Community Support Networks Research Articles

Negative Economic Shocks and Child Schooling: Evidence from Rural Malawi

This study investigates the impacts of negative economic shocks on child schooling in households of rural Malawi, one of the poorest countries in Sub-Saharan Africa (SSA). Two waves of household panel data for years 2006 and 2008 from the Malawi Longitudinal Study of Families and Health (MLSFH) are used to examine the impact of negative shocks on child schooling. Both individually-reported and community-level shocks are investigated. A priori the impact of negative shocks on schooling may be negative (if income effects dominate) or positive (if price effects dominate). Also the effects may be larger for measures of idiosyncratic shocks (if there is considerable within-community variation in experiencing shocks) or for aggregate shocks (if community support networks buffer better idiosyncratic than aggregate shocks). Finally there may be gender differences in the relevance for child schooling of shocks reported by men versus those reported by women with, for example, the former having larger effects if resource constraints have strong effects on schooling and if because of gender roles men perceive better than women shocks that affect household resources. The study finds that negative economic shocks have significant negative impacts on child school enrollment and grade attainment, with the estimated effects of the community shocks larger and more pervasive than the estimated effects of idiosyncratic shocks and with the estimated effects of shocks reported by men as large or larger than the estimated effects of shocks reported by women.

Confronting Sexual Assault: Transformative Justice on the Ground in Philadelphia

Confronting Sexual Assault: Transformative Justice on the Ground in Philadelphia

The psychosocial response to the 2011 Tohoku earthquake

On 11 March 2011, an earthquake with a magnitude of 9.0 on the Richter scale struck off the coast of Japan, triggering destructive tsunami waves of up to 40 metres high that swept over the north-eastern coast of the country. It was the most powerful earthquake known in the country’s history. As of July 2011, 15 585 people were confirmed dead, 5070 missing and 5694 injured.1 Furthermore, the earthquake and tsunami led to explosions and release of radioactive materials at the Fukushima Daiichi nuclear power station. From its experience of massive earthquakes (Kobe in 1995 and Niigata in 2004 and 2007), Japan was prepared to respond quickly.2 The Japanese government set up the emergency disaster response headquarters to initiate disaster relief immediately and, within 24 hours, 178 disaster medical assistance teams were dispatched to the disaster zone. In addition, the Japanese Medical Association sent teams, each comprising one doctor, two nurses and a health staff member, and the Japanese Association of Psychiatric Hospitals dispatched psychiatric staff through these teams. On day two after the disaster struck, the Japanese Society for Psychiatry and Neurology set up a disaster response committee, together with other academic, clinical and medical organizations. On day three, the National Center of Neurology and Psychiatry launched a web site to provide guidelines and manuals for professionals. Within one week, the Ministry of Heath, Labour and Welfare had organized mental care teams, which provided standard care to people who already had mental disorders and to those who needed care as a result of the disaster including health workers. Mental health services were severely disrupted. Even before the disaster, community care in particular was not available to many people in need. Initially the priorities were: (i) to transfer existing psychiatric patients to hospitals outside the affected area, and (ii) to re-establish and strengthen mental health services in the disaster zone. This disaster will likely increase the long-term incidence of mental disorder and distress.3 Many people have lost their families, their work, their property and their entire community. Such life stressors are an established risk factor for depression. Many of the bodies of the deceased have not been found yet so people may have difficulties finishing the mourning process because, culturally, Japanese people have a strong attachment to the remains of their loved ones. An increase in isolated deaths among the elderly is also expected due to the breakdown in community support networks. In addition, the anxiety surrounding the nuclear disaster will further increase the need for psychosocial care, not only in the disaster-affected area but in all of eastern Japan, including Tokyo. The increased demand and interest in mental health by the public, including the media and politicians, provide opportunities for improvements. In recent years, countries including Indonesia and Sri Lanka have established sustainable community mental health systems in disaster areas.4,5 While Japan has an established mental health system, there is great room for improvement in community mental health especially in rural areas. In the existing situation, it would have been impossible for psychiatric clinics and hospitals to provide care to such large numbers of people. So, what is needed to make the mental health system sustainable? First, we need to strengthen the available community mental health services, with the back-up of specialist care (i.e. hospitals and clinics). Psychiatrists, psychiatric nurses, social workers and psychologists in the affected area have been working to their full capacity supported by teams dispatched from other parts of the country, but this is not sustainable. Therefore, it is important to strengthen the capacity of the existing local hospitals and clinics by providing mental health training and supervision to community health workers. Second, assuming that many people will not seek help at mental health facilities, these services should be integrated into general health services with back-up by specialized mental health services. Third, we need to establish a network of self-help groups for survivors of disasters because community and personal support is important for sharing information about self-care and psychological first aid. During this process, it is important to consider local culture and community. The traditional coping mechanism in Japan is not to express grief or anger, but to endure, tolerate and to move on, quietly supporting one another. This could explain why, amid this devastation, these communities have succeeded in maintaining social stability. After each disaster, people put the trauma to the back of their minds and re-establish their communities.

