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Terms modified by Low-income Selected AbstractsRelational Factors and Family Treatment Engagement among Low-Income, HIV-Positive African American MothersFAMILY PROCESS, Issue 1 2003Victoria B. Mitrani Ph.D. Clinically derived hypotheses regarding treatment engagement of families of low-income, HIV-positive, African American mothers are tested using univariate and multivariate logistic regression models. Predictors are baseline family relational factors (family support, mother's desire for involvement with family, and family hassles) and mother's history of substance dependence. The study examines a subsample of 49 mothers enrolled in a clinical trial testing the efficacy of Structural Ecosystems Therapy (SET). SET is a family-based intervention intended to relieve and prevent psychosocial distress associated with HIV/AIDS. Participants in the subsample were randomly assigned to SET and attended at least two therapy sessions. Findings reveal that family relational factors predicted family treatment engagement (family support, p < 004; mother's desire for involvement with family, p < 008; family hassles, p < 027). Family support predicted family treatment engagement beyond the prediction provided by the other relational factors and the mother's own treatment engagement (p < 016). History of substance dependence was neither associated with family treatment engagement nor family support. Post hoc analyses revealed that family hassles (p < 003) and mother's desire for involvement with family (p < 018) were differentially related to family treatment engagement in low-versus high-support families. Implications for clinical practice and future research are discussed. [source] Civic Engagement Among Low-Income and Low-Wealth Families: In Their WordsFAMILY RELATIONS, Issue 2 2006Amanda Moore McBride Abstract: Using in-depth interviews, we explored civic engagement that included volunteering through religious organizations, neighboring, involvement in children's activities, and contributing. The sample consisted of 84 low-income, low-wealth families. Findings indicate that although people of limited resources may be engaged, they face substantial challenges to active engagement. Data are suggestive of a modified life cycle theory, a resource or "stakeholding" theory, and institutional theories regarding challenges to engagement. In the context of the study's limitations, implications are discussed for measurement, research, and interventions. [source] Complexity of Family Life Among the Low-Income and Working Poor: Introduction to the Special IssueFAMILY RELATIONS, Issue 2 2004Patricia Hyjer Dyk Like all families, low-income and working-poor families need economic stability, safety, good health, and engagement in the larger community. However, the complexity of their lives is greatly impacted by limited economic resources. Three primary themes are explored by the 12 articles in this special issue: competing stressors and tensions, effective parenting, and economic stability and financial decision making. Key findings and program and policy implications identified by each set of authors are discussed. This body of work provides research-based practice and policy suggestions to guide future efforts in partnering with families to strengthen their families and communities for successful enhancement of child well-being. [source] School Violence, Adjustment, and the Influence of Hope on Low-Income, African American YouthAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010Linda A. Cedeno The current study investigated the prevalence and impact of exposure to school violence using a cross-sectional design with a sample of 132 low-income, African American fifth graders (mean age = 10.20). Additionally, hope was examined in relation to adjustment and as a potential resilience factor in the context of school violence. Students completed self-report measures for exposure to school violence frequencies, self-concept, and hope. Teachers completed a teacher-rated survey assessing levels of problem behaviors, social skills, and academic competence. Results indicated that the majority of youth had been personally victimized or witnessed violence during a 3-month period. Exposure to school violence was positively associated with problem behaviors, and negatively associated with social skills, self-concept, and academic competence; hope was inversely related to externalizing behaviors and positively related to self-concept. Hope buffered the effects of personal victimization and witnessing violence on self-concept. Gender differences were observed for a number of the analyses. The implications of both the prevalence and impact of exposure to school violence, as well as the moderating effects of hope, are discussed. [source] The Unintended Impact of Welfare Reform on the Medicaid Enrollment of Eligible ImmigrantsHEALTH SERVICES RESEARCH, Issue 5 2004Namratha R. Kandula Background. During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollment of legal immigrants who immigrated before 1996 (pre-1996 immigrants) and who should have remained Medicaid eligible. Objectives. To compare the Medicaid enrollment of U.S.