No uniform definition of homelessness. There is no uniform definition of homelessness. Scott  detailed several concepts and classifications of homelessness. ‘Homelessness’ can be conceptualised as ‘disaffiliation and detachment from society’, ‘any single person with no home of his own’ and ‘anyone who lacks adequate shelter, resources and community ties’. Homelessness can also be classified according to temporal, geographical and topographical fea- tures. Fischer and Breakey  proposed that the line between the truly homeless and sporadi- cally or marginally housed people is blurred. The conventional definition, based on the lack of a permanent place to live, has led investigators to sample from streets and from various facili- ties that serve the needs ofpeople without shelter. A broader definition, which encompasses marginally housed people and people at risk of homelessness, can include single room occu- pancy hostels, doubled-up accommodation and institutions such as jails, residential substance abuse programmes and hospitals as sampling sites. However, studies that adopted an opera- tional definition of homelessness based on target facilities have often been criticised for repre- senting only the higher functioning group of the diverse population ofhomeless individuals. In a systemic review by Fazel et al. , most of the reviewed articles sampled subjects from shel- ters or hostels. Of the 31 articles reviewed, only 5 featured subjects from the streets. Gill, Melt- zer and Hinds  demonstrated that the prevalenceofmentalillness differed between samples from hostels, private-sector leased accommodation, night shelters and streets.
From comparisons between the WAIS-III and JART, 64 participants showed decrements that were larger than a normal range of dissociation (11 points). Since the JART cannot mea- sure IQ scores lower than 69, participants with low IQ values due to developmental issues likely would show a greater dissociation between IQ scores and the JART. Thus, we excluded partici- pants with a JART-estimated IQ score that was within the spectrum of cognitive disability or borderline (IQ < 80). Forty-eight participants met this criterion; 24 that had a diagnosed men- tal illness (Fig 1), 14 with no cognitive disability, 6 with mild cognitive disability, 4 with moder- ate-severe cognitive disability. Among those diagnosed with mentalillness, 2 were diagnosed with schizophrenia or other psychotic disorder, 10 with a mood disorder, 2 with an anxiety dis- order, 9 with a substance-related disorder, and 1 with a personality disorder. It was suggested that participants’ mentalillness might have impaired cognitive ability in some cases. Twenty participants were estimated to have acquired their cognitive disability because ofmentalillness or other reasons, even though they likely had normal intellectual functioning at previous ages. Consequently, the estimated number of individuals with an intellectual disability, excluding those with intellectual decline due to aging or mentalillness, was 19 (16.7%). Approximately half of the participants who had a cognitive disability developed their dysfunction over time.
ABSTRACT. Objective: Population aging is a global phenomenon associated with a rising prevalenceof chronic degenerative diseases such as dementia. Dementia poses a challenge not only for patients but also their family caregivers who, in exercising this role, are at higher risk ofmentalillness. The present study investigated the prevalenceof common mental disorders (CMD) in family caregivers of demented elderly seen at a geriatric outpatient clinic of a Brazilian teaching hospital. Methods: A cross-sectional study was conducted in which the following assessment instruments were applied: the Self Reporting Questionnaire, Zarit Burden Interview, Hospital Anxiety and Depression Scale and Mini- Mental State Examination (caregivers aged ≥65 years) plus a sociodemographic questionnaire. Results: The sample comprised 90 caregivers; 83 (92.2%) women, 51 (56.7%) married, 60 (66.7%) son/daughter of elder and 62 (68.6%) holding another job besides caring for the demented elder. Caregivers had a mean age of 57.3 (±11.7) years and mean education of 9.5 (±4.9) years; 62.2% of caregivers were diagnosed with common mental disorder, 50% exhibited anxiety symptoms, 52.2% depression symptoms and 66.7% reported burden. Caregivers with common mental disorder had higher scores on the anxiety, depression and burden scales (p<0.01). Logistic regression showed that caregivers with anxiety symptoms were 15 times more likely to present common mental disorder (OR: 15.0; 95% CI: 3.5-71.2) and caregivers with symptoms of depression were 8 times more likely to have CMD (OR: 8.0; 95% CI: 2.1-31.1). Conclusion: Results revealed a high prevalenceof common mental disorder in the population studied.