Life on the Outside

With record-high incarceration rates, unprecedented extension of state supervision over individuals leaving prison, and a complex maze of legal barriers to reintegration, more people than ever before are returning home after serving time in prison. These individuals face daunting barriers to successful reintegration. Successful reentry requires strong community support networks and comprehensive services, both of which are lacking in urban areas to which most former prisoners return. Interventions that reflect these principles may hold the greatest promise for success. Yet reentry policies are still quite primitive; researchers are just now beginning to develop an approach to reentry based on evidence of best practices. At this moment, it is critically important that the federal government invest in the development and testing of new ideas and rigorous evaluations to determine which interventions are effective at promoting public safety and prisoner reintegration.

Study on dilemma and strategy of community support network by community organization for prevention of isolated death in an urban area

Study on dilemma and strategy of community support network by community organization for prevention of isolated death in an urban area

Providing universal access to antiretroviral therapy in Thyolo, Malawi through task shifting and decentralization of HIV/AIDS care

To describe how district-wide access to HIV/AIDS care was achieved and maintained in Thyolo District, Malawi. In mid-2003, the Ministry of Health and Médecins Sans Frontières developed a model of care for Thyolo district (population 587, 455) based on decentralization of care to health centres and community sites and task shifting. After delegating HIV testing and counseling to lay counsellors, uptake of testing increased from 1300 tests per month in 2003 to 6500 in 2009. Shifting responsibility for antiretroviral therapy (ART) initiations to non-physician clinicians almost doubled ART enrollment, with a majority of initiations performed in peripheral health centres. By the end 2009, 23, 261 people had initiated ART of whom 11, 042 received ART care at health-centre level. By the end of 2007, the universal access targets were achieved, with nearly 9000 patients alive and on ART. The average annual cost for achieving these targets was € 2.6 per inhabitant/year. The Thyolo programme has demonstrated the feasibility of district-wide access to ART in a setting with limited resources for health. Expansion and decentralization of HIV/AIDS service-capacity to the primary care level, combined with task shifting, resulted in increased access to HIV services with good programme outcomes despite staff shortages.

Family needs in caregivers of individuals with traumatic brain injury from Colombia, South America

Objective: The aim of the present study was to determine the most and least important family needs in a group of family caregivers of individuals with TBI from Cali, Colombia, and to examine which of those needs were more likely to be met and unmet.Design: Cross-sectional descriptive study.Setting: Valle University Hospital in Cali, Colombia.Participants: Twenty-nine family caregivers of individuals with traumatic brain injury.Outcome measure: The Family Needs Questionnaire, a 40-item questionnaire divided into six sub-scales.Results: Health Information, Community Support Network and Professional Support Network sub-scales were the most important needs reported by this group of Colombian TBI family caregivers. The most frequently met needs in the present study fell within Health Information, Involvement with Care and Instrumental Support sub-scales and the most frequently unmet needs fell within the Emotional Support, Instrumental Support and Professional Support sub-scales.Conclusions: Family needs in caregivers of individuals with TBI from Colombia are similar, but more likely to be unmet, than those reported in previous studies. Interventions designed to meet family caregivers’ needs in these areas should be implemented in Colombia.