-born citizens to pre-1996 immigrants, before and after welfare reform, and to determine if variation in state Medicaid policies toward post-1996 immigrants modified the effects of welfare reform on pre-1996 immigrants. Data Source/Study Design. Secondary database analysis of cross-sectional data from 1994,2001 of the U.S. Census Bureau, Annual Demographic Survey of March Supplement of the Current Population Survey. Subjects. Low-income, U.S.-born adults (N=116,307) and low-income pre-1996 immigrants (N=24,367) before and after welfare reform. Measures. Self-reported Medicaid enrollment. Results. Before welfare reform, pre-1996 immigrants were less likely to enroll in Medicaid than the U.S.-born (OR=0.55; 95 percent CI, 0.51,0.59). After welfare reform, pre-1996 immigrants were even less likely to enroll in Medicaid. The proportion of immigrants in Medicaid dropped 3 percentage points after 1996; for the U.S.-born it dropped 1.6 percentage points (p=0.012). Except for California, state variation in Medicaid policy toward post-1996 immigrants did modify the effect of welfare reform on pre-1996 immigrants. Conclusions. Federal laws limiting the Medicaid eligibility of specific subgroups of immigrants appear to have had unintended consequences on Medicaid enrollment in the larger, still eligible immigrant community. Inclusive state policies may overcome this effect. [source] Nursing shortages and international nurse migrationINTERNATIONAL NURSING REVIEW, Issue 4 2005S. J. Ross mpa/id Background:, The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. Aim:, To predict the international migration of nurses to the UK using widely available data on country characteristics. Method:, The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. Results:, The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Conclusion:, Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery. [source] Morning cortisol Levels in preschool-aged foster children: Differential effects of maltreatment type,DEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2009Jacqueline Bruce Abstract Maltreated foster children are subjected to a range of early adverse experiences, including neglect, abuse, and multiple caregiver disruptions. Research suggests that such disturbances alter the development and subsequent functioning of the hypothalamic-pituitary-adrenocortical system. The current study was designed to investigate morning cortisol levels in 117 foster children and 60 low-income, nonmaltreated children. Maltreatment and foster care placement experiences were coded from official records. Analyses revealed that the foster children were significantly more likely than the nonmaltreated children to have low morning cortisol levels. Additionally, specific maltreatment experiences were significantly associated with the foster children's morning cortisol levels. Foster children with low morning cortisol levels experienced more severe physical neglect than the other foster children. In contrast, foster children with high morning cortisol levels experienced more severe emotional maltreatment. These results suggest that specific early adverse experiences have differential effects on the functioning of the hypothalamic-pituitary-adrenocortical system. © 2008 Wiley Periodicals, Inc. Dev Psychobiol 51: 14,23, 2009 [source] Injury and alcohol: a hospital emergency department studyDRUG AND ALCOHOL REVIEW, Issue 2 2001ANN M. ROCHE Abstract A pilot survey was undertaken of injury presentations to a public hospital emergency department to determine patterns of alcohol use in this population. Of the 402 injury presentations in the study period, a total of 236 injury cases were interviewed, of whom 45% (n = 107) and 29% (n = 69) had consumed alcohol 24 and 6 hours prior to injury. Mean age for all injury presentations was 35.1 years, and 32.6 years for alcohol injury cases. For both injury groups, males were significantly younger than females. Recent alcohol ingestion was three times more common among male than female injury presentations, but with females drinking at significantly lower levels. Of males who had consumed alcohol 6 hours prior to injury, nearly 70% were drinking at NHMRC harmful levels and 61% had drunk more than eight standard drinks. Overall, alcohol-involved injury cases commonly occurred among low-income, single males around 30 years of age who were regular heavy drinkers who were drinking heavily in licensed premises prior to their injury, and who sustained injury through intentional harm. In addition, one in five of the alcohol-involved injury cases were aged 15,18 years, i.e. below the legal age of purchase. The high proportion of hazardous and harmful drinkers among those who had consumed alcohol within the last 6 hours, and the injury sample overall, highlights the need for further research to explore the relationship between the occurrence of injury and the drinking patterns and environments associated with injury. Further research is also required to assess the efficacy of early and brief interventions for alcohol and drug use within the emergency ward setting. This information would enable appropriate public health interventions to be initiated. [source] The impact of eliminating the global illicit cigarette trade on health and revenueADDICTION, Issue 9 2010Luk Joossens ABSTRACT Aims The purpose of this study was to update global estimates of the illicit cigarette trade, based on recent data, and estimate how many lives could be saved by eliminating it and how much revenue governments would gain. Data sources and methods Our estimates of illicit market share are