For middle-aged peopleof 50–64 years, vaccination through private healthcare providers is their only option. In order to prepare general practice for pandemic influenza, planned, practised and habitual infection controls such as annual influenza immunisation and pneumococcal immunisation for at-risk people are recommended . Lack of recommendation by their general practitioners (GPs) and holding a belief that vaccine can cause illness or symptoms were main reasons for refusal of pneumococcal vaccine reported in a qualitative study . In addition, knowledge about the availability and purpose of the pneumococcal vaccine was also found to be poor. This suggests that beside appropriate education campaigns, it is important for GPs to develop a trusting and positive relationships with their patients to improve the likelihood of immunisation uptake.
The perceived identity before the development ofmentalillness resulted from life stories marked with suffering, particularly domestic violence, which was strongly evident in the participant’s biographies. Violence alters the construction of identity. Women often remain in abusive relationships due to fear, financial dependence and feelings of insecurity caused by threats made by their partners. This causes the victim to suppress her wants and desires, wounding her identity, violating her way of being and existing 11,12 . In such situations, “the mortification of the self” occurs, similar to the process
The mentally ill are often blamed for bringing on their own illness, whereas others may see mentally ill people as victims of unfortunate fate, religious and moral transgression, or even witchcraft. This may lead to denial by both sufferers and their families, with subsequent delays in seeking professional treatment. The belief that a disturbed mental state is a result of an “evil eye” or black magic leads the majority of patients to seek traditional healers first and only present to a psychiatrist once the disturbance is severe or unmanageable at home, often quite late in the illness. This clearly reflects negatively on the prognosis and response to treatment. The belief that mentalillness is incurable can also be damaging, preventing patients from being referred for appropriate mental health care. These factors highlight the importance of conducting research to assess public knowledge and attitudes toward mentalillness. Only few studies reported regarding knowledge and attitudes of the public toward people with mentalillness from India. Hence, the aim of the present study was to assess the knowledge about mentalillness and attitude of the public toward people with mentalillness. OBJECTIVES OF THE STUDY
Conclusion. “The Housing First approach involves a change in the balance of power between service providers and service users compared with more institutional provision.” . It is the more human oriented way of solving the problem that has demonstrated great success rates all over the world. In times of scarce government budgets the awareness for preventive measures needs to be increased. Especially in the case of homelessness, given the high level of support needs and unstable lifestyles of the target group, the cohort places a significant burden on public sector resources, primarily around high usage of acute health services. Taxpayers’ money is spent for emergency measures that have no long-term impact on the future potential to increase the tax revenues. Furthermore, and especially applicable for Portugal, a more rigorous data collection and evaluation on the number and profile of individuals as well as the costs associated would be fostered, as they present the basic requirement for the SIB structuring  31 .
To illustrate the applicability of the present numerical model (the modified Takahashi model or the MT model), the 1990 Tsing Shan debris flow occurred on the eastern flank of Ts- ing Shan is selected for parameter calibration. This event occurred on 11 September 1990 and is the largest debris flow in the recorded history ofHongKong (see Fig. 2a). It was estimated that a total of 19 000 m 3 of debris were deposited down slope. The total travel distance is about 1 km (King, 1996). Although this event is relatively well-documented, similar to most other debris flows reported elsewhere no dis- charge histrograph was measured. Approximation becomes inevitable in generating the histrographs for numerical sim- ulations. One simple way to establish the discharge histro- graph is to assume that the general characteristics of dis- charge are similar for different events. In particular, a de- tailed literature review shows that most discharge histro- graphs measured in field have an initial sharp increase in dis- charge, followed by an exponential decay of the flow rate. One such example is the debris flow measured after the 1980 eruption of Mount. St. Helens (Pierson, 1995). Therefore, in this study, the discharge histrograph recorded at Mount. St. Helens will be scaled down to match to the total vol- ume of debris reported for the 1990 Tsing Shan debris flow. Regarding the solid (both fine and coarse) concentrations in the discharge, we use the solid concentrations adopted for the Horadani debris flow simulation (private communication, Takahashi and Nakagawa). Most of the other model parame- ters can be estimated from the report of King (1996); if not, they have been adopted from the data set for the Horadani de- bris flow simulation. For example, the coarse and fine solid concentrations were obtained from the laboratory results re- ported by King (1996).
