1-5). This panel completed a one day workshop during the remaining Delphi rounds ending with a structured discussion of the results.

Results: Very strong consensus was achieved on the relative importance of potential relapse indicators. There was complete agreement about some aspects of a definition of relapse (such as recurrence of positive symptoms) and a number of the complex issues underlying the concept were clearly articulated. Conclusions: This four stage Delphi process achieved consensus on core features of relapse. The elucidation of the "softer" features at the threshold between normal fluctuations in functioning and the start of relapse require continuing investigations.
Against Over-Interpretation: the Understanding of Pain Amongst Turkish and Kurdish Speakers in London
Authors: Yazar Jale , Littlewood Roland
Published: March 2007

The understanding of experienced pain has recently moved from the biological to the metaphorical. Detailed interviews with twelve Turkish and Kurdish patients in London who had been unsuccessfully investigated medically for chronic pain showed that their understanding reflected local, typically humoural, conceptions of self and body. However there was little to suggest interpretation of the illness as a more specific and grounded idiom for social or political experience. It is suggested that the current vogue for 'interpretation' in medical anthropology and social psychiatry may occasionally be, as Umberto Eco puts it, 'over-interpretation'.
Buffers for the Bereaved: the Impact of Social Factors On the Emotional Health of Bereaving Parents
Authors: Roskin Michael
Published: March 2007

Emotional health of bereaving parents (N = 62; control N = 56) were explored 5 years after the death of a child (age 0-12) in Israel. The Symptom Check List-90 was utilized as the primary measurement instrument. Comparisons to controls according to geographic area of birth indicated more interpersonal (over)sensitivity, obsessive-compulsiveness and anxiety among Asia/African born parents as compared to either European/American or Israeli-born. All geographical groupings of bereaving parents indicated significantly greater somatic concerns than their respective controls. The college-educated Israeli-born bereaving parents indicated significantly healthier SCL-90 scores than similarly educated European/American-born bereaving parents. This was in contrast to the trend in which European-American-born parents (regardless of educational level) exhibited scores indicating the least symptomatology.

Bereaving parents are a uniquely problematic population at risk. Deaths of infants and children produce isolation and diffusion among family members. 8,18 Furthermore, the scant literature indicates that the death of a child produces higher intensities of bereavement, as well as the widest range of reactions among parents as compared to those who experience the death of either a spouse or parent. 17 Family stability and equilibrium is disturbed. Indeed, higher than average rates of marital discord occur between parents after the loss of a child. 7,3

Bereavement itself carries a considerable increased risk of morbidity and mortality.11, 12 Levav indicates that the increased risk of mortality for parents is quite high within a 5-year period after the death of their child.9 Parkes and Brown report that the bereaved differ significantly from the non-bereaved in being sicker and being admitted to the hospital more in the year following loss. They also noted increased consumption of alcohol, tobacco and tranquilizers and more disturbances of appetite, weight and sleep.11 In addition; more evidence of strain and depression was indicated among the bereaved than among the non-bereaved.11

Bereaving parents react to their loss through grief. This often manifests itself through resistance to change — a reluctance to give up possessions, relationship, status and expect ations. One approach to measuring this resistance to change is vis-a-vis levels of emotional symptomatology, e.g. depression, anxiety, obsessive-compulsiveness. In a wider sense, emotional health parameters may be utilized as a means of calibrating resistance to change and response to loss.

Roskin15 in his work with bereaving parents in Israel reported that even 5 years after their child died, bereaving parents indicated less emotional health than comparable controls. Bereaving mothers were more somatic and interpersonally (over)sensitive than control mothers. Bereaving fathers indicated only more somatic complaints than control fathers.
Comparison of Depressive Symptomatology Between Saudi and American Pysychiatric Outpatients in an Eastern Province Medical Center, Saudi Arabia
Authors: West Julia
Published: March 2007

This study compares the responses to a self-report depression inventory administered to a sample of 243 Saudi and American expatriate psychiatric outpatients of a large Eastern Pro vince medical centre in Saudi Arabia. The inventory was developed by Beck et al. (1961), and the Arabic language form was validated by West and Al-Kaisi (1982).