based on formal and informal sources. Our method for estimating the effect of eliminating the illicit trade on tobacco related deaths is based on West et al. with some minor modifications, and involves calculating the size of the illicit cigarette trade; the effect of eliminating it on the price of cigarettes and thus on consumption; the revenue governments are losing because of it; and the number of tobacco-related premature deaths that would be avoided if this illicit trade were eliminated. Results According to available estimates, the size of the illicit trade varies between countries from 1% to about 40,50% of the market, 11.6% globally, 16.8% in low-income and 9.8% in high-income countries. The total lost revenue is about $40.5 billion a year. If this illicit trade were eliminated governments would gain at least $31.3 billion a year, and from 2030 onwards more than 164 000 premature deaths a year would be avoided, the vast majority in middle- and low-income countries. Conclusions The burden of deaths and lost revenue caused by the illicit cigarette trade falls disproportionately on low- and middle-income countries. Eliminating this trade would avoid millions of premature deaths, and recover billions of dollars for governments. [source] THE OPTIMAL PUBLIC EXPENDITURE FINANCING POLICY: DOES THE LEVEL OF ECONOMIC DEVELOPMENT MATTER?ECONOMIC INQUIRY, Issue 3 2007NILOY BOSE This paper explores how the optimal mode of public finance depends on the level of economic development. The theoretical analysis suggests that in the presence of capital market imperfection and liquidity shocks, the detrimental effect of inflation on growth is stronger (weaker) at lower (higher) levels of economic development. Consequently, income taxation (seigniorage) is a relatively less distortionary way of financing public expenditure for low-income (high-income) countries. We provide empirical support for our model's predictions using a panel of 21 Organization for Economic Cooperation and Development countries and 40 developing countries observed over the period 1972,1999. (JEL E44, E6, H6, O42) [source] THE SCHOOL AS AN EXCEPTIONAL SPACE: RETHINKING EDUCATION FROM THE PERSPECTIVE OF THE BIOPEDAGOGICALEDUCATIONAL THEORY, Issue 2 2006Tyson E. LewisArticle first published online: 3 MAY 200 Agamben's theory of the camp provides a challenging, critical vantage point for looking at the ambiguities that emerge from the complex field of disciplinary procedures now prevalent in inner-city, low-income, minority schools, and helps to clarify what exactly is at stake in the symbolic and sometimes physical violence of schooling. Key to understanding the primary relation between camp and classroom is Agamben's framework of the biopolitical, which paradoxically includes life as a political concern through its exclusion from the political sphere. Here Lewis appropriates Agamben's terminology in order to theorize the biopedagogical, wherein educational life is included in schooling through its abandonment. For Lewis, the theory of the camp is necessary to recognizing how schools function and, in turn, how they could function differently. [source] Effects of home access and availability of alcohol on young adolescents' alcohol useADDICTION, Issue 10 2007Kelli A. Komro ABSTRACT Aims The purpose of the present study was to examine the effects of parental provision of alcohol and home alcohol accessibility on the trajectories of young adolescent alcohol use and intentions. Design Data were part of a longitudinal study of alcohol use among multi-ethnic urban young adolescents who were assigned randomly to the control group of a prevention trial. Setting Data were collected from a cohort of youth, and their parents, who attended public schools in Chicago, Illinois (2002,2005). Participants The sample comprised the 1388 students, and their parents, who had been assigned randomly to the control group and were present and completed surveys at baseline, in the beginning of 6th grade (age 12). The sample was primarily low-income, and African American and Hispanic. Measurements Students completed self-report questionnaires when in the 6th, 7th and 8th grades (age 12,14 years; response rates 91,96%). Parents of the 6th grade students also completed questionnaires (70% response rate). Findings Student report, at age 12, of parental provision of alcohol and home alcohol availability, and parental report of providing alcohol to their child and the accessibility of alcohol in the home, were associated with significant increases in the trajectories of young adolescent alcohol use and intentions from ages 12,14 years. Student report of receiving alcohol from their parent or taking it from home during their last drinking occasion were the most robust predictors of increases in alcohol use and intentions over time. Conclusions Results indicate that it is risky for parents to allow children to drink during early adolescence. When these findings are considered together with the risks associated with early onset of alcohol use, it is clear that parents can play an important role in prevention. [source] Sociodemographic disparities in epilepsy care: Results from the Houston/New York City health care use and outcomes studyEPILEPSIA, Issue 5 2009Charles E. Begley Summary Purpose:, The purpose of this study was to identify sociodemographic disparities in health care use among epilepsy patients receiving care