Gambling, ou jogatina, é algo bem marcante na cultura chinesa. Apesar de o jogo ser ilegal na China, nas duas regiões administrativas – HongKong, previamente uma colônia inglesa; e Macau, colônia portuguesa – a atividade é liberada, o que atrai muito chineses de todos os lugares. Essa metáfora aparece também em outros domínios conceituais. Su (2002), por exemplo, analisou metáforas em chinês sobre casamento no corpus do Chinese Knowledge Information Processing Group (CKIP), um corpus todo em chinês com 3.5 milhões de palavras etiquetadas com dados gerados a partir de discursos orais: conversas, palestras e entrevistas de rádio. A pesquisadora concluiu que O CASAMENTO É UMA JOGATINA está entre as metáforas mais familiares com que os chineses conceptualizam o casamento, o que reflete cognitivamente a visão chinesa atual sobre esse evento. Outras metáforas encontradas foram: O CASAMENTO É UMA VIAGEM EM ANDAMENTO, O CASAMENTO É UM NEGÓCIO, e O CASAMENTO É UMA LIGAÇÃO.
e China. Em HongKong, os serviços de enfermagem comunitários são fornecidos na casa dos pacientes, com o objetivo de cuidar da condição ativa e melhorar a qualidade de vida dos pacientes. A prestação de mais serviços em profundidade e melhora na qualidade do serviço de enfermagem são importantes. Capacitação e melhoria nas habilidades avançadas de enfermagem desempenham um papel importante. Na China, serviços de enfermagem comunitários são fornecidos em centros comunitários de saúde com foco na melhoria da saúde pública. Diferenças geográicas, população e distribuição da população são fatores a serem considerados na determinação dos serviços a serem entregues e o modo de entrega. Mais serviços “dentro da comunidade”, tais como a “enfermaria virtual” para os casos de pacientes menos complicados, pode aumentar ainda mais a acessibilidade do serviço, melhorar a qualidade de vida, e estender o serviço para aqueles que têm diiculdade de acesso a centros CHN de serviços. Esse tipo de serviço também apela à colaboração de vários proissionais de saúde. Experimentar esses modelos de serviço nas grandes cidades pode ser um passo inicial e um resultado positivo pode ajudar a aumentar ainda mais a cobertura de saúde universal em um país tão grande.
Abstract—The present study was developed to comprehensively investigate the occupational health problems among teachers of primary and secondary schools inHongKong. A random sample of 6000 teachers was generated from the database ofHongKong Professional Teachers’ Union (HKPTU) members. A self-administrated questionnaire was designed and sent by mail to the teachers of primary and secondary schools inHongKong, together with a cover letter and a reply paid envelope. A total of 1,710 usable questionnaires were returned. The results indicated that comparing with one year and five years ago, 91.6% and 97.3% of the responding teachers reported an increase of perceived stress level, respectively. Heavy workload, time pressure, education reforms, external school review, pursuing further education, and managing students' behaviour and learning were the most frequently reported sources of work stress. The four most frequently reported stress management activities were sleeping, talking to neighbors and friends, self-relaxing, and watching television, whereas the least frequently reported activity was doing more exercises or sports. The findings of this research could serve as a useful reference for the government and related organizations such as the Education and Manpower Bureau and Professional Teachers’ Union when formulating the policies and strategies to help the teachers relieve and cope with their work-related health problems.
as in 2003 - the year of performance of the Cantonese version. The Cantonese rendition is a HongKong modern political version of Neil Simon’s God’s Favorite and, in turn, of the Biblical Job. The transformation process is as follows. Job, a prosperous Jewish farmer in the Old Testament, is transformed by Neil Simon into Joe Benjamin of Long Island, a wealthy manufacturer of cardboard boxes, but nonetheless a devout and simple man, grateful to God for his success, his rags-to-riches story. In turn, Joe is transformed by Si-tou Waigin into Gwok Zungseon, a rich HongKong businessman devoted to the Chinese Communist Party (CCP). God is transformed into Chairman Jiang of CCP and Satan into Governor Patten, whom Beijing used to call “the guilty figure of all time.” As a result of a bet between Chairman Jiang and Governor Patten, Jiang sets out to test Gwok’s loyalty to the CCP by depriving him of his business, his properties, his wealth, his family in 1995. Still, Gwok would not renounce the CCP.