Evaluating implementation of a voluntary responsible gambling code in Queensland, Australia

This study investigated levels of implementation and perceptions of adequacy of the voluntary Queensland Responsible Gambling Code of Practice with thirty managers and staff in selected casinos, hotels and licensed clubs in three regions in Queensland. This particular paper examines those factors that act as facilitators of, and impediments to, implementation of the Code and reflects on how organization size has influenced implementation of the Code. Using a mix of quantitative and qualitative methods, venues with small gaming installations had a lower implementation rate (56%) of the Code’s practices than venues with large gaming installations (85%). Facilitators included: adequate staff training and education; industry association membership; understanding of the philosophy of the Code; appropriate support materials; legislative overlap; prior experience with responsible gambling; regular audits; and links to community support networks. In contrast, impediments included: high staff turnover; managerial apathy; remote location; and being a busy small business manager.

Longing for Stillness: The Forced Movement of Asylum Seekers

Longing for Stillness: The Forced Movement of Asylum Seekers

Correlates of Violent Response Among Peruvian Women Abused by an Intimate Partner

The authors sought to identify correlates of violent response among women exposed to intimate partner violence (IPV) in Lima, Peru. A structured questionnaire was used to collect information on exposure to IPV and women's physical violent reaction towards their abuser. Women who were sexually abused by their partners, as compared with women who experienced emotional abuse only, were more than twice as likely to respond in a violent manner to the abuse (OR = 2.32, 95% CI = 1.14-4.74). Similarly, women who reported being physically abused, were 4 times as likely than those who experienced emotional abuse only to retaliate in a physically violent manner (OR = 4.04, 95% CI = 2.68-6.11). Women's educational status, history of witnessing parental violence as a child, and type of IPV are significantly associated with women's violent response. Community support networks and culturally appropriate intervention programs designed to prevent and mitigate the impact of IPV are needed.

Regenerating Communities: Women's Experiences of Urban Regeneration

In the UK, New Labour has placed great emphasis on community-based urban regeneration as part of its strategy to combat social exclusion. However, there is little understanding of the ways in which regeneration policies impact on the lives and communities of `socially excluded' women. This paper draws on qualitative research into women's experiences of urban regeneration. It argues that, although local communities continue to play an important role for many of the women in the research, regeneration policies can increase exclusion and lead to the destruction of many of these communities—and in particular that this can have a dramatic impact on women, as they are more likely to rely on local community support networks than men.

A subjective measure of environmental facilitators and barriers to participation for people with mobility limitations

Purpose. The aim of this paper is to describe the development and psychometric properties of a self-report survey of environmental facilitators and barriers to participation by people with mobility impairments.Method. A measure called the Facilitators And Barriers Survey of environmental influences on participation among people with lower limb Mobility impairments and limitations (FABS/M) was developed using items based on focus groups to ensure content validity. Discriminant validity was assessed on 604 individuals who completed the FABS/M once. Internal consistency and test-retest reliabilities were based on 371 individuals who completed two surveys.Results. The FABS/M includes 61 questions, 133 items and six domains including the type of primary mobility device; built features of homes; built and natural features in the community; community destination access; community facilities access; community support network. Environmental items are scored for the frequency of encounter and the magnitude of influence on their participation. The internal consistencies and the test-retest reliabilities of the domains of the FABS/M ranged from low to moderate. The discriminant validity of domains differed for device and diagnostic groups.Conclusion. The FABS/M joins the MQE and the CHIEF as another subjective measure for use in assessing environmental features important for understanding participation. The FABS can be used to assess the influence of environmental interventions at the individual and community levels of analysis. The type of primary mobility device that is used can be related to reported environmental barriers. Community-based improvements in built features, access to destinations, access to facilities and augmented support networks can be tracked through the reports of people with mobility impairments.

While coping with displacement despair: A healthy child/baby, the pregnant woman’s main yearning.