at different sites and the extent to which the disparities persisted after adjusting for patient characteristics and site of care. Methods:, Three months of health care use data were obtained from baseline interviews of approximately 560 patients at four sites. One-half of the patients were from a Houston site and two NYC sites that serve predominantly low-income, minority, publicly insured, or uninsured patients. The other half were at the remaining site in Houston that serves a more balanced racial/ethnic and higher sociodemographic population. Differences in general and specialist visits, hospital emergency room (ER) care, and hospitalizations were associated with race/ethnicity, income, and coverage. Logistic regression was used to assess the extent to which the differences persisted when adjusting for individual patient characteristics and site of care. Results:, Compared to whites, blacks and Hispanics had higher rates of generalist visits [odds ratio (OR) = 5.3 and 4.9, p < 0.05), ER care (OR = 3.1 and 2.9, p < 0.05) and hospitalizations (OR = 5.4 and 6.2, p < 0.05), and lower rates of specialist visits (OR = 0.3 and 0.4, p < 0.05). A similar pattern was found related to patient income and coverage. The magnitude and significance of the disparities persisted when adjusting for individual characteristics but decreased substantially or were eliminated when site of care was added to the model. Discussion:, There are sociodemographic disparities in health care for people with epilepsy that are largely explained by differences in where patients receive care. [source] One-year changes in glucose and heart disease risk factors among participants in the WISEWOMAN programmeEUROPEAN DIABETES NURSING, Issue 2 2007JC Will PhD Abstract Background: WISEWOMAN provides chronic disease risk factor screening, referrals and lifestyle interventions to low-income, uninsured women, to reduce their heart disease and stroke risk. Participants learn behaviour-changing skills tailored to low-income populations, such as collaborative goal setting, the need to take small steps and other empowerment techniques. Aim: To quantify the baseline prevalence of pre-diabetes (fasting blood glucose 5.5,6.9 mmol/l) and diabetes among WISEWOMAN participants and assess one-year changes in glucose levels and other diabetes risk factors. Methods: We used 1998,2005 baseline and one-year follow-up data from WISEWOMAN participants. Using a multilevel regression model, we assessed one-year changes in glucose, blood pressure (BP), total cholesterol and 10-year risk of coronary heart disease (CHD) among participants with baseline pre-diabetes (n=688) or diabetes (n=338). Results: At baseline, 15% of participants had pre-diabetes and 10% had diabetes. Of those with diabetes, 26% were unaware of their condition before baseline screening. During the one-year follow-up period, participants with pre-diabetes experienced statistically significant improvements in glucose (2.9%) and cholesterol (2.1%) levels and 10-year CHD risk (4.3%). Participants with newly diagnosed diabetes experienced statistically significant improvements in glucose (11.5%), BP (3.1%,3.5%) and cholesterol (6.4%) levels. Participants with previously diagnosed diabetes experienced significant improvements in BP (1.9%,3.4%), cholesterol level (3.8%), and 10-year CHD risk (8.5%). Conclusions: Implementing patient-centered, comprehensive and multilevel interventions and demonstrating their effectiveness will likely lead to the adoption of this approach on a much broader scale. [source] Relational Factors and Family Treatment Engagement among Low-Income, HIV-Positive African American MothersFAMILY PROCESS, Issue 1 2003Victoria B. Mitrani Ph.D. Clinically derived hypotheses regarding treatment engagement of families of low-income, HIV-positive, African American mothers are tested using univariate and multivariate logistic regression models. Predictors are baseline family relational factors (family support, mother's desire for involvement with family, and family hassles) and mother's history of substance dependence. The study examines a subsample of 49 mothers enrolled in a clinical trial testing the efficacy of Structural Ecosystems Therapy (SET). SET is a family-based intervention intended to relieve and prevent psychosocial distress associated with HIV/AIDS. Participants in the subsample were randomly assigned to SET and attended at least two therapy sessions. Findings reveal that family relational factors predicted family treatment engagement (family support, p < 004; mother's desire for involvement with family, p < 008; family hassles, p < 027). Family support predicted family treatment engagement beyond the prediction provided by the other relational factors and the mother's own treatment engagement (p < 016). History of substance dependence was neither associated with family treatment engagement nor family support. Post hoc analyses revealed that family hassles (p < 003) and mother's desire for involvement with family (p < 018) were differentially related to family treatment engagement in low-versus high-support families. Implications for clinical practice and future research are discussed. [source] Civic Engagement Among Low-Income and Low-Wealth Families: In Their WordsFAMILY RELATIONS, Issue 2 2006Amanda Moore McBride Abstract: Using in-depth interviews, we explored civic engagement that included volunteering