A Kruskal-Wallis statistical analysis revealed that American male patients tended to be more depressed than American female patients, Saudi female patients reported "depression scores" higher than those of Saudi male patients, and Saudi patients overall reported higher "depres sion scores" than American patients participating in the same study. The highest and lowest significant response frequencies for Saudis were: Pessimism (H=74.26) and Hypochondria (H=17.13); for Americans: Indecisiveness (H=25.57) and Self-Image (H=7.85). (Statistical significance when H=7.82, p<.05; H=16.27, p<.001; df=3). Although explanations are offered, the appearance of psychopathology as designated by this cross-cultural scale requires further cultural examination.
Prevalence of Depressive Symptoms and Depression in Elderly Finnish Home Nursing Patients and Home Help Clients
Authors: Kivelä Sirkka-Lsa , Lehtomäki Erkki , Kivekäs Jorma
Published: March 2007

Depressive symptoms in a population (N=419) aged 65 years or over and receiving home nursing, home help or both were assessed by postal questionnaires including the Zung self- rating depression scale (SDS). Eighty-six percent participated, and 38 percent of both men and women scored 45 raw sumpoints or more in the SDS. The mean of the raw sumpoints was 42.1 (± 9.6) for men (N = 100) and 41.4 (± 9.0) for women (N = 238, the difference being nonsignificant. Home help clients scored less than home nursing patients or patients receiving both home nursing and home help.

The population scoring 45 raw SDS sumpoints or more was investigated by a general prac titioner, and the diagnosis of depression was made according to DSM III-criteria. The clinical investigations showed 26 percent of both men and women who participated to be depressive. Chronic depression was the most common class, folowed by atypical depression. About two thirds of the depressive men and half of the depressive women were 'new' cases in that it had not been realized earlier that they suffer from depression. Atypical depression was the class where underdiagnozing was most evident.

Among elderly men psychomotor retardation, libido loss, anorexia and indecisiveness and among elderly women psychomotor retardation, indecisiveness, emptiness and diurnal varia tion were common symptoms of depression.
The Psychological Effects of Apartheid Psychoanalysis
Authors: Dommisse John
Published: March 2007

The notorious governmental policy of Apartheid affects the people of that country psycho logically, as well as politically, socially, economically and medically. It does so in a variety of ways, including: the humiliating effects on blacks and arrogance inducing effects on whites; the disruption of family-life by the enforced migrant labor system; the stunted brain-development and behavioral effects that result from the inexcusably widespread childhood malnutrition in that wealthy country, (the world's 6th-largest food-exporter); the distortions and alienations in personality development, on racial lines; the mental breakdowns and suicides that result from the physical and mental torture that uncharged security-police detainees are subjected to while under interrogation. In addition, when mental health services are required they are grossly inferior for blacks, especially in the rural areas and particularly in out-patient care. The white-doctor: black-patient relationship, perforce the rule, is distinctly problematic in this socio-political climate.

The World Medical Association and the World Psychiatric Association have been supportive to the South African government and silent, respectively, in the face of all the documented information on this hazardous public health situation. The United Naitons and its agencies, the World Health Organization and the Centre Against Apartheid, should be commended for their work and unequivocal stands on this issue and should be heeded in their calls for a principled response by more of the world's psychiatric, psychological and medical communities.
Admission To General Hospital Psychiatric Wards in Italy
Authors: De Girolamo Giovanni , Mors Ole , Rossi Giovanni , Grandi Lucia , Ardigo Walter , Munk-Jørgensen Povl
Published: March 2007

Epidemiological comparisons carried out in Italian settings regarded very different areas. In this paper, we investigate the effects on the hospital activity of two different organizational models of care in two neighbouring areas in Northern Italy, Cremona and Mantua, very similar in sociodemographic features. Cremona is hospital oriented, while Mantua has well developed community services.

All the patients of the catchment areas admitted during 1986 were studied. Age distribution for males, marital status, education and percentage of employed were very similar in the two samples. However, age distribution and mean age at the time of the first ever psychiatric admission for females were different, as well as the percen tage of patients living alone and the percentage of patients discharged home. But the cogent finding was the number of admissions, much higher in Cremona than in Mantua, especially for some age groups. Some explanations of this strong difference, regarding two neighbouring and similar areas, are discussed.
Biomedical Potential for Symptom Choice in Koro
Authors: Chowdhury Arabinda N.
Published: March 2007

The distribution of different biomedical sexual factors in relation to Koro in 162 cases in a North Bengal Koro epidemic, has been analysed. Anatomo-sexual factors such as venereal disease and scrotal filaria were found to be significantly commoner in Koro patients. The commonest cited precipitating factor was extramarital intercourse (23.5%).
Somatic Symptoms Among Older Soviet Immigrants: an Exploratory Study
Authors: Kohn Robert , Flaherty Joseph A. , Levav Itzhak
Published: March 2007

This exploratory study investigates the overlap of somatization and depressive symp toms among older Jewish-Soviet immigrants to the United States. It has been sug gested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatiza tion subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Com pared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.