Introduction: Colombia occupies the third place in the world as a country with more displacements approaching two million persons in the last fifteen years and the major percentage corresponds to women. This «feminization» of the displacement, brings with itself the break of couple relations, the loss for the wife of her companion, of the goods and means ofsubsistence turning her into a household keeper. It takes to break the community support networks, the destruction of the social cohesion and of the solidarity altering the collective identity. With relation to health, a high number of displaced pregnant women do not attend pregnancy health controls and their self care during this process is related to the traditions, beliefs and values that they bring with them into the context that the displacement situation awards them. The displacement brings a great cultural heterogeneity related to the previous experiences of these women’s self care and their families’ during pregnancy. Objective: this research is related to the meaning of the pregnant mother’s self care and her child to be born using a group of displaced women living in Pampas del Mirador neighborhood in the city of Cali, and based in their own beliefs. It tries to discover the dynamics and the way they reconstruct the practices of the care related to pregnancy, within their new social tissue. Method: Ethno nursing includes deep interviews. Nine displaced pregnant women participated in the survey besides two general reporters. The size of the survey was taken by applying the criteria of data saturation. Findings: The big concern for women is that the child is born well and this means for them that they will achieve this provided they develop the same care they saw their mothers to practice, their aunts and the great majority of women of their land. They are convinced that in the city everything will be like when they were in the field and that the customs during the period of pregnancy can be similar to those that they know. During pregnancy they realize actions mainly oriented to – «try that the child is well placed» «this means with the little head down placed», «avoid to do a bad force», «maintain the balance of the body between cold and heat», «eat well», «transmit safety and wellbeing to the son» and finally «cultivate the family collaboration and support». The indicated patterns are linked to produce a synergy aimed to achieve that the son is born well. These beliefs, practices and customs related to the maternity, are sometimes considered irrelevant in the care that is provided in the health centers thus generating distrust feelings in the use of these services. To get to know the self care practices of displaced pregnant women forces to an exchange of knowledge that allows to determine which of those practices are important to keep, which to adjust or to negotiate and which to be restructured so that the health and well being of the mother and her son will be the best possible.

Liberalism and Married Women’s Property Rights in Nineteenth-Century Latin America

Liberalism and Married Women’s Property Rights in Nineteenth-Century Latin America

A Case Against Physician-Assisted Suicide

To discuss the issues surrounding physician-assisted suicide, I use myself as a case study to address the arguments surrounding dignity, unbearable pain, autonomy, length of life, quality of life, and duress as they apply to one's life. Problems are identified along with possible solutions. The lack of encouragement by society leads to an unsupportive environment, which causes us to underestimate any potential for a quality life we might obtain. A remedy to this problem would be the establishment of a community support network in which people could develop socially as well as mentally. Such a network would allow people with painful and life-threatening conditions to have access to information regarding both the technology that would enable them to explore life and the basic knowledge to enjoy life.

BREAKING THROUGH BARRIERS: THE POLITICAL ACTIONS OF HONG KONG OUTREACH YOUTH WORKERS

Based on the narratives generated from in-depth interviews with 18 outreach youth workers in Hong Kong, this paper investigates the political actions of these youth workers and shows how they have invented strategies to construct their own style of emancipatory practice. Such strategies include (1) seeking new allies for development of community support networks; (2) establishing a research center for policy advocacy; and (3) organizing with youth for social change. The implications of the findings for realizing the liberating potential of youth work are discussed. 根據深入訪問18位外展青年工作者所得的敘述，本文探究這些青年工作者的政治行動，並展示他們如何創造出一些策略，以建構具備他們自己獨特風格的解放式青年工作。這些策略包括：(1)尋找新盟友以發展社區支援網絡；(2)成立一研究中心作政策倡議；及(3)組織青年人以推動社會變革。本文並討論上述發現對實現青年工作之解放潛力的含義。.

Correctional Mental Health Services in New York: Then and Now

This article chronicles the legislation, litigation, and the agency initiatives which have shaped the New York State correctional mental health system into what it is today. An historical perspective provides a context and framework for the examination of the current and future salient issues and challenges in providing a comprehensive range of mental health services in a correctional setting. The Central New York Psychiatric Center organization, which is comprised of a 206 bed maximum-security forensic hospital and a community support network of 23 prison-based mental health units was established in 1977. This article takes an in-depth look at the organization's 25-year growth and development, the implementation and outcome of some innovative treatment programs, and the unique partnership between the New York State Office of Mental Health (OMH) and the New York State Department of Correctional Services (DOCS).