through religious organizations, neighboring, involvement in children's activities, and contributing. The sample consisted of 84 low-income, low-wealth families. Findings indicate that although people of limited resources may be engaged, they face substantial challenges to active engagement. Data are suggestive of a modified life cycle theory, a resource or "stakeholding" theory, and institutional theories regarding challenges to engagement. In the context of the study's limitations, implications are discussed for measurement, research, and interventions. [source] Complexity of Family Life Among the Low-Income and Working Poor: Introduction to the Special IssueFAMILY RELATIONS, Issue 2 2004Patricia Hyjer Dyk Like all families, low-income and working-poor families need economic stability, safety, good health, and engagement in the larger community. However, the complexity of their lives is greatly impacted by limited economic resources. Three primary themes are explored by the 12 articles in this special issue: competing stressors and tensions, effective parenting, and economic stability and financial decision making. Key findings and program and policy implications identified by each set of authors are discussed. This body of work provides research-based practice and policy suggestions to guide future efforts in partnering with families to strengthen their families and communities for successful enhancement of child well-being. [source] The role of permanent income and family structure in the determination of child health in CanadaHEALTH ECONOMICS, Issue 4 2001Lori J. Curtis Abstract We use data from the Ontario Child Health Study (OCHS) to provide the first Canadian estimates of how the empirical association between child health and both low-income and family status (lone-mother versus two-parent) changes when we re-estimate the model with pooled data. Two waves of data provide a better indication of the family's long-run level of economic resources than does one wave. Our measures of health status include categorical indicators and the health utility score derived from the Health Utilities Index Mark 2 (HUI2) system. Consistent with findings from other countries, we find that most outcomes are more strongly related to low-average income (in 1982 and 1986) than to low-current income in either year. Unlike some previous research, we find the quantitative impact of low-income on child health to be modest to large. Lone-mother status is negatively associated with most outcomes, but the lone-mother coefficients did not change significantly when we switched from low-current income to low-average income. This implies that the lone-mother coefficient in single cross-sections is not just a proxy for low-permanent income. Copyright © 2001 John Wiley & Sons, Ltd. [source] The Unintended Impact of Welfare Reform on the Medicaid Enrollment of Eligible ImmigrantsHEALTH SERVICES RESEARCH, Issue 5 2004Namratha R. Kandula Background. During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollment of legal immigrants who immigrated before 1996 (pre-1996 immigrants) and who should have remained Medicaid eligible. Objectives. To compare the Medicaid enrollment of U.S.-born citizens to pre-1996 immigrants, before and after welfare reform, and to determine if variation in state Medicaid policies toward post-1996 immigrants modified the effects of welfare reform on pre-1996 immigrants. Data Source/Study Design. Secondary database analysis of cross-sectional data from 1994,2001 of the U.S. Census Bureau, Annual Demographic Survey of March Supplement of the Current Population Survey. Subjects. Low-income, U.S.-born adults (N=116,307) and low-income pre-1996 immigrants (N=24,367) before and after welfare reform. Measures. Self-reported Medicaid enrollment. Results. Before welfare reform, pre-1996 immigrants were less likely to enroll in Medicaid than the U.S.-born (OR=0.55; 95 percent CI, 0.51,0.59). After welfare reform, pre-1996 immigrants were even less likely to enroll in Medicaid. The proportion of immigrants in Medicaid dropped 3 percentage points after 1996; for the U.S.-born it dropped 1.6 percentage points (p=0.012). Except for California, state variation in Medicaid policy toward post-1996 immigrants did modify the effect of welfare reform on pre-1996 immigrants. Conclusions. Federal laws limiting the Medicaid eligibility of specific subgroups of immigrants appear to have had unintended consequences on Medicaid enrollment in the larger, still eligible immigrant community. Inclusive state policies may overcome this effect. [source] Emotional vitality in infancy as a predictor of cognitive and language abilities in toddlerhoodINFANT AND CHILD DEVELOPMENT, Issue 4 2005Amanda J. Moreno Abstract Previous work by our group has shown that infant emotional vitality (EV), the lively expression of shared emotion both positive and negative, predicts cognitive and language abilities in toddlerhood. Specifically, infants who demonstrated a pattern of high emotional expression combined with high bids to their caregivers, fared significantly better on the Bayley II and Preschool Language Scales (PLS-3) at 2 years of age than infants who showed both low expression and low bids to mother. That study was conducted on a large, low-income, ethnically diverse sample. The current study was undertaken with a smaller but demographically similar sample as an effort to demonstrate