Relational continuity is jointly produced by the system, the individual provider, and the patient. Problems can occur when there are barriers at any of these levels (e.g. an appointment system that makes personal continuity difficult) or if the patient is not an effective negotiator or is disadvantaged, for example because of their social circumstances or ethnic group . People with severe mentalillness value continuity of care but this study suggests that for a substantial minority this is not currently being achieved in primary care. Poor informational continuity was also present in almost a third of all new referrals – a finding consistent with Bindman’s study over 15 years ago , which is disappointing given the intervening evidence of its importance. A recent survey undertaken at the same time as this study found that almost a third
On May 10, 2011, the Australian government announced new funding commitments of A$419.7 million for two major youth mental health programs: Early Psychosis Prevention and Intervention Centres (EPPIC) and Headspace. EPPIC is an integrated mental health service aimed at youth aged 15 to 24 years with a first episode of psychosis. Headspace comprises one-stop early treatment centers aimed at improving youth mental health and pro- viding drug and alcohol, employment, and other integrated social services (Commonwealth of Australia, 2011; Headspace, 2011; Muir et al., 2009; Russell, 2011). These reforms were promoted as “the centerpiece” of the federal Labor government’s mental health commitments by the then Prime Minister Julia Gillard (Australian Associated Press, 2011b). In this article, we examine the events leading up to the 2011 budget to identify the reasons why early intervention services for youth were adopted. Our aim is to increase the awareness of both mental health policy makers and researchers of the socio-political dynamics that affect the uptake of research findings by governments.
may have limited the power of the longitudinal analysis. Although we found significant associations between ‘‘vegetables-fruits’’ and ‘‘snacks-drinks-milk products’’ patterns and depressive symptoms in the cross-sectional analysis, the directionality of the associations was uncertain. The possibility of reverse causation may not be ruled out. People with major depression may change their eating behavior and food choices, either adopting an unhealthy diet (i.e. high-calorie foods) or reducing food intake [47,52], thus interpreting the relationship between diet and depression may be difficult in view of the bidirectional changes in diet as a consequence ofmental health symptoms. We tried to conduct a sensitivity analysis excluding participants with extreme GDS (i.e. GDS$11 (n = 56)) and the significant association between dietary patterns and depressive symptoms remained at baseline. These results possibly suggest that reverse causation seems an unlikely explanation for the significant findings in our cross-sectional analysis. Furthermore, we did not have dietary data at the 4-year follow-up whereas dietary patterns may have changed between baseline and follow-up. Moreover, although we controlled for various common factors and major chronic conditions in the analysis, residual potential confounding from some other factors related to the development of depression, such as family history of depression and recent life stress events might still be present. In
With regard to mood changes, it appears that there is the same proportion ofpeople with hypertension and mood problems. As the BMI increases, moving from one category to the next, decreases by 13% the likelihood of having mood problems. States of anxiety and fear of what might happen to them are some of the reasons for presenting this sample of high history of psychological disease and hypertension, which is in agreement with other authors that indicate anxiety as one of the factors that predispose to hypertension . Most peoplein this sample have high blood pressure and dementia, especially those who are overweight. In this context, we take the values found in the variables ofmental state. According to neuropsychology of orientation, temporospatial disorientation occurs generally in psycho-organic frameworks, while three brain areas are compromised, particularly in diffuse cortical lesions as in Alzheimer's disease, the mesial lesions as is known in Korsakoff syndrome and diseases that affect the brain stem and the ascending activating reticular system as in confusion states where there floating impaired consciousness . These data are consistent with the data from this sample, which was tend to be more oriented towards themselves and the world around them than what happened to the time variable, since more than half of the people was disoriented, had hypertension and high body mass index.
4. On completion of each module, interviews with representative focus groups explored the students’ experience and whether their expectations were fulfilled. A series of questions were also used to further investigate student learning styles, profiles as a learner and importantly, how they compared the efficacy of online learning. This data was used to ex- plore whether the innovative practices used in the modules had been effective. A focus group is a group of individuals selected and assembled by researchers to discuss and comment on a research topic from their personal experience (Powell et al., 1996) and benefit from interaction and group dynamics (Gibbs, 1997). Interaction enables respondents to ask questions of each other, as well as to re-evaluate and reconsider their own understandings of specific experiences (Kitzinger, 1995). Semi-structured interviews were conducted with a sufficiently open- ended framework to allow for focused, conversational, two-way communication. The flexibility of the interview schedule enabled re-ordering of content, encouraged digressions and expansions, revealed new topics, and identified any needed further investigation (Cohen et al., 2000). Focus groups, alongside semi- structured interviews, allowed the researcher to keep
As expected, the main synonyms of hygiene are ‘healthy’ and ‘fragrance’. The conditions ofhomelesspeople, associated with dirt and poor hygiene, are factors that prevent and/or hinder access to health services and increase social exclusion. In Brazil, the hygienic mentality was propagated between the second half of the 1940s until the mid-1960s, to address commercial issues of the industrial era. The production and commercialization of new and varied products related to health and hygiene were widely covered by the press, dis- seminating a new modern and healthy way to live (16) . This