Research for High-Quality Urban Teaching

Policy makers and school district administrators have responded to the current teacher shortage with a characteristic focus on the short run. Popular responses include Peace Corps-like recruitment strategies to persuade college graduates to teach for a year or two on alternative or emergency certification. To compensate for the shortcomings of an underprepared teaching staff, policy makers have adopted highly prescriptive, teacherproof curricula. These accomplish little in the short run and will diminish the capacity of the teaching force for decades to come. Nowhere has the rush to boost supply and de-skill teaching been more acutely felt than in urban schools. The tight labor market for teachers places low-resourced, urban districts at a competitive disadvantage relative to better resourced suburban districts. Although periodic economic downturns may temporarily heighten interest in teaching jobs, historically, this easing of pressure has not had a lasting impact on the supply of qualified teachers in urban schools. Hence, urban students who face the challenges of poverty, immigration, limited facility with English, and/or racial discrimination have the least access to a qualified teaching force. Often overlooked by short-term policy initiatives is that the shortage of qualified urban teachers is fueled at least as much by high rates of teacher turnover and attrition as it is by insufficient numbers of qualified people being attracted to teaching. Therefore, in addition to increasing the supply of new teachers, we must learn what makes teaching in urban schools a fulfilling career and offer policy solutions to enact that knowledge. We have early indications that a key to such career satisfaction and longevity lies in creating cadres of urban teachers who have the technical, collegial, and political support required to have an impact on the quality of students' lives in classrooms and communities. Data about our University of California, Los Angeles, graduates, for example, suggest that they are remaining in classrooms longer than most new teachers precisely because of such support (Quartz & TEP Research Group, under review). Longer term solutions to the crisis in teaching require addressing a more broadly defined and intertwined program of research on urban teacher competency, teacher recruitment, and career longevity. AN EXPANDED DEFINITION OF URBAN TEACHER QUALITY Through our experience crafting a program of teacher education that promotes social justice for urban schools, we have learned that urban teachers need more than the generic teaching competencies articulated by the National Board for Professional Teaching Standards (NBPTS). They need to understand local urban cultures, the urban political economy, the bureaucratic structure of urban schools, and the community and social service support networks serving urban centers. They need skills to draw on and develop urban youth literacies across the academic content areas, promote college access for first-generation college goers, build social capital across schools and community organizations, and create alliances and engage in joint work with other reform-minded teachers. We have come to see competent urban teachers simultaneously as skilled classroom practitioners and as public intellectuals who work for educational equity and access through multiple forms of democratic participation. In urban schools, competence cannot be parsed into teacher skills and social action. An effective urban teacher cannot be skilled in the classroom but lack skills and commitment to equity, access, and democratic participation. Likewise, if one is to be a teacher, a deep caring and democratic commitment must be accompanied by highly developed subject matter and pedagogical skills. Such teachers are agents of fundamental change, helping to shape urban educational contexts--in and out of school--where being a good teacher means that people are accountable to each other, express themselves authentically, and negotiate common understandings that support collective action. …

The assessment of parent needs following paediatric traumatic brain injury.

The paediatric version of the Family Needs Questionnaire was administered to parents of children with traumatic brain injuries (TBI) a year or more post-injury. Parents of diabetic children (DIAB) and parents of orthopaedically (ORTHO) injured children were included as control groups. Parents rated items on their importance and how well these needs have been met. The ORTHO group rated significantly fewer items as important relative to the TBI and DIAB groups (who endorsed a similar number of items). Of those items rated as important, TBI parents' needs were more likely to remain unmet relative to both the DIAB and the ORTHO groups: out of 28 items rated as important, TBI parents report that 19 needs are still unmet. DIAB and ORTHO parents more consistently reported their needs as met. Needs most often rated as unmet for TBI parents include the needs for health/medical information, professional support, community support networks, and the need to be involved in their child's care. These results present important findings for TBI rehabilitation professionals. Future studies need to investigate whether TBI parents' needs are unmet because of the lack of community resources, or if available resources do not adequately target the needs of the TBI parents.

Women's strategic responses to violence in Nicaragua

STUDY OBJECTIVETo describe the responses of women in León, Nicaragua to partner abuse and identify contextual factors associated with the use of certain coping mechanisms and the likelihood of permanent...