the value of EV as a construct and to provide additional information about its links with later developmental outcomes. Replication that included a variation in the age at which EV was assessed provides support for the generalizability of the construct. In addition, this study examined EV's effects further into childhood than did the original study in order to insure they are not limited to a brief window in toddlerhood. The results indicate that over and above maternal psychological resources, EV expressed during positive/joyful and frustrating circumstances in 8-month-olds accounted for significant portions of variance in expressive language at 30 months and cognitive-developmental assessments at 24 and 36 months. This study supports EV as an important relational-emotional behaviour that increases experiences that optimize developmental outcomes. Successful replication suggests that EV holds promise as a construct with clinical utility for early interventions attempting to improve developmental outcomes in children from poor families. Copyright © 2005 John Wiley & Sons, Ltd. [source] The Chances for Children Teen Parent,Infant Project: Results of a pilot intervention for teen mothers and their infants in inner city high schools,INFANT MENTAL HEALTH JOURNAL, Issue 4 2008Hillary A. Mayers Adolescent motherhood poses serious challenges to mothers, to infants, and ultimately to society, particularly if the teen mother is part of a minority population living in an urban environment. This study examines the effects of a treatment intervention targeting low-income, high-risk teen mothers and their infants in the context of public high schools where daycare is available onsite. Our findings confirm the initial hypothesis that mothers who received intervention would improve their interactions with their infants in the areas of responsiveness, affective availability, and directiveness. In addition, infants in the treatment group were found to increase their interest in mother, respond more positively to physical contact, and improve their general emotional tone, which the comparison infants did not. Importantly, these findings remain even within the subset of mothers who scored above the clinical cutoff for depression on the Center for Epidemiological Studies-Depression Scale (CES-D; L. Radloff, 1977), confirming that it is possible to improve mother,infant interaction without altering the mother's underlying depression. The implications of these findings are significant both because it is more difficult and requires more time to alter maternal depression than maternal behavior and because maternal depression has been found to have such devastating effects on infants. [source] The nurse,family partnership: An evidence-based preventive interventionINFANT MENTAL HEALTH JOURNAL, Issue 1 2006David L. Olds Pregnancy and the early years of the child's life offer an opportune time to prevent a host of adverse maternal, child, and family outcomes that are important in their own right, but that also reflect biological, behavioral, and social substrates in the child and family that affect family formation and future life trajectories. This article summarizes a 27-year program of research that has attempted to improve early maternal and child health and future life options with prenatal and infancy home visiting by nurses. The program is designed for low-income mothers who have had no previous live births. The home-visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health, to improve the child's health and development by helping parents provide more sensitive and competent care of the child, and to improve parental life course by helping parents plan future pregnancies, complete their education, and find work. The program has been tested in three separate large-scale, randomized controlled trials with different populations living in different contexts. Results from these trials indicate that the program has been successful in achieving two of its most important goals: (a) the improvement of parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect and better infant emotional and language development; and (b) the improvement of maternal life course, reflected in fewer subsequent pregnancies, greater work-force participation, and reduced dependence on public assistance and food stamps. The impact on pregnancy outcomes is equivocal. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. In general, the impact of the program was greater on those segments of the population at greater risk for the particular outcome domain under examination. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that organizational and community contexts are favorable for development of the program, to providing excellent training and guidance to the nurses in their use of the program's visit-by-visit guidelines, to monitoring the functioning of the program with a comprehensive clinical information system, and to improving the performance of the programs over time with continuous improvement strategies. [source] The New Mega-Projects: Genesis and ImpactsINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 4 2008FERNANDO DIAZ ORUETA Abstract Critiques of urban renewal and large-scale developments were prominent in the period 1960,80. In particular, they emphasized the negative environmental and social consequences of these schemes and especially attacked them for displacing low-income and ethnically different populations. In the 1980s and 1990s, we saw a decline in such projects in many places, responding to popular protest and intellectual dissent, along with a new emphasis on preservation. More recently, however, we see the revival of mega-projects, often connected with tourism and sports development and incorporating the designs of world-famous architects. Frequently these are on landfill or abandoned industrial sites. The symposium for which this is an introduction shows the growing convergence of North American and European projects. This convergence is visible in their physical form, their financing, and in the role played by the state in a world marked by neoliberalism. At the same time, the new projects do display a greater environmental sensitivity and commitment to urbanity than the modernist schemes of an earlier epoch. Résumé Dans la période 1960,1980, les critiques sur les aménagements à grande échelle et les grandes rénovations urbaines étaient fréquentes. Elles soulignaient notamment les conséquences environnementales et sociales néfastes de ces programmes, en leur reprochant en particulier de déplacer les populations à faible revenu ou d'appartenance ethnique différente. Dans les années 1980 et 1990, ces projets se sont faits plus rares dans bien des endroits, répondant à la contestation populaire et au désaccord des intellectuels, parallèlement à une préoccupation nouvelle pour la préservation. Dernièrement, pourtant, les mégaprojets ont réapparu, souvent associés à un aménagement touristique ou sportif et intégrant des créations d'architectes de renommée mondiale. Ils se situent fréquemment sur le site d'anciennes décharges ou usines abandonnées. Le symposium dont ce texte sert d'introduction montre la convergence croissante des projets nord-américains et européens, convergence que l'on constate dans leur forme physique, leur financement et dans le rôle que joue l'État dans un monde empreint de néolibéralisme. En même temps, les nouveaux projets affichent une sensibilitéà l'environnement et un engagement vis-à-vis de l'urbanité plus marqués que les programmes modernistes antérieurs. [source] The Dynamics of Farm Incomes: Panel data analysis using the Farm Accounts SurveyJOURNAL OF AGRICULTURAL ECONOMICS, Issue 2 2004Euan Phimister This paper uses longitudinal information from the Scottish Farm Accounts Survey to explore the dynamics of Scottish farm incomes between 1988/89 and 1999/2000. Both the Net Farm Income and Cash Income of farms are considered. The results show high levels of income variability and income mobility within Scottish agriculture. Although exit rates from the lowest income groups remain relatively high even when spells of low income have lasted a number of years, there is evidence of farms with persistent low farm income and farms experiencing repeated spells of low-income. Smaller farm size and having a farmer aged over 65 increase both the probability that a farm will fall into the lowest income group and the length of time spent in that income group. Further the results suggest that the impact of the post-1997 agricultural recession on income mobility depended on the income status of the farm when the recession began. [source] Health and Psychiatric Disparities in Children with Cognitive and Developmental Delays: Implications for Health Policy in QuebecJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2009Jennifer S. Nachshen Background, Previous research on psychiatric and health disparities according to level of cognitive functioning has focused on adults within an American healthcare context. The current study compares children with and without cognitive and developmental delays in Quebec, Canada, using physician billing data from a longitudinal study of low-income, francophone families. Canada is an ideal context for studying medical billing data as its equal access healthcare system removes many socioeconomic biases. Methods, A large sample (n = 1050) of children is used to describe psychiatric and health disparities, as well as differences in Ambulatory Care Sensitive (ACS) conditions and primary healthcare, between children with (n = 107) and without (n = 943) diagnoses in their billing history indicative of delays. Results, The findings demonstrated a relatively high level of psychiatric diagnoses for children with delays. However, no difference was found between children with and without delays in regard to emergency room visits and hospitalizations for ACS conditions and primary healthcare. Conclusions, The findings suggest that, within a universal healthcare system, disparities in primary healthcare may not emerge until adulthood in individuals with delay status. [source] Longitudinal relations between employment and depressive symptoms in low-income, suicidal African American womenJOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2007Nathan Mascaro Unemployment and depression are problematic at both individual and societal levels, and research suggests that the two phenomena are related. More thorough and longitudinal analyses, particularly ones within low-income minority populations, are needed to guide the development of programs to increase employment in persons with mental health problems. The current study aimed to specify the relations over time between depressive symptoms and employment status within a sample of 46 low-income African American women participating in an intervention study for intimate partner violence and suicidal behavior. Hierarchical logistic regression analysis indicated that baseline levels of depressive symptoms predicted employment status at the end of a 10-week intervention period, controlling for baseline employment status. Chi-square analysis and qualitative analyses of trends in depression scores showed that changes in employment status during the 10-week intervention period predicted 6-month and one-year follow-up levels of depressive symptoms. Results imply that, for women in the currently sampled population, depressive symptoms create vulnerability for job loss, but the ability to gain employment despite high levels of depressive symptoms is linked to lowered depression levels over the long term. Community programs assisting such women could therefore not just lower the vulnerability to job loss by treating depressive symptoms, but they could potentially lower long-term depression levels through interventions that enhance employability and motivation to pursue work. © 2007 Wiley Periodicals, Inc. J Clin Psychol. [source] Coping variables that mediate the relation between intimate partner violence and mental health outcomes among low-income, African American womenJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2006Michelle D. Mitchell Coping variables that mediate the relation between intimate partner violence (IPV) and mental health outcomes among African American women were investigated. The study sample included 143 economically disadvantaged African American women ranging in age from 21 to 64 years old who were receiving services at an urban public health system. Sixty-five had experienced IPV within the past year and 78 had never experienced IPV. Results indicated that (a) the IPV status,depressive symptoms link was mediated by multiple ways of coping, spiritual well-being, and social support; (b) the IPV status,anxiety symptoms link was mediated by multiple ways of coping, social support, and ability to access resources; and (c) the IPV status,parenting stress link was mediated by multiple ways of coping, spiritual well-being, and social support. Implications of these findings for clinical practice with abused women are discussed. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 1503,1520, 2006. [source] From parent education to collective action: ,Childrearing with love' in post-war GuatemalaJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 3 2009Anita Schrader McMillan Abstract The paper discusses the implementation and effect of group-based parenting workshops oriented by the principles of liberation psychology in a low-income, hispanicized community in Guatemala City. The objective of this initiative was not only to improve outcomes in the parent,child relationship, but to galvanize the formation of community-based support groups that could have multiple ends. The theoretical foundations of the project are introduced, before illustrating their practical application. Sixteen months post-intervention, largely positive effects were being sustained in parent child relations. The project was also successful in generating social action through the formation of grass-roots women's organizations. Copyright © 2008 John Wiley & Sons, Ltd. [source] Impact of neighborhood disadvantage on overt behavior problems during early childhoodAGGRESSIVE BEHAVIOR, Issue 3 2007Emily B. Winslow Abstract Researchers have yet to examine the impact of neighborhood disadvantage on early child behavior problems (BPs) longitudinally. We examined the impact of neighborhood disadvantage on overt BPs in a low-income, urban sample of 281 African American and European American boys followed longitudinally from toddlerhood to school entry. Measures included census data and maternal report of BPs, sociocultural factors, parental criminality, and maternal depressive symptomatology. After controlling for age 2 overt BPs, family selection variables, and residential instability, neighborhood effects on boys' behavior emerged, but only at age 6 and only at the extreme of neighborhood disadvantage (i.e., underclass). Findings suggest boys in underclass neighborhoods are at risk for overt BPs as they make the transition to elementary school. Aggr. Behav. 33:1,13, 2007.© 2007 Wiley-Liss, Inc. [source] Constraints to expanding access to health interventions: an empirical analysis and country typologyJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 1 2003M. Kent Ranson This paper adopts three approaches to classifying countries by level of constraint, in order to inform the choice of strategies for expanding access to health interventions in different contexts. We find substantial heterogeneity across the 84 low-income and (all) sub-Saharan African countries analysed. Poor sub-Saharan African countries are the most highly constrained; Asian countries, in general, less constrained; and the two Asian giants, China and India, consistently fall above the median. Former Soviet Union countries rank low in terms of governance, but high for health systems variables. Only 10 per cent of the total population of the countries included lives in countries with the greatest constraints. The potential applications of the analysis are discussed, as are the limitations of the cross-sectional, macro level approach. Copyright